Frontotemporal dementia (FTD) is a dementia syndrome characterized by
peculiar behavioral changes arising from frontotemporal involvement an
d distinct from Alzheimer's disease (AD). The purpose of this study wa
s to elucidate the specific patterns in cerebral glucose metabolism in
patients with FTD and to compare them with the patterns in patients w
ith AD and normal elderly subjects using fluorodeoxyglucose (FDG) and
PET. Methods: Twenty-one patients with a clinical diagnosis of FTD [me
an age 67.0 +/- 7.0 yr, Mini Mental State Examination (MMSE) score 18.
7 +/- 5.7], 21 age-, sex- and dementia-severity-matched patients with
probable AD (mean age 66.9 +/- 7.1 yr, MMSE score 20.2 +/- 5.5) and 21
age- and sex matched normal control subjects (mean age 66.8 +/- 5.7 y
r) were studied. The cerebral metabolic rate for glucose (CMRglc) was
measured with FDG and PET. Absolute measures of regional CMRglc were c
ompared among the three groups. One-way ANOVA and the posthoc Tukey HS
D test were used for statistical analyses. Results: In the FTD group,
CMRglc was preserved only in the left cerebellum, right sensorimotor a
rea and occipital lobes, The CMRglc was significantly lower in the FTD
group as opposed to the AD group in the hippocampi, orbital gyri, ant
erior temporal lobes, anterior cingulate gyri, basal ganglia, thalami,
middle and superior frontal gyri and left inferior frontal gyrus. Con
clusion: Although metabolic abnormality in FTD is predominant in the f
rontal and anterior temporal lobes and the subcortical structures, it
is more widespread than has been previously stressed. These findings d
ocument an FTD-specific cerebral involvement and facilitate differenti
al diagnosis of degenerative dementias.