Abstract Details

Title VBM-DTI Morphologic and Voxel-Based [18F]FDG-PET Metabolic Imaging in Posterior Cortical Atrophy: Beyond the Posterior Involvement

Topic Aging and Dementia

Presentation(s) P06 - (-)

Poster/Presentation
Number 036

Objective

Background BACKGROUND: PCA is characterized by progressive decline of higher order visuo-spatial processing. VBM provided evidence for a selective posterior brain damage (Migliaccio et al., 2009). DTI showed alteration of long white-matter tracts. Consistently, [18F]FDG-PET showed a broader functional damage, involving not only the occipital cortex, but also the frontal lobes (Nestor et al., 2003; Schmidtke et al., 2005). The latter findings support disconnection mechanisms.

Design/Methods DESIGN/METHODS: 9 PCA patients (mean time from symptom's onset = 3 years) were enrolled for the study. Brain glucose metabolism was measured in 6 subjects. A large population (112 PET scans) of normal subjects represented the database for single-subjects SPM [18F]FDG-PET analysis. Six out of 9 patients were also investigated using VBM and DTI, and compared with 20 controls.

Results RESULTS: In PCA patients, VBM results showed atrophy involving the inferior occipital (fusiform gyrus), lateral temporal and posterior parietal regions. DTI analysis was consistent with previous findings of microstructural changes in long connecting tracts, namely ILF, SLF, IFOF and CC, suggesting a wide fibre degeneration. In each PCA case, SPM [18F]FDG-PET analysis showed hypometabolism in the whole occipital regions, and in lateral temporal and parietal lobes. In some cases, dorsolateral and/or medial frontal hypometabolism was present.

Conclusions CONCLUSIONS: These anatomo-functional data suggest an extensive brain involvement in PCA patients, due to a degeneration of occipital, temporal and parietal regions and of the connecting main fibre tracts. SPM [18F]FDG-PET imaging at single subject level can detect a specific functional pattern that also reflects deafferentation processes from the posterior occipital lobes to more anterior frontal regions.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Konstantin E. Balashov, MD, PhD, FAAN (Department of Neurology, BMC and BUSM)	Dr. Balashov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech.
	No disclosure on file
	No disclosure on file
Stefano F. Cappa, MD	Dr. Cappa has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elservier. The institution of Dr. Cappa has received research support from Italian Minsitry of Health.
Daniela Perani	No disclosure on file

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