Right temporal lobe atrophy: A neuropsychological and functional imaging study

Clinical data about right temporal lobe atrophy (RTLA) are relatively limited in the neuropsychological literature. However, this kind of focal atrophy, which occurring in a context of a neurodegenerative disease, seems to have a specific clinical profile. Some authors reported the prevalence of verbal and non-verbal episodic memory impairment, topographical disorientation, progressive prosopagnosia and deterioration of semantic knowledge about famous people (Chan et al. 2009 ; Josephs et al. 2009; Gorno-Tempini et al. 2004). This study aimed to clarify the specific neuropsychological and behavioral profile associated with RTLA and to correlate cerebral hypoperfusion with cognitive and emotional impairments in RTLA patients.Fourteen patients (five women, and nine men, mean aged 61.1 range = 39 to 74), with RTLA on brain MRI, were compared to fourteen control subjects matched for age and sex. Several neuropsychological tests were administrated to patients and behaviour was assessed with questionnaire to participants and caregivers. Besides the patients had ethylcysteinate dimer (ECD) SPECT imagery. Brain perfusion will be correlated to cognitive data using Voxel Based Morphometry (VBM) analysis (with Matlab 7.7 software, SPM5). Our first results showed a deficit in visual recognition memory and a mild impairment in verbal episodic memory. Specific semantic knowledge about famous people was severely impaired, whereas general semantic knowledge was relatively spared. Language, visuo-perceptive and visuo-spatial skills and executive functions were well preserved. RTLA patients were impaired at recognizing emotions from faces, especially fear and disgust. Finally, many patients suffered from depression to the beginning of the disease. Others behavioral manifestations were observed in some patients (apathy, impulsivity, disinhibition, anxiety etc.). At time, SPECT imagery is ongoing for the patients and correlations with perfusion will be presented during the congress. This study will objective the neuropsychological impairments associated with RTLA and precise their brain localization.