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. 1994 Jul;57(7):790–796. doi: 10.1136/jnnp.57.7.790

Specificity of changes in cerebral blood flow in patients with frontal lobe dementia.

S E Starkstein 1, R Migliorelli 1, A Tesón 1, L Sabe 1, S Vázquez 1, M Turjanski 1, R G Robinson 1, R Leiguarda 1
PMCID: PMC1073017  PMID: 8021663

Abstract

Eight patients with a clinical diagnosis of probable Alzheimer's disease, eight patients with the clinical diagnosis of frontal lobe dementia, and eight controls were examined with single photon emission tomography (SPECT) using 99Tc-HMPAO. Patients with Alzheimer's disease and those with frontal lobe dementia met DSM-III-R criteria for mild dementia and were in the early stages of the illness. Compared with patients with Alzheimer's disease, the group with frontal lobe dementia had significantly lower blood flow in the frontal lobes (dorsolateral and orbital), the anterior temporal cortex, and the basal ganglia. Within the frontal lobe dementia group, blood flow was significantly lower in the orbital than in the dorsal frontal cortex, and in the anterior temporal than in the dorsal temporal cortex. The present study shows the specificity of changes in regional cerebral blood flow in the diagnosis of different types of dementia, and supports the importance of orbitofrontal, anterior temporal, and basal ganglia dysfunction in the production of the psychiatric syndrome of frontal lobe dementia.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burns A., Philpot M. P., Costa D. C., Ell P. J., Levy R. The investigation of Alzheimer's disease with single photon emission tomography. J Neurol Neurosurg Psychiatry. 1989 Feb;52(2):248–253. doi: 10.1136/jnnp.52.2.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Buschke H., Fuld P. A. Evaluating storage, retention, and retrieval in disordered memory and learning. Neurology. 1974 Nov;24(11):1019–1025. doi: 10.1212/wnl.24.11.1019. [DOI] [PubMed] [Google Scholar]
  3. Chase T. N., Burrows G. H., Mohr E. Cortical glucose utilization patterns in primary degenerative dementias of the anterior and posterior type. Arch Gerontol Geriatr. 1987 Sep;6(3):289–297. doi: 10.1016/0167-4943(87)90028-8. [DOI] [PubMed] [Google Scholar]
  4. Cummings J. L., Duchen L. W. Kluver-Bucy syndrome in Pick disease: clinical and pathologic correlations. Neurology. 1981 Nov;31(11):1415–1422. doi: 10.1212/wnl.31.11.1415. [DOI] [PubMed] [Google Scholar]
  5. Cummings J. L. Organic psychoses. Delusional disorders and secondary mania. Psychiatr Clin North Am. 1986 Jun;9(2):293–311. [PubMed] [Google Scholar]
  6. De Renzi E., Faglioni P. Normative data and screening power of a shortened version of the Token Test. Cortex. 1978 Mar;14(1):41–49. doi: 10.1016/s0010-9452(78)80006-9. [DOI] [PubMed] [Google Scholar]
  7. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  8. Grady C. L., Haxby J. V., Schapiro M. B., Gonzalez-Aviles A., Kumar A., Ball M. J., Heston L., Rapoport S. I. Subgroups in dementia of the Alzheimer type identified using positron emission tomography. J Neuropsychiatry Clin Neurosci. 1990 Fall;2(4):373–384. doi: 10.1176/jnp.2.4.373. [DOI] [PubMed] [Google Scholar]
  9. Gustafson L., Nilsson L. Differential diagnosis of presenile dementia on clinical grounds. Acta Psychiatr Scand. 1982 Mar;65(3):194–209. doi: 10.1111/j.1600-0447.1982.tb00840.x. [DOI] [PubMed] [Google Scholar]
  10. Jagust W. J., Reed B. R., Seab J. P., Kramer J. H., Budinger T. F. Clinical-physiologic correlates of Alzheimer's disease and frontal lobe dementia. Am J Physiol Imaging. 1989;4(3):89–96. [PubMed] [Google Scholar]
  11. Kamo H., McGeer P. L., Harrop R., McGeer E. G., Calne D. B., Martin W. R., Pate B. D. Positron emission tomography and histopathology in Pick's disease. Neurology. 1987 Mar;37(3):439–445. doi: 10.1212/wnl.37.3.439. [DOI] [PubMed] [Google Scholar]
  12. Kling A., Steklis H. D. A neural substrate for affiliative behavior in nonhuman primates. Brain Behav Evol. 1976;13(2-3):216–238. doi: 10.1159/000123811. [DOI] [PubMed] [Google Scholar]
  13. Kumar A., Schapiro M. B., Haxby J. V., Grady C. L., Friedland R. P. Cerebral metabolic and cognitive studies in dementia with frontal lobe behavioral features. J Psychiatr Res. 1990;24(2):97–109. doi: 10.1016/0022-3956(90)90050-z. [DOI] [PubMed] [Google Scholar]
  14. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  15. Neary D., Snowden J. S., Mann D. M., Northen B., Goulding P. J., Macdermott N. Frontal lobe dementia and motor neuron disease. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):23–32. doi: 10.1136/jnnp.53.1.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Neary D., Snowden J. S., Northen B., Goulding P. Dementia of frontal lobe type. J Neurol Neurosurg Psychiatry. 1988 Mar;51(3):353–361. doi: 10.1136/jnnp.51.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Neary D., Snowden J. S., Shields R. A., Burjan A. W., Northen B., MacDermott N., Prescott M. C., Testa H. J. Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia. J Neurol Neurosurg Psychiatry. 1987 Sep;50(9):1101–1109. doi: 10.1136/jnnp.50.9.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Nelson H. E. A modified card sorting test sensitive to frontal lobe defects. Cortex. 1976 Dec;12(4):313–324. doi: 10.1016/s0010-9452(76)80035-4. [DOI] [PubMed] [Google Scholar]
  19. Risberg J. Frontal lobe degeneration of non-Alzheimer type. III. Regional cerebral blood flow. Arch Gerontol Geriatr. 1987 Sep;6(3):225–233. doi: 10.1016/0167-4943(87)90023-9. [DOI] [PubMed] [Google Scholar]
  20. Starkstein S. E., Boston J. D., Robinson R. G. Mechanisms of mania after brain injury. 12 case reports and review of the literature. J Nerv Ment Dis. 1988 Feb;176(2):87–100. doi: 10.1097/00005053-198802000-00004. [DOI] [PubMed] [Google Scholar]
  21. Starkstein S. E., Mayberg H. S., Berthier M. L., Fedoroff P., Price T. R., Dannals R. F., Wagner H. N., Leiguarda R., Robinson R. G. Mania after brain injury: neuroradiological and metabolic findings. Ann Neurol. 1990 Jun;27(6):652–659. doi: 10.1002/ana.410270612. [DOI] [PubMed] [Google Scholar]

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