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Decreased cerebral blood flow and prognosis of Alzheimer's disease: A multicenter HMPAO-SPECT study

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Abstract

Purpose: To determine the usefulness of brain perfusion SPECT for evaluating the severity and progression of Alzheimer's disease (AD).Methods: Eighty-four AD patients were included. At entry,99mTc-HMPAO-SPECT, the Mini Mental State Examination (MMSE), Mental Function Impairment Scale (MENFIS), and the Raven Colored Progression Matrix (RCPM) were performed for all 84 patients. During the follow-up periods, two individual MMSE evaluations in 34 patients, two MENFIS evaluations in 30 patients, and two RCPM evaluations in 20 patients were performed. Based on the regions of decreased cerebral blood flow demonstrated on 3D-SSP images of SPECT, the cases were classified as type A (no decrease), type B (decreased blood flow in the parietal or temporal lobe), type C (decreased blood flow in the frontal lobe and parietal or temporal lobe), type Pc (decreased blood flow in posterior cingulate gyrus only), and “other types”. The types of decreased blood flow, scores on neuropsychological evaluations, and symptom progression were analyzed.Results: The MENFIS, MMSE, and RCPM scores were poorest in type C patients at entry. The degree of decrease of these scores during the follow-up periods was also greatest in type C. The greatest difference between patients with and without rapid progression in SPECT data of the mild AD patients (MMSE score ≥ 24) was in the frontal lobe.Conclusion: Decreased blood flow in the frontal lobe of AD patients is correlated not only with reduced cognitive function at the time of the evaluation but with rapid progression in the subsequent clinical course.

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi Hirokoji Sagaru, Kamigyo-ku, 602-8566, Kyoto, Japan

    Tsunehiko Nishimura & Takao Kubota M.D.

  2. Department of Functional Brain Imaging, Human Brain Research Center, Graduate School of Medicine, Kyoto University, Japan

    Kazuo Hashikawa & Hidenao Fukuyama

  3. Department of Internal Medicine, Nippon Medical School Second Hospital, Japan

    Shin Kitamura

  4. Department of Radiology, National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry, Japan

    Hiroshi Matsuda

  5. Department of Geriatric Medicine, Tokyo Medical University, Japan

    Haruo Hanyu

  6. Department of Neurology, Shiga Medical Center for Adults, Japan

    Hidehiko Nabatame

  7. Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, Japan

    Naohiko Oku

  8. Department of Neuropsychiatry, Ehime University School of Medicine, Japan

    Hirotaka Tanabe

  9. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan

    Yasuo Kuwabara

  10. Department of Radiology, Miyazaki Medical College, Japan

    Seishi Jinnouchi

  11. Department of Radiology, Keio University School of Medicine, Japan

    Atsushi Kubo

Authors
  1. Tsunehiko Nishimura
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  2. Kazuo Hashikawa
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  3. Hidenao Fukuyama
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  4. Takao Kubota M.D.
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  5. Shin Kitamura
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  6. Hiroshi Matsuda
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  7. Haruo Hanyu
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  8. Hidehiko Nabatame
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  9. Naohiko Oku
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  10. Hirotaka Tanabe
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  11. Yasuo Kuwabara
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  12. Seishi Jinnouchi
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  13. Atsushi Kubo
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Nishimura, T., Hashikawa, K., Fukuyama, H. et al. Decreased cerebral blood flow and prognosis of Alzheimer's disease: A multicenter HMPAO-SPECT study. Ann Nucl Med 21, 15–23 (2007). https://doi.org/10.1007/BF03033995

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  • DOI: https://doi.org/10.1007/BF03033995

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