A 64-year-old woman with poor short-term memory was first suspected as early Alzheimer disease. 99m Tc ECD brain SPECT was arranged for differential diagnosis. A small area of mild hypoperfusion was noted in the left temporal lobe on conventional display. Further statistical analysis of SPECT with an easy Z-score imaging system showed large areas of distinct hypoperfusion in left precentral and perisylvian cortical areas, compatible with typical pictures of nonfluent variant primary progressive aphasia (PPA), but no involvement in areas characteristic for Alzheimer disease. Further detailed neuropsychological examination and 6 months of clinical follow-up confirmed the final diagnosis of PPA.
