Journal of the Neurological Sciences
Volume 290, Issue 1 , Pages 96-101, 15 March 2010

The progression of cognitive deterioration and regional cerebral blood flow patterns in Alzheimer's disease: A longitudinal SPECT study

  • Haruo Hanyu

      Affiliations

    • Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
    • Corresponding Author InformationCorresponding author. Department of Geriatric Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan. Tel.: +81 3 3342 6111; fax: +81 3 3342 2305.
    • ,
  • Tomohiko Sato

      Affiliations

    • Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
    • ,
  • Kentaro Hirao

      Affiliations

    • Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
    • ,
  • Hidekazu Kanetaka

      Affiliations

    • Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
    • ,
  • Toshihiko Iwamoto

      Affiliations

    • Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
    • ,
  • Kiyoshi Koizumi

      Affiliations

    • Department of Radiology, Tokyo Medical University, Tokyo, Japan

Received 8 April 2009; received in revised form 29 October 2009; accepted 30 October 2009. published online 23 November 2009.

Abstract 

Background and purpose

The progression of cognitive deterioration in patients with Alzheimer's disease (AD) is considerably variable. The ability to predict the progression rate is important for clinicians to treat and manage patients with AD. We examined the possible relationship between the rate of cognitive deterioration and regional cerebral blood flow (rCBF) patterns in patients with AD.

Methods

We followed 48 patients with AD for an average of 37months. They were subsequently divided into the rapidly progressing group (n=24) and slowly progressing group (n=24) based on an annual Mini-Mental State Examination (MMSE) score change. Initial and follow-up rCBF were assessed using single photon emission CT (SPECT) and the SPECT data were analyzed by 3D-stereotactic surface projections.

Results

At initial evaluation, the rapidly progressing group had greater rCBF deficits mainly in the parietotemporal and frontal regions, and left posterior cingulate than did the slowly progressing group. When compared with initial SPECT, follow-up SPECT showed a significant rCBF reduction in widespread regions, including parietotemporal and frontal lobes, of the rapidly progressing group, while showed in the scattered and small regions of hemispheres of the slowly progressing group.

Conclusion

Our longitudinal SPECT study suggests a significant association between rCBF deficits in the parietotemporal, posterior cingulate, and frontal regions and subsequent rapid cognitive and rCBF deterioration.

Keywords: Alzheimer's disease, Perfusion, SPECT, Progression

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0022-510X(09)00940-X

doi:10.1016/j.jns.2009.10.022

Journal of the Neurological Sciences
Volume 290, Issue 1 , Pages 96-101, 15 March 2010

Article Tools

* Image Usage & Resolution