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

Article type: Short Communication

Authors: Mitolo, Micaela^{a; 1} | Stanzani-Maserati, Michelangelo^{b; 1} | Manners, David N.^c | Capellari, Sabina^{b; c} | Testa, Claudia^d | Talozzi, Lia^c | Poda, Roberto^b | Oppi, Federico^b | Evangelisti, Stefania^c | Gramegna, Laura L.^{a; c} | Magarelli, Silvia^e | Pantieri, Roberta^e | Liguori, Rocco^{b; c} | Lodi, Raffaele^{a; c} | Tonon, Caterina^{a; c; *}

Affiliations: [a] Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, OUC Neurologia, Bologna, Italy | [b] IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy | [c] Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy | [d] Department of Physics and Astronomy, University of Bologna, Bologna, Italy | [e] IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia, Bologna, Italy

Correspondence: [*] Correspondence to: Prof.ssa Caterina Tonon, IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy. E-mail: caterina.tonon@unibo.it.

Note: [1] These authors contributed equally to this work.

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: Alzheimer’s disease, ¹H-MRS, magnetic resonance imaging, primary progressive aphasia

DOI: 10.3233/JAD-210211

Journal: Journal of Alzheimer's Disease, vol. 82, no. 4, pp. 1467-1473, 2021