Eating Disorders in Frontotemporal Dementia and Alzheimer’s Disease: Evaluation of Brain Perfusion Correlates Using 99mTc-HMPAO SPECT with Brodmann Areas Analysis

Article type: Research Article

Authors: Valotassiou, Varvara^{a; *} | Sifakis, Nikolaos^b | Tzavara, Chara^a | Lykou, Evi^c | Tsinia, Niki^d | Kamtsadeli, Vasiliki^c | Sali, Dimitra^e | Angelidis, George^a | Psimadas, Dimitrios^a | Tsougos, Ioannis^f | Papageorgiou, Sokratis G.^g | Georgoulias, Panagiotis^a | Papatriantafyllou, John^{c; h}

Affiliations: [a] Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece | [b] Nuclear Medicine Department, “Alexandra” General Hospital, Athens, Greece | [c] 3rd Age Day Care Center, IASIS, Athens, Greece | [d] 1st University Psychiatric Department, Aeginition Hospital, Athens, Greece | [e] Neurology Department, Evrokliniki, Athens, Greece | [f] Medical Physics Department, Medical School, University of Thessaly, Greece | [g] 2nd University Department of Neurology, Attikon Hospital, Athens, Greece | [h] Memory Disorders Clinic, Medical Center, Athens, Greece

Correspondence: [*] Correspondence to: Varvara Valotassiou, MD, PhD, Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece. Tel.: +30 2413502916; Fax: +30 2413501851; E-mail: vvalotasiou@gmail.com and valotasiou@med.uth.gr.

Abstract: Background:Eating disorders (ED) in dementia represent a significant impairment affecting patients’ and caregivers’ lives. In frontotemporal dementia (FTD), ED include overeating, sweet food preference, stereotypical eating, and hyperorality, while in Alzheimer’s disease (AD), anorexia and appetite loss are the most common ED. Objective:The aim of our study was to highlight Brodmann areas (BAs) implicated specifically in the appearance of ED in FTD and AD. Methods:We studied 141 patients, 75 with FTD and 66 with AD. We used the NeuroGamTM software on the reconstructed single photon emission computed tomography-SPECT data for the automated comparison of BAs perfusion on the left (L) and right (R) hemisphere with perfusion in corresponding BAs of a normal database. Results:The FTD group included 27 men and 48 women, age (mean±SD) 65.8±8.5 years, duration of disease 3.4±3.3 years, Mini-Mental State Examination (MMSE) 17.9±8.6, ED score on Neuropsychiatric Inventory (NPI) 4.7±8.5. ED in FTD were correlated with hypoperfusion in right anterior and dorsolateral prefrontal cortices (BAs 10R, 46R), left orbitofrontal cortex (BA 12L), orbital part of the right inferior frontal gyrus (BA 47R), and left parahippocampal gyrus (BA 36L). The AD group included 21 men and 45 women, age (mean±SD) 70.2±8.0 years, duration of disease 3.3±2.4 years, MMSE 20.2±6, ED-NPI score 2.7±3.9. ED in AD were correlated with hypoperfusion in left inferior temporal cortex (BA 20L). Conclusion:SPECT imaging with automated mapping of brain cortex could contribute to the understanding of the neural networks involved in the manifestation of ED in dementia.

Keywords: Alzheimer’s disease, Brodmann areas, eating disorders, frontotemporal dementia, perfusion, SPECT

DOI: 10.3233/JAD-201434

Journal: Journal of Alzheimer's Disease, vol. 80, no. 4, pp. 1657-1667, 2021