额叶变异型阿尔茨海默病的临床和影像学特征一例

目的额叶变异型阿尔茨海默病(AD)是一种以精神行为等症状为主要表型的少见特殊类型AD,本文报道1例额叶变异型AD的临床特点、影像学特征,以增加临床医生对该病的认识。方法报道1例额叶变异型AD患者的临床资料,分析其临床表现、辅助检查及影像学资料。结果本例患者以妄想和行为异常等为主要和最早临床表现,发病2年后才出现记忆力减退、言语表达困难、计算不能等症状,头颅MRI提示双侧额颞叶萎缩,以左侧为著。头颅SPECT显示:双侧额叶、颞叶和顶叶葡萄糖摄取普遍减低。PIB-PET(淀粉样蛋白PET):大脑皮质PIB显著滞留,考虑为PIB阳性显像。结论额叶变异型AD与行为变异型额颞叶痴呆临床表现类似,淀粉样蛋白PET检查可有效区分两者。

Clinical and neuroimaging features of frontal variant Alzheimer's disease

Objective To explore the clinical and neuroimaging features of frontal variant Alzheimer's disease.Method We collected and analyzed the clinical, auxiliary examination and neuroimaging documents of a case of frontal variant Alzheimer's disease.Results The patient presented with illusion and behavioral dysfunction as the first and predominant symptoms, then followed by memory decline, speech and calculation problems two years later. Brain MRI showed bilateral frontal and temporal atrophy. SPECT revealed lower glucose uptake in bilateral frontal, temporal and parietal lobes. Amyloid PET scans using 11C-Pittsburgh compound B (PiB)] showed PIB retention in the diffuse brain regions.Conclusion The clinical picture of frontal variant Alzheimer's disease may mimic that of behavioural variant frontotemporal dementia (FTD). Amyloid PET is helpful to differentiate these two diseases.