Single photon emission computed tomography (SPECT) in Pick’s disease: two case reports

  • F. Reisecker
  • E. Laich
  • F. Leblhuber
  • J. Trenkler
  • E. Deisenhammer
Part of the Key Topics in Brain Research book series (KEYTOPICS)


The diagnostic value of SPECT in Pick’s disease is discussed on the basis of two cases. Personality changes predominated in both of them. Atrophy of the frontal and temporal lobes was seen on CT only in one of the two female patients, who was in a stage of advanced dementia. SPECT showed reduced frontal accumulation in both cases in analogy to PET studies. The results of the present study demonstrate that a tentative diagnosis of Pick’s disease can either be excluded or substantiated with the help of SPECT.

Pick’s disease has a special position among the dementias because of its rare incidence, particular epidemiology and circumscribed (lobar) atrophy. Its histological characteristics are gliosis and neuronal loss in the atrophic area and intracellular Pick bodies in various localizations (Seitlberger et al., 1983). Clinical observations of the few neuropathologically verified cases show that personality changes, emotional disor?ders, speech disturbances and hyperorality — similar to Kluver-Bucy syndrome — predominate in the early stages of the disease, while intellectual defects prevail only later in the illness (Constantinidis et al., 1974; Cummings and Duchen, 1981; Gustafson and Nilson, 1982; Knopman et al., 1989; Munoz-Garcia and Ludwin, 1984; Seitlberger et al., 1983). Therefore, it is often difficult to distinguish Pick’s disease in its inital stages from affective psychoses and also from Alzheimer’s disease in cases with marked intellectual deficits or memory impairment (Cummings and Duchen, 1981; Knopman et al., 1989).


Single Photon Emission Compute Tomography Positron Emission Tomography Study Single Photon Emission Compute Tomography Image Personality Change Single Photon Emission Compute Tomography Study 
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  1. Constantinidis J, Richard J, Tissot T (1974) Pick’s disease. Histological and clinical correlations. Eur Neurol 11: 208–217CrossRefGoogle Scholar
  2. Corsellis J (1977) Aging and dementias. In: Blackwood W, Corsellis J (eds) Greenfield’s neuropathology. Edward Arnold, London, pp 796–848Google Scholar
  3. Cummings JL, Duchen LW (1981) Kluver-Bucy syndrome in Pick disease: clinical and pathologic correlations. Neurology 31: 1415–1422PubMedCrossRefGoogle Scholar
  4. Deisenhammer E, Reisecker F, Leblhuber F, Höll K, Markut H, Trenkler J (1989) Beitrag der Single-Photon-Emissions-Computer-Tomographie (SPECT) zur Differentialdiagnose der Demenz. Dtsch Med Wochenschr 114: 1639 —1644PubMedCrossRefGoogle Scholar
  5. Groen J J, Hekster REM (1982) Computed tomography in Pick’s disease: findings in a family affected in three consecutive generations. J Comput Assist Tomogr 6 (5): 907–911PubMedCrossRefGoogle Scholar
  6. Gustafson L, Nilson L (1982) Differential diagnosis of presenile dementia on clinical grants. Acta Psychiatr Scand 65: 194–209PubMedCrossRefGoogle Scholar
  7. Kamo H, McGeer PL, Harrop R, McGeer EG, Caine DB, Martin WRW, Pate D (1987) Positron emission tomography and histopathology in Pick’s disease. Neurology 37: 439–445PubMedCrossRefGoogle Scholar
  8. Knopman DS, Christensen KJ, Schut LJ, Harbaugh RE, Reeder T, Ngo T, Frey W (1989) The spectrum of imaging and neuropsychological findings in Pick’s disease. Neurology 39: 362 —368Google Scholar
  9. Leblhuber F, Brucker B, Reisecker F, Trenkler J, Deisenhammer E (1989) Single photon emission computed tomography in probable Huntington’s chorea. J Neural Transm (P-D Sect) 1: 93–94CrossRefGoogle Scholar
  10. Lou HC, Edvinson L, McKenzie ET (1987) The concept of coupling blood flow to brain function: revision required? Ann Neurol 22: 289–297PubMedCrossRefGoogle Scholar
  11. Munoz-Garcia D, Ludwin SK (1984) Classic and generalized variants of Pick’s disease: a clinicopathological, ultrastructural, and immunocytochemical comparative study. Ann Neurol 16: 467–480PubMedCrossRefGoogle Scholar
  12. Seitlberger F, Gross H, Pilz P (1983) Pick’s disease: a neuropathologie study. In: Hirano A, Miyoshi K (eds) Neuropsychiatrie disorders in the elderly. IgakuShoin, Tokio, pp 87–117Google Scholar
  13. Szelies B, Karenberg A (1986) Störungen des Glukosestoffwechsels bei Pickscher Erkrankung. Fortschr Neurol Psych 54: 393–397CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1990

Authors and Affiliations

  • F. Reisecker
    • 1
  • E. Laich
    • 2
  • F. Leblhuber
    • 3
  • J. Trenkler
    • 4
  • E. Deisenhammer
    • 2
  1. 1.Department of NeurologyHospital Barmherzige BrüderGrazAustria
  2. 2.Department of Clinical NeurophysiologyWagner Jauregg HospitalLinzAustria
  3. 3.Department of Neurologic-Psychiatric GerontologyWagner Jauregg HospitalLinzAustria
  4. 4.Institute of RadiologyWagner Jauregg HospitalLinzAustria

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