Correlation of neuropsychological evaluation and SPECT imaging in patients with Alzheimer's disease.
BACKGROUND
Mini-Mental State Examination (MMSE) is a very useful tool for diagnosing changes in cognitive functions by the general practitioner or other medical staff who is not familiar with neuropsychological tests. On the other hand, HMPAO brain SPECT has been shown to have a high sensitivity to detect neurodegenerative processes, which lead to dementia. The correlation between both methods is unknown. We compared both methods in order to find a rational evaluation tool for the practitioner to obtain a higher efficacy and cost effective way of using both methods.


METHODS
Fifty-one patients diagnosed as having Alzheimer's disease (AD) were examined. Each patient underwent MMSE analysis, as well as HMPAO brain SPECT. The severity of SPECT abnormalities was categorized into mild, moderate and severe. Statistical analysis was performed in order to evaluate the correlation between imaging findings and neuropsychological testing.


RESULTS
Marginal inverse correlation was found between global MMSE SPECT imaging on right and left side (p = 0.05) and the left temporal region (p = 0.05). MMSE subgroup component of orientation was highly significantly inversely associated with SPECT imaging of right and left frontal region (p > 0.0001). The MMSE subgroup of immediate memory was significantly correlated to left and right temporal regions (