Dement Neurocogn Disord.  2015 Dec;14(4):168-171. 10.12779/dnd.2015.14.4.168.

Atypical Early-Onset Alzheimer's Disease Dementia Diagnosed by Biomarker Study

• Lee SK
• Shin DS
• Shin HS
• Kim JH
• Park SA

• KMID: 2442935
• DOI: http://doi.org/10.12779/dnd.2015.14.4.168

Abstract

BACKGROUND
The described clinical characteristics of early-onset Alzheimer's disease (EOAD) are distinct from that of late-onset AD. We reported a patient with atypical EOAD.
CASE REPORT
A 54-year-old, truck driver developed gradual visuospatial, language and calculation deficits for 3 months. The neuropsychological impairments were extensive. Brain MRI revealed asymmetric atrophy in left medial temporal lobe along with distinct widening of sylvian fissure. (18)F-florbetapir-positron emission tomography (PET) showed a high uptake in the cortex. Further, the profiles of cerebrospinal fluid (CSF) biomarker were compatible with AD.
CONCLUSIONS
We diagnosed the patient as EOAD based on the result of biomarker study. Increased Abeta burden was identified through amyloid PET imaging and decreased CSF Abeta level. The high rise of CSF Tau proteins was in agreement with the patient's extensive and rapid cognitive decline. This case report demonstrates the importance of AD biomarker study in confronting early-onset dementia with atypical clinical presentation.

Keyword

amyloid imaging; biomarker; cerebrospinal fluid; early-onset Alzheimer's disease; positron emission tomography

MeSH Terms

Alzheimer Disease*
Amyloid
Atrophy
Brain
Cerebrospinal Fluid
Dementia*
Humans
Magnetic Resonance Imaging
Middle Aged
Motor Vehicles
Positron-Emission Tomography
tau Proteins
Temporal Lobe
Amyloid
tau Proteins

Figure

• 

  Fig. 1 Neuroimaging studies. The axial T2-weighted fluid-attenuated inversion recovery image demonstrates left sided asymmetry in medial temporal atrophy (A). On the coronal 3D T1-weighted images, the asymmetric widening of left sylvian fissure (B and C), and bilateral parietal atrophy (D) are noted. The (18)F-florbetapir-PET reveals a high uptake in the whole hemisphere (E-H). The stronger uptake in the bilateral parietal lobes is suspected (G and H). PET: positron emission tomography.

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