When It's Not Alzheimer's: Differential Dx of Frontotemporal Lobar Degeneration

  • MRI Features of bvFTD

    MRI Features of bvFTD

    MRI features of bvFTD in 2 different patients. In panel A there is striking atrophy in the bilateral mesial frontal regions, including the anterior cingulate gyri. There are also finger-like periventricular FLAIR hyperintensities and enlargement of the sylvian fissures, particularly anteriorly. In panel B, the insular surface is relatively featureless with cortical thinning and sharp angular gyri.

  • FDG-PET Scan Features of bvFTD

    FDG-PET Scan Features of bvFTD

    FDG-PET scan features of bvFTD. FDG surface reconstructions of the right and left lateral cerebral hemispheres (A and B, respectively) and the left and right mesial cerebral hemispheres (C and D, respectively) demonstrate severe disproportionate FDG hypometabolism in the left frontal lobe and medial left temporal pole.

  • Temporal Variant FTLD

    Temporal Variant FTLD

    A patient with right temporal variant FTLD.

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Frontotemporal lobar degeneration (FTLD) refers to a group of non-Alzheimer's dementias that cause portions of the frontal and temporal lobes to atrophy, leading to impairments in behavior, personality, language, and movement. FTLD is estimated to cause up to 10% of dementia cases, and it is the most common cause of dementia in individuals younger than 60 years old, with symptoms usually appearing between the ages of 50 and 60.

In people under the age of 65, FTLD is believed to be as common as Alzheimer's disease (AD), and therefore it may be mistaken for AD.

Read the associated article here.

Images courtesy of Melanie B. Shulman, MD and Richard J. Caselli, MD.

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