Neuroimaging findings in an illustrative case in the VSM-20 kindred with c9FTD/ALS. (a) Axial fluid attenuation inversion recovery magnetic resonance images (top row) and coronal T1-weighted magnetic resonance images (bottom row) demonstrating the minimal atrophy in the frontal and temporal lobes at ages 50, 53, and 57. (b) Flourodeoxyglucose positron emission tomography scan images of the brain at age 57. The color scheme on the left side of the set of images shows the relative degree of hypometabolism. Areas in black and blue are considered to be within normal limits, areas in green are considered mildly abnormal, areas in yellow are considered moderately abnormal, and areas in orange and red are considered markedly abnormal. Note the relatively mild and symmetric hypometabolism in the frontal, temporal, parietal, and cingulate cortices; this is remarkable given that this scan was performed eight years after the onset of symptoms. c9FTD/ALS, frontotemporal dementia or amyotrophic lateral sclerosis (or both) linked to chromosome 9; VSM-20, Vancouver-San Francisco-Mayo Clinic family 20.