PMU-Autor/inn/en
Bergmann JürgenAbstract
Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimerxxxs type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration.
Useful keywords (using NLM MeSH Indexing)
Aged
Alzheimer Disease/complications*
Alzheimer Disease/diagnosis*
Alzheimer Disease/pathology
Automation
Brain/pathology*
Cognition Disorders/complications*
Cognition Disorders/diagnosis*
Cognition Disorders/pathology
Depression/complications*
Depression/diagnosis*
Depression/pathology
Diagnosis, Computer-Assisted
Female
Humans
Male
Middle Aged
Neurodegenerative Diseases/diagnosis
Neurodegenerative Diseases/pathology
Perfusion
ROC Curve
Tomography, Emission-Computed, Single-Photon/methods*
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Brain perfusion SPECT