Psychiatric symptoms associated with cortical-subcortical dysfunction in Alzheimer's disease.
Positron emission tomography was used to evaluate 3 Alzheimer's disease (AD) patients: 1 with major depression, 1 with emotional lability, and 1 with apathy. Compared with 5 non-mood-disordered AD patients, the patient with depression had diminished relative regional cerebral blood flow (rel-CBF) in the anterior cingulate and superior temporal cortices, bilaterally. This patient also showed diminished rel-CBF in the left dorsolateral prefrontal and right medial temporal and parietal cortices. The patient with emotional lability had diminished rel-CBF in the anterior cingulate and dorsolateral prefrontal cortices, bilaterally, and left basal ganglia. The patient with apathy had diminished rel-CBF in the basal ganglia and dorsolateral prefrontal cortex, bilaterally. Results are consistent with the hypothesis of a common frontal-temporal-subcortical substrate (e.g., involving aminergic nuclei) in the etiology of depression in AD. Frontal-subcortical dysfunction may also be associated with emotional lability and apathy in AD, although these may be related to a greater involvement of frontal-basal ganglia circuits.
Lopez
O L
OL
Alzheimer's Disease Research Center and Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Zivkovic
S
S
Smith
G
G
Becker
J T
JT
Meltzer
C C
CC
DeKosky
S T
ST
D000339:Affect / Q000502:physiology; D000342:Affective Symptoms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000503:physiopathology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004292:Dominance, Cerebral / Q000502:physiology; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D009042:Motivation; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D014055:Tomography, Emission-Computed