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Vol. 35. Issue 6.
Pages 394-397 (November - December 2016)
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Vol. 35. Issue 6.
Pages 394-397 (November - December 2016)
Clinical note
DOI: 10.1016/j.remnie.2016.07.006
18F-FDG PET/CT and functional MRI in a case of crossed logopenic primary progressive aphasia
Pet-Tc 18F-FDG y RM funcional en un caso de afasia progresiva primaria logopénica cruzada
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M.N. Cabrera-Martína,
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mncabreram@hotmail.com

Corresponding author.
, J.A. Matías-Guiub, M. Yus-Fuertesc, M. Valles-Salgadob, T. Moreno-Ramosb, J. Matías-Guiub, J.L. Carreras Delgadoa
a Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
b Servicio de Neurología, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
c Servicio de Radiodiagnóstico, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
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Abstract

Primary progressive aphasia is a clinical syndrome caused by a neurodegeneration of areas and neural networks involved in language, usually in the left hemisphere. The term “crossed aphasia” denotes an acquired language dysfunction caused by a lesion in the hemisphere ipsilateral to the dominant hand.

A case is presented on a 75-year-old right-handed woman with a logopenic variant of primary progressive aphasia with word-finding difficulties of 2 years onset. The 18F-FDG PET/CT showed right temporoparietal hypometabolism. A functional MRI scan was performed during a verb naming task in order to characterise language lateralisation patterns. A similar activation pattern was observed in both hemispheres, with less activation than expected in bilateral inferior frontal gyrus.

These findings support that logopenic variant of primary progressive aphasia should not be considered as a neurodegeneration starting in the left brain hemisphere, but as a syndrome characterised by asymmetric neurodegeneration of brain regions and neural networks involved in language.

Keywords:
Logopenic variant of primary progressive aphasia
Crossed aphasia
Language lateralisation
18F-FDG PET/CT
Functional MRI
Resumen

La afasia progresiva primaria es un síndrome clínico secundario a la neurodegeneración de las áreas y redes neuronales involucradas en el lenguaje, habitualmente en el hemisferio izquierdo. El término «afasia cruzada» se refiere a una alteración del lenguaje como consecuencia de una lesión del hemisferio cerebral ipsilateral a la mano dominante.

Presentamos el caso de una mujer diestra de 75 años con afasia progresiva primaria logopénica, con dificultad para encontrar palabras de 2 años de evolución. La 18F-FDG PET/TC mostró un hipometabolismo temporoparietal derecho. Se realizó una RM funcional para caracterizar patrones de lateralización del lenguaje. Se observó un patrón de activación similar en ambos hemisferios y una menor activación de la esperada en el giro frontal inferior bilateral.

Estos hallazgos apoyan que la afasia progresiva primaria logopénica no debería considerarse como una afectación de inicio en el hemisferio izquierdo, sino un síndrome caracterizado por una neurodegeneración asimétrica con preferencia por áreas y redes neuronales implicadas en el lenguaje.

Palabras clave:
Afasia progresiva primaria variante logopénica
Afasia cruzada
Lateralización del lenguaje
PET/TC 18F-FDG
RM funcional

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