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Letters to the Editor
June 2000

Topography, Histology, and Seminology in Dementia

Arch Neurol. 2000;57(6):899-900. doi:

Johnson et al1 provided convincing neuropsychological evidence for a frontal lobe pattern of dementia in patients with pathologically confirmed Alzheimer disease (AD), and were able to correlate this pattern with anatomical evidence of increased frontal lobe burden of neurofibrillary tangles compared with that found in "typical" cases of AD. I have a similar case of a 64-year-old man with a striking progressive frontal lobe syndrome marked by perseverative, retentive, hoarding behavior, radiologically evident bifrontal atrophy (the left side worse than the right side), and an apolipoprotein E (APOE) genotype of APOE3/4 suggesting he may have AD rather than Pick disease (although we presently lack tissue confirmation).

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