The Human Brain:
The Structural Basis for Understanding Human Brain Function and Dysfunction

+++ INTERNATIONAL CONFERENCE +++ ROME +++ IRCCS SANTA LUCIA +++ Oct. 5-10, 2002 +++
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Serge Rombouts
Dept KFI, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
e-mail: sarb.rombouts@vumc.nl

Poster Presentation:
REGIONAL FUNCTIONAL LOSS IN THE FRONTAL CORTEX IN EARLY FRONTOTEMPORAL DEMENTIA COMPARED TO EARLY ALZHEIMER\'S DISEASE DEMONSTRATED BY FUNCTIONAL MRI.
Serge A.R.B. Rombouts, John C. van Swieten*, Yolande A.L. Pijnenburg, Rutger Goekoop, Frederik Barkhof, and Philip Scheltens
Vrije Universiteit Medical Center Amsterdam and *Erasmus Medical Center Rotterdam, The Netherlands.
Functional MR imaging (fMRI) was used to study frontal cortex activation in seven patients with early frontotemporal dementia (FTD), in whom the frontal region is known to be the earliest affected region. To address the specificity of frontal lobe dysfunction, seven patients with early Alzheimer’s disease (AD) were studied for comparison (Clinical Dementia Rating (CDR): four FTD patients 0.5, three FTD patients 1; all AD patients 1; Mini Mental State Examination of AD: 23.1 ± 2.7). Cerebral atrophy on MRI was mild, with no differences between FTD and AD, reflecting the relatively early stage of the disease of both groups. A parametric working memory (WM) task was applied allowing assessment of frontal activation as function of WM load. The activated WM network in both patient groups included the frontal and parietal lobe and the thalamus. In the frontal and parietal cortex, brain activation was significantly decreased in FTD compared to AD. Furthermore, especially the frontal regions displayed a lack of capability to increase activation when WM load was increased compared to AD patients in whom a more linear increase was seen. Possibly as a compensation mechanism, the cerebellum showed a stronger increasing response in FTD than in AD. These data provide for the first time evidence for regional functional loss in the frontal cortex in early FTD and shows that fMRI provides a means to probe frontal circuitry and may be useful to identify FTD subjects in an early stage when structural MRI is regarded normal.

 
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