Co-morbid seizures in frontotemporal dementia: MRI and PET correlations

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Seizures are a frequent clinical manifestation in patients with frontotemporal dementia (FTD).
• Neuroimaging techniques like MRI and PET are valuable tools for diagnosing neurological disorders but are understudied in FTD patients experiencing seizures.
• Understanding the specific neuroimaging findings associated with seizures in FTD is crucial for improved diagnosis and management.

Purpose of the Study:

• To investigate the MRI and PET findings in patients with frontotemporal dementia (FTD) with and without comorbid seizures.
• To determine if specific neuroimaging patterns correlate with the presence of seizures in FTD.
• To assess the diagnostic utility of structural and functional neuroimaging in FTD patients with seizures.

Main Methods:

• A retrospective, single-center study included 326 FTD patients, divided into groups with (FTD + SZ) and without (FTD-SZ) seizures.
• Demographic data, PET findings (hypometabolism presence, laterality, region), and MRI findings (atrophy, white matter hyperintensities, stroke, etc.) were collected.
• Statistical analysis included Pearson's Chi-squared, Fisher's exact, and t-tests to compare groups. FreeSurfer was used for image analysis.

Main Results:

• Thirty-three patients (10%) had FTD + SZ, and 293 (90%) had FTD-SZ. Temporal lobe hypometabolism on PET was more frequent in FTD + SZ (85.71%) compared to FTD-SZ (59.26%).
• MRI revealed abnormalities in 86.21% of FTD + SZ patients, predominantly showing a frontotemporal pattern.
• While not statistically significant, findings suggest temporal hypometabolism is a common correlate of seizures in FTD. No significant differences were found in atrophy, WMH, or mesial temporal sclerosis between groups.

Conclusions:

• Temporal hypometabolism on PET scans is a notable finding in frontotemporal dementia patients experiencing seizures.
• Although differences in neuroimaging findings between FTD with and without seizures did not reach statistical significance in this study, they suggest potential diagnostic value.
• Structural and functional neuroimaging warrant wider utilization in clinical practice for FTD patients with seizures, with larger multi-center studies needed to confirm these findings.