Quantitative analysis of brain perfusion SPECT in Alzheimer's disease using a fully automated regional cerebral blood flow quantification software, 3DSRT

Kobayashi, Seiju; Tateno, Masaru; Utsumi, Kumiko; Takahashi, Akira; Saitoh, Masaki; Morii, Hidetoshi; Fujii, Kazuki; Teraoka, Masatoshi

doi:10.1016/j.jns.2007.07.015

« Previous Next »Journal of the Neurological Sciences
Volume 264, Issue 1 , Pages 27-33, 15 January 2008

Quantitative analysis of brain perfusion SPECT in Alzheimer's disease using a fully automated regional cerebral blood flow quantification software, 3DSRT

Seiju Kobayashi
- Department of Psychiatry, Sunagawa City Medical Center, Japan
Masaru Tateno
- Department of Psychiatry, Sunagawa City Medical Center, Japan
- Department of Neuropsychiatry, Sapporo Medical University, Sapporo, Japan
- Corresponding author. Department of Psychiatry, Sunagawa City Medical Center, 1-1,West 4, North 2, Sunagawa, Hokkaido, 0730196, Japan. Tel.: +81 125 54 2131; fax: +81 125 54 0101.
Kumiko Utsumi
- Department of Psychiatry, Sunagawa City Medical Center, Japan
Akira Takahashi
- Departments of Neurology and Neurosurgery, Sunagawa City Medical Center, Japan
Masaki Saitoh
- Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Fukuoka, Japan
Hidetoshi Morii
- Department of Radiology, Sunagawa City Medical Center, Japan
Kazuki Fujii
- Department of Radiology, Sunagawa City Medical Center, Japan
Masatoshi Teraoka
- Department of Psychiatry, Sunagawa City Medical Center, Japan

Received 9 November 2006; received in revised form 9 March 2007; accepted 11 July 2007.

Abstract

Purpose

The clinical symptoms of Alzheimer's disease (AD) show great diversity depending on the clinical stage. We investigated the correlation of regional cerebral blood flow (rCBF) changes and the clinical severity of AD patients.

Methods

Thirty-nine AD patients and 16 normal subjects participated in this study. AD patients were divided into three subgroups by clinical severity. Quantitative brain perfusion SPECT analyses were performed using a rCBF quantification software, 3DSRT.

Results

In mild AD, significant decreases of rCBF were detected in the bilateral parietal, angular gyrus, pericallosal, thalamus, right temporal and left hippocampal regions. Moderate AD patients showed significantly lower blood flow than those with mild AD only to the right hippocampus. Analysis of the severe AD group revealed a nearly diffuse decrease of rCBF throughout the cerebral cortex except for part of the frontal lobe compared with moderate patients.

Conclusions

These results were consistent with previous findings demonstrated by qualitative analysis of CBF. The decreased thalamic blood flow was noteworthy as this finding has rarely been reported. In consideration of the structure and function of the Papez circuit, which connects the medial temporal lobe and thalamus, a remote metabolic effect might be the cause of lower rCBF in the thalamus.

Keywords: Alzheimer's disease, Dementia, Regional cerebral blood flow (rCBF), Region of interest (ROI), 3DSRT, Thalamus, Papez circuit