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OtherClinical Investigations

Evidence of Bilateral Temporal Lobe Involvement in Primary Progressive Aphasia: A SPECT Study

Marie-Hélène Soriani-Lefèvre, Didier Hannequin, Serge Bakchine, Jean-François Ménard, Alain Manrique, Anne Hitzel, Pierre-Olivier Kotzki, Vincent Boudousq and Pierre Vera
Journal of Nuclear Medicine July 2003, 44 (7) 1013-1022;
Marie-Hélène Soriani-Lefèvre
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Didier Hannequin
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Serge Bakchine
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Jean-François Ménard
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Alain Manrique
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Anne Hitzel
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Pierre-Olivier Kotzki
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Vincent Boudousq
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Pierre Vera
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  • FIGURE 1.
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    FIGURE 1.

    Brain systematization. (A) Lateral side. (B) Medial side. Broca = Broca region; Calc = calcarine region; CinA = anterior cingulate region; EF = external frontal region; IF = internal frontal region; Insul = insular region; LobQ = lobulus quadrilatere; LT = lateral temporal region; MT = medial temporal region; Occ = occipital region; OF = orbitofrontal region; P = parietal lobe; PreC = precentral region; PreF = prefrontal region; SM = sensorimotor region; Tha = thalamus; TP = temporal pole; W = Wernicke region.

  • FIGURE 2.
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    FIGURE 2.

    Percentage of PI decrease in 29 patients vs. 12 control subjects. (A) Right hemisphere. (B) Left hemisphere.

  • FIGURE 3.
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    FIGURE 3.

    Comparison of PI in patients with lexicosemantic disorders and control subjects. (A) Right hemisphere, lateral and medial side. (B) Left hemisphere, lateral and medial side.

  • FIGURE 4.
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    FIGURE 4.

    Comparison of PI in patients with or without atrophy and control subjects. (A) Right hemisphere, atrophic and nonatrophic groups. (B) Left hemisphere, atrophic and nonatrophic groups.

Tables

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    TABLE 1

    Results of Neuropsychologic Tests and Grouping

    Patient no.LexicosemanticArthritic
    BDAE02 (n = 72)DES1 (n = 48)DES2 (n = 27)Verbal Cat (n = 220)Visual Cat (n = 220)Verbal App (n = 20)Visual App (n = 20)LS+/LS−BDAE08 (n = 14)BDAE06 (n = 7)Rep (%)A+/A−
    17247272082132020LS−9532A+
    27248272122061819LS−9612A+
    36647ND2062021819LS−7447A+
    47247ND2081981919LS−8612.5A+
    57247272012012019LS−6359.5A+
    67048272112071918LS−2384.6A+
    77148251982011919LS−35100A+
    87148271941811819LS−8454.5A+
    97047271791841719LS+5578.8A+
    106947ND1492122020LS+967.5A+
    117148221871871618LS+1270A−
    1235ImpImpImpImpImpImpLS+1270A−
    136947ND1791651719LS+Imp70A−
    146646261891741818LS+970A−
    156546271922021819LS+1270A−
    166647ND1921901618LS+1070A−
    1738ImpImpImpImpImpImpLS+Imp70A−
    184833ND1521871313LS+1170A−
    197148241931891920LS+1070A−
    2048ImpImp1315ImpImpLS+1270A−
    21382214105144119LS+1470A−
    22382721ImpImpImpImpLS+Imp70A−
    234532161011671015LS+1470A−
    246948272052022018LS−1370A−
    257146ND2092051919LS−1470A−
    267248ND2042082020LS−1470A−
    277248262192101920LS−1470A−
    287148272072082019LS−1470A−
    297048261972021920LS−1470A−
    • ND = not done; Imp = impossible; BDAE = Boston Diagnostic Aphasia Examination; DES = Designation.

    • See text for description of neuropsychologic tests.

