Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2278  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (315 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References

 Article Access Statistics
    Viewed1934    
    Printed180    
    Emailed0    
    PDF Downloaded143    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
EDITORIAL
Year : 2010  |  Volume : 58  |  Issue : 6  |  Page : 823-824

The role of single photon emission computed tomography scan in the diagnosis of dementia


Cognition and Behavioral Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India

Date of Web Publication10-Dec-2010

Correspondence Address:
P S Mathuranath
Cognition and Behavioral Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum - 695 011
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.73734

Rights and Permissions



How to cite this article:
Mathuranath P S. The role of single photon emission computed tomography scan in the diagnosis of dementia. Neurol India 2010;58:823-4

How to cite this URL:
Mathuranath P S. The role of single photon emission computed tomography scan in the diagnosis of dementia. Neurol India [serial online] 2010 [cited 2019 Aug 25];58:823-4. Available from: http://www.neurologyindia.com/text.asp?2010/58/6/823/73734


Accurate subtyping of the dementia in the initial couple of years after its onset is the most important initial step in the management of dementia, but is often a challenge. In most instances it requires the expertise of an experienced cognitive neurologist with supportive ancillary investigations, such as detailed neuropsychological tests, which may not be always easily available. Thus it often requires an established setup going beyond the purview of general neurology. Given this situation, any other valid investigation that would assist the clinician in the process of typing the dementia would be welcome. In this issue of the journal Tripathi and colleagues [1] report in a well-conducted study the role of visual analysis of Single Photon Emission Computed Tomography (SPECT) in the diagnosis of different types of dementia, at about two and a half years from the onset of the disease, and estimate its validity against the diagnosis made clinically. Although the clinical profile of frontotemporal dementia (FTD) can be more easily differentiated from that of Alzheimer's disease (AD), it is often difficult to clinically distinguish AD from dementia with Lewy bodies (DLB), in the early stages of the disease, when amnesia is the feature in the forefront in both the conditions, and visual hallucination or  Parkinsonism More Details might not yet have set in, in DLB.

Although the authors have used the older terminology of diffuse Lewy body disease for DLB, they have used fairly well-characterized criteria for the SPECT diagnosis of AD, FTD, DLB and vascular dementia. In addition, the gender distribution, the duration of symptoms and the mini mental status examination scores of all the three groups of AD, FTD and DLB are well matched, suggesting that the validity is being established in a well-matched group of dementia subjects. The authors go on to demonstrate a fairly high sensitivity and specificity of SPECT in the diagnosis of AD and FTD. They also go on to show a high positive predictive value of SPECT thereby suggesting that there is a low false-positive rate. The study could have been further strengthened if the authors had demonstrated that the different groups of dementia were also matched on a measure of the severity of dementia such as Clinical dementia rating. One of the other limitations of the study is that the diagnostic accuracy is rated against the clinical diagnosis. However, it is interesting to note that their sensitivity figures for AD and FTD are somewhat comparable to the sensitivity of SPECT determined against the pathological diagnosis by Mc Neill et al. [2]

 
  References Top

1.Tripathi M, Tripathi M, Vibha D, Gowda N, Bal C, Malhotra A. Tc-99m ethylcysteinate dimer SPECT in the differential diagnosis of dementias. Neurol India 2010;58:857-62.  Back to cited text no. 1
  Medknow Journal  
2.McNeill R, Sare GM, Manoharan M, Testa HJ, Mann DM, Neary D, et al. Accuracy of single-photon emission computed tomography in differentiating frontotemporal dementia from Alzheimer's disease. J Neurol Neurosurg Psychiatry 2007;78:350-5.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  




 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow