The Combination of Metabolic Posterior Cingulate Cortical Abnormalities and Structural Asymmetries Improves the Differential Diagnosis Between Primary Progressive Aphasia and Alzheimer's Disease

J Alzheimers Dis. 2021;82(4):1467-1473. doi: 10.3233/JAD-210211.

Abstract

Differential diagnosis between primary progressive aphasia (PPA) and Alzheimer's disease (AD) could be difficult if based on clinical grounds alone. We evaluated the combination of proton MR spectroscopy of posterior cingulate cortex (PCC) and quantitative structural imaging asymmetries to differentiate PPA from AD patients. A greater left-lateralized temporo-parietal atrophy (higher accuracy for the PCC, 81.4%) and metabolic neurodegenerative changes in PCC (accuracy 76.8%) was demonstrated in PPA versus AD. The combined multiparametric approach increased the accuracy to 94%in the differential diagnosis between these two neurodegenerative diseases.

Keywords: 1H-MRS; Alzheimer’s disease; magnetic resonance imaging; primary progressive aphasia.

Publication types

  • Letter

MeSH terms

  • Aged
  • Alzheimer Disease* / diagnosis
  • Alzheimer Disease* / pathology
  • Aphasia, Primary Progressive* / diagnosis
  • Aphasia, Primary Progressive* / pathology
  • Atrophy / pathology*
  • Brain / pathology
  • Diagnosis, Differential*
  • Female
  • Gyrus Cinguli / metabolism*
  • Humans
  • Magnetic Resonance Spectroscopy*
  • Male
  • Neuropsychological Tests / statistics & numerical data