    • View popup
    TABLE 2

    Comparison of PI in Patients and Control Subjects

    RegionLeftRight
    Patients (n = 29) Mean ± SDControl subjects (n = 12) Mean ± SDFPPatients (n = 29) Mean ± SDControl subjects (n = 12) Mean ± SDFP
    Temp
     W0.905 ± 0.0750.973 ± 0.0289.3700.00400.967 ± 0.0570.972 ± 0.0230.0770.7824
     TP0.776 ± 0.0520.812 ± 0.0315.0960.02970.819 ± 0.0530.828 ± 0.0340.2630.6110
     LT0.833 ± 0.0620.929 ± 0.03325.181<0.00010.883 ± 0.0450.928 ± 0.02211.0310.0020
     MT0.748 ± 0.0770.790 ± 0.0383.2500.07920.776 ± 0.0680.789 ± 0.0360.4260.5176
    Front
     Broc0.856 ± 0.0580.888 ± 0.0303.3350.07550.903 ± 0.0560.918 ± 0.0200.8260.3691
     Insul0.869 ± 0.0510.861 ± 0.0490.2400.62720.897 ± 0.0600.887 ± 0.0470.2340.6315
     PreC0.858 ± 0.0610.883 ± 0.0491.5860.21540.892 ± 0.0580.902 ± 0.0420.2870.5951
     PreF0.844 ± 0.0650.859 ± 0.0370.5650.45690.869 ± 0.0620.880 ± 0.0430.3130.5792
     EF0.905 ± 0.0720.924 ± 0.0370.7700.38560.942 ± 0.0620.957 ± 0.0260.6930.4101
     IF0.887 ± 0.0680.918 ± 0.0422.1810.14770.908 ± 0.0570.921 ± 0.0510.4560.5033
     OF0.811 ± 0.0780.809 ± 0.0330.0090.92560.828 ± 0.0620.825 ± 0.0360.0230.8794
     CinA0.800 ± 0.0630.817 ± 0.0570.6290.43260.814 ± 0.0570.816 ± 0.0440.0050.9418
     SM0.852 ± 0.0590.876 ± 0.0331.6780.20290.881 ± 0.0590.880 ± 0.0340.0030.9550
    Par
     Par0.880 ± 0.0620.940 ± 0.02510.1470.00280.926 ± 0.0600.941 ± 0.0350.6730.4170
     LobQ0.913 ± 0.0830.913 ± 0.0674.5430.98310.920 ± 0.0800.904 ± 0.0600.3930.5343
    Occ
     OcA0.999 ± 0.0571.005 ± 0.0290.1340.71671.009 ± 0.0521.001 ± 0.0300.2540.6171
     Calc1.148 ± 0.0581.122 ± 0.0441.8960.17641.151 ± 0.0621.112 ± 0.0443.9330.0544
    Tha0.821 ± 0.0510.813 ± 0.0430.2780.60120.825 ± 0.0500.828 ± 0.0450.0360.8500
    • F = F test; Temp = temporal region; W = Wernicke region; TP = temporal pole; LT = lateral temporal region; MT = medial temporal region; Front = frontal region; Broc = Broca region; Insul = insular region; PreC = precentral region; PreF = prefrontal region; EF = external frontal region; IF = internal frontal region; OF = orbitofrontal region; CinA = anterior cingulate region; SM = sensorimotor region; Par = parietal lobe; LobQ = lobulus quadrilatere; Occ = occipital region; OcA = occipital cortex; Calc = calcarine region; Tha = thalamus.

    • Bold values correspond to significant differences when a global test was performed.

    • View popup
    TABLE 3

    Comparison of PI in Patients With (LS+) or Without (LS−) Lexicosemantic Disorders vs. Control Subjects

