case_images: PMC4868940_01
case_images: a FLAIR images show diffuse atrophy and periventricular white matter hyperintensities that are probably due to hypertension, diabetes mellitus, or multifocal intracranial cerebral artery stenosis in this patient. Temporal atrophy appears to be more severe in the right than the left hemisphere. b Cortical thickness analysis of MRI. Compared to data collected from 55 normal elderlies, the patient's MRI shows that atrophy was mostly noticeable in the right anterior temporal and parietal area. c FDG-PET images show moderate hypometabolism in the bilateral fronto-parieto-temporal cortex, more remarkable in the right than the left hemisphere. d FDG-PET SUVR. Glucose hypometabolism is more severe in the right than the left fronto-parieto-temporal cortices compared to the mean activity of the pons area (left vs. right SUVR: frontal cortex: 1.46 vs. 1.35; temporal cortex: 1.32 vs. 1.09; parietal cortex: 1.42 vs. 1.21; occipital cortex: 1.58 vs. 1.48).
case_images: crn-0008-0078-g01.jpg
case_images: PMC4868940_01_crn-0008-0078-g01.jpg
case_images: F1
case_images: MRI showed bilateral periventricular white matter hyperintensities and diffuse brain atrophy on fluid-attenuated inversion recovery (FLAIR) sequence (fig. 1a). This patient showed decreased cortical thickness in all cortical area, and the right anterior temporal and parietal cortices were observed to be the thinnest regions (fig. 1b). 18F-fludeoxyglucose positron emission tomography (FDG-PET) showed moderate hypometabolism in the bilateral fronto-parieto-temporal cortex (fig. 1c). The patient's FDG-PET SUVRs of the right hemisphere were lower than those of the left (left vs. right SUVR: frontal cortex: 1.46 vs. 1.35; temporal cortex: 1.32 vs. 1.09; parietal cortex: 1.42 vs. 1.21; occipital cortex: 1.58 vs. 1.48) (fig. 1d).
case_images: a PiB-PET images show asymmetrical amyloid accumulation which is more outstanding in the left hemisphere than the right. b PiB-PET SUVR. Compared to cerebellar gray matter, amyloid accumulation is dominant in the left fronto-parieto-temporal cortices (left vs. right SUVR: frontal cortex: 2.01 vs. 1.75; temporal cortex: 1.82 vs. 1.57; parietal cortex: 2.07 vs. 1.76; occipital cortex: 1.68 vs. 1.50).
case_images: crn-0008-0078-g02.jpg
case_images: PMC4868940_01_crn-0008-0078-g02.jpg
case_images: F2
case_images: Pittsburgh compound B (PiB)-PET which revealed amyloid accumulation mostly in the left fronto-parieto-temporal cortex (fig. 2a). PiB-PET was also analyzed using the same methods as FDG-PET except that for PiB-PET, the cerebellar gray matter was used as the reference area. Higher SUVRs were extracted in the right hemisphere than the left (left vs. right SUVR: frontal cortex: 2.01 vs. 1.75; temporal cortex: 1.82 vs. 1.57; parietal cortex: 2.07 vs. 1.76; occipital cortex: 1.68 vs. 1.50) (fig. 2b). 18F-T807-PET performed at 3.5 years after symptom onset showed that tau deposition was more predominant in the right fronto-parieto-temporal cortex than the left (fig. 3a).
case_images: a
  18F-T807-PET images show an asymmetric tau accumulation which is more prominent in the right than the left hemisphere. b
  18F-T807-PET SUVR. Compared to cerebellar gray matter, tau accumulation is more prominent in the right fronto-parieto-temporal cortices than the left (left vs. right SUVR: frontal cortex: 1.76 vs. 2.33; temporal cortex: 2.18 vs. 2.67; parietal cortex: 2.01 vs. 2.51; occipital cortex: 1.84 vs. 1.97).
case_images: crn-0008-0078-g03.jpg
case_images: PMC4868940_01_crn-0008-0078-g03.jpg
case_images: F3
case_images: Higher SUVRs were extracted in the right hemisphere than the left (left vs. right SUVR: frontal cortex: 2.01 vs. 1.75; temporal cortex: 1.82 vs. 1.57; parietal cortex: 2.07 vs. 1.76; occipital cortex: 1.68 vs. 1.50) (fig. 2b). 18F-T807-PET performed at 3.5 years after symptom onset showed that tau deposition was more predominant in the right fronto-parieto-temporal cortex than the left (fig. 3a). When SUVRs were calculated using the same process as PiB-PET, higher SUVRs were observed in the right cortices than the left (left vs. right SUVR: frontal cortex: 1.76 vs. 2.33; temporal cortex: 2.18 vs. 2.67; parietal cortex: 2.01 vs. 2.51; occipital cortex: 1.84 vs. 1.97) (fig. 3b).