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