    RegionLeftRight
    LS+ (n = 15) Mean ± SDLS− (n = 14) Mean ± SDControl subjects (n = 12) Mean ± SDFPLS+ (n = 15) Mean ± SDLS− (n = 14) Mean ± SDControl subjects (n = 12) Mean ± SDFP
    Temp
     W0.886* ± 0.0730.925 ± 0.0740.973 ± 0.0286.2420.00450.967 ± 0.0650.967 ± 0.0500.972 ± 0.0230.0380.9627
     TP0.755* ± 0.0490.797 ± 0.0470.812 ± 0.0316.2480.00450.823 ± 0.0560.814 ± 0.0510.828 ± 0.0340.2530.7781
     LT0.805*† ± 0.0620.864* ± 0.0490.929 ± 0.03320.435<0.00010.885* ± 0.0450.881* ± 0.0460.928 ± 0.0225.4360.0084
     MT0.717*† ± 0.0750.781 ± 0.0650.790 ± 0.0385.7530.00660.779 ± 0.0650.772 ± 0.0740.789 ± 0.0360.2490.7810
    Front
     Broc0.833*† ± 0.0680.881 ± 0.0310.888 ± 0.0305.5450.00770.897 ± 0.0690.909 ± 0.0390.918 ± 0.0200.6210.5430
     Insul0.858 ± 0.0620.881 ± 0.0330.861 ± 0.0490.9140.40950.898 ± 0.0780.896 ± 0.0330.887 ± 0.0470.1200.8876
     PreC0.850 ± 0.0770.867 ± 0.0390.883 ± 0.0491.0990.34360.893 ± 0.0740.891 ± 0.0370.902 ± 0.0420.1450.8659
     PreF0.825 ± 0.0810.865 ± 0.0310.859 ± 0.0372.1580.12950.859 ± 0.0810.880 ± 0.0310.880 ± 0.0430.5660.5252
     EF0.884 ± 0.0880.927 ± 0.0430.924 ± 0.0372.1570.13070.934 ± 0.0770.951 ± 0.0390.957 ± 0.0260.6880.5087
     IF0.861 ± 0.0760.915 ± 0.0470.918 ± 0.0424.3970.01910.900 ± 0.0690.916 ± 0.0420.921 ± 0.0510.5380.5880
     OF0.791 ± 0.1030.834 ± 0.0280.809 ± 0.0331.4950.23710.824 ± 0.0840.832 ± 0.0270.825 ± 0.0360.0860.9173
     CinA0.797 ± 0.0760.804 ± 0.0470.817 ± 0.0570.3520.70560.808 ± 0.0720.821 ± 0.0360.816 ± 0.0440.2270.7982
     SM0.850 ± 0.0720.855 ± 0.0430.876 ± 0.0330.8510.43520.881 ± 0.0750.881 ± 0.0370.880 ± 0.0340.0020.9977
    Par
     Par0.866* ± 0.0730.896 ± 0.0470.940 ± 0.0256.3390.00420.925 ± 0.0750.926 ± 0.0420.941 ± 0.0350.3320.7199
     LobQ0.904 ± 0.0920.922 ± 0.0740.913 ± 0.0670.1900.82750.920 ± 0.0950.921 ± 0.0640.904 ± 0.0600.1920.8262
    Occ
     OcA0.985 ± 0.0571.014 ± 0.0551.005 ± 0.0291.2820.28921.002 ± 0.0621.016 ± 0.0411.001 ± 0.0300.4640.6321
     Calc1.133 ± 0.0541.163 ± 0.0611.122 ± 0.0442.0570.14191.135 ± 0.0681.169 ± 0.0531.1120 ± 0.0443.3420.0460
    Tha0.809 ± 0.0630.834 ± 0.0320.813 ± 0.0431.1000.34330.819 ± 0.0580.832 ± 0.0390.828 ± 0.0450.2960.7458
    • ↵* P < 0.05 vs. control subjects.

    • ↵† P < 0.05 vs. LS−.

    • F = F test.

    • See Table 2 legend for abbreviations of cerebral segmentation. Bold values correspond to significant differences when a global test was performed.

    • View popup
    TABLE 4

    Comparison of PI in Patients With (A+) or Without (A−) Arthritic Disorders vs. Control Subjects

    RegionLeftRight
    A+ (n = 10) Mean ± SDA− (n = 19) Mean ± SDControl subjects (n = 12) Mean ± SDFPA+ (n = 10) Mean ± SDA− (n = 19) Mean ± SDControl subjects (n = 12) Mean ± SDFP
    Temp
     W0.936 ± 0.0690.888* ± 0.0740.973 ± 0.0286.8800.00280.980 ± 0.0510.960 ± 0.0600.972 ± 0.0230.5640.5735
     TP0.795 ± 0.0490.765 ± 0.0510.812 ± 0.0314.0560.02530.820 ± 0.0250.818 ± 0.0640.828 ± 0.0340.1320.8772
     LT0.885† ± 0.0340.806* ± 0.0570.929 ± 0.03328.293<0.00010.895 ± 0.0340.877* ± 0.0490.928 ± 0.0226.2630.0045
     MT0.788 ± 0.0820.727 ± 0.0670.790 ± 0.0384.8210.01360.781 ± 0.0560.773 ± 0.0750.789 ± 0.0360.2690.7657
    Front
     Broc0.859 ± 0.0650.854 ± 0.0560.888 ± 0.0301.6540.20470.894 ± 0.0400.908 ± 0.0640.918 ± 0.0200.6700.5177
     Insul0.879 ± 0.0370.864 ± 0.0570.861 ± 0.0490.3970.67530.895 ± 0.0280.898 ± 0.0720.887 ± 0.0470.1220.8853
     PreC0.848 ± 0.0550.864 ± 0.0650.883 ± 0.0491.0190.37070.874 ± 0.0410.901 ± 0.0640.902 ± 0.0420.9800.3845
     PreF0.840 ± 0.0640.846 ± 0.0670.859 ± 0.0370.3130.73290.857 ± 0.0510.875 ± 0.0680.880 ± 0.0430.4830.6208
     EF0.891 ± 0.0840.912 ± 0.0670.924 ± 0.0370.7330.48710.923 ± 0.0350.952 ± 0.0710.957 ± 0.0261.3300.2765
     IF0.894 ± 0.0820.883 ± 0.0620.918 ± 0.0421.1660.32250.903 ± 0.0580.911 ± 0.0590.921 ± 0.0510.2820.7562
     OF0.811 ± 0.0480.812 ± 0.0910.809 ± 0.0330.0050.99550.818 ± 0.0180.833 ± 0.0760.825 ± 0.0360.2490.7809
     CinA0.808 ± 0.0530.796 ± 0.0680.817 ± 0.0570.4360.64980.827 ± 0.0320.808 ± 0.0660.816 ± 0.0440.4170.6619
     SM0.850 ± 0.0440.854 ± 0.0660.876 ± 0.0330.8340.44230.881 ± 0.0380.881 ± 0.0680.880 ± 0.0340.0020.9984
    Par
     Par0.906 ± 0.0360.867* ± 0.0700.940 ± 0.0257.2120.00220.936 ± 0.0500.920 ± 0.0660.941 ± 0.0350.6130.5471
     LobQ0.932 ± 0.0680.903 ± 0.0900.913 ± 0.0670.4570.63650.948 ± 0.0460.906 ± 0.0910.904 ± 0.0601.2650.2939
    Occ
     OcA1.032 ± 0.0390.981 ± 0.0581.005 ± 0.0293.9320.02801.024 ± 0.0351.001 ± 0.0591.101 ± 0.0300.9210.4066
     Calc1.149 ± 0.0571.147 ± 0.0611.122 ± 0.0440.9290.40381.161 ± 0.0521.146 ± 0.0681.112 ± 0.0442.1620.1290
    Tha0.825 ± 0.0420.819 ± 0.0570.813 ± 0.0430.1760.83920.825 ± 0.0330.825 ± 0.0570.828 ± 0.0450.0180.9824
    • ↵* P < 0.05 vs. control subjects.

    • ↵† P < 0.05 vs. A−.

    • F = F test.

    • See Table 2 legend for abbreviations of cerebral segmentation. Bold values correspond to significant differences when a global test was performed.

    • View popup
    TABLE 5

    Comparison of PI in Patients With (Atrop+) or Without (Atrop−) Atrophy vs. Control Subjects

    RegionLeftRight
    Atrop+Atrop−Control subjects (n = 12) Mean ± SDFPAtrop+Atrop−Control subjects (n = 12) Mean ± SDFP
    Mean ± SDnMean ± SDnMean ± SDnMean ± SDn
    Temp
     W0.869* ± 0.070100.924 ± 0.072190.973 ± 0.0287.7230.00150.990 ± 0.05720.965 ± 0.058270.972 ± 0.0230.2640.7690
     TP0.755*† ± 0.043170.804 ± 0.051120.812 ± 0.0317.7840.00150.815 ± 0.034110.821 ± 0.063180.828 ± 0.0340.1740.8411
     LT0.808*† ± 0.055150.860* ± 0.060140.929 ± 0.03318.286<0.00010.877 ± 0.03130.884 ± 0.046260.928 ± 0.0225.4290.0084
     MT0.717 ± 0.06040.753 ± 0.079250.790 ± 0.0382.0860.1382—00.776 ± 0.068290.789 ± 0.0360.4260.5176
    Front
     Broc0.838 ± 0.10550.860 ± 0.046240.888 ± 0.0302.0110.14780.855 ± 0.04920.907 ± 0.056270.918 ± 0.0201.4980.2365
     Insul0.861 ± 0.05670.872 ± 0.050220.861 ± 0.0490.2280.7974—00.897 ± 0.060290.887 ± 0.0470.2340.6315
     PreC0.839 ± 0.04370.865 ± 0.065220.883 ± 0.0491.3280.27700.879 ± 0.05570.896 ± 0.060220.902 ± 0.0420.4120.6654
     PreF0.813 ± 0.056120.866 ± 0.063170.859 ± 0.0373.5890.03730.839 ± 0.05580.880 ± 0.062210.880 ± 0.0431.7790.1826
     EF0.865 ± 0.095100.926 ± 0.048190.924 ± 0.0373.8090.03110.903 ± 0.05560.952 ± 0.060230.957 ± 0.0262.4820.0970
     IF0.807 ± 0.07630.896 ± 0.062260.918 ± 0.0424.4270.01870.835 ± 0.03520.913 ± 0.055270.921 ± 0.0512.2310.1213
     OF—00.811 ± 0.078290.809 ± 0.0330.0090.9256—00.828 ± 0.062290.825 ± 0.0360.0230.8794
     CinA0.77010.801 ± 0.064280.817 ± 0.0570.4300.65360.81010.815 ± 0.058280.816 ± 0.0440.0060.9939
     SM0.818 ± 0.01940.858 ± 0.061250.876 ± 0.0331.9100.16200.91010.880 ± 0.060280.880 ± 0.0340.1530.8584
    Par
     Par0.832*† ± 0.08560.893* ± 0.050230.940 ± 0.0259.3160.00050.933 ± 0.07630.925 ± 0.060260.941 ± 0.0350.3620.6986
     LobQ0.877 ± 0.09530.917 ± 0.082260.913 ± 0.0670.3510.70640.85010.923 ± 0.081280.904 ± 0.0600.6480.5285
    Occ
     OcA1.00010.999 ± 0.058281.005 ± 0.0290.0650.93671.02011.009 ± 0.053281.001 ± 0.0300.1520.8597
    • ↵* P < 0.05 vs. control subjects.

    • ↵† P < 0.05 vs. Atrop−.

    • F = F test.

    • See Table 2 legend for abbreviations of cerebral segmentation. Bold values correspond to significant differences when a global test was performed.

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Evidence of Bilateral Temporal Lobe Involvement in Primary Progressive Aphasia: A SPECT Study
Marie-Hélène Soriani-Lefèvre, Didier Hannequin, Serge Bakchine, Jean-François Ménard, Alain Manrique, Anne Hitzel, Pierre-Olivier Kotzki, Vincent Boudousq, Pierre Vera
Journal of Nuclear Medicine Jul 2003, 44 (7) 1013-1022;

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Evidence of Bilateral Temporal Lobe Involvement in Primary Progressive Aphasia: A SPECT Study
Marie-Hélène Soriani-Lefèvre, Didier Hannequin, Serge Bakchine, Jean-François Ménard, Alain Manrique, Anne Hitzel, Pierre-Olivier Kotzki, Vincent Boudousq, Pierre Vera
Journal of Nuclear Medicine Jul 2003, 44 (7) 1013-1022;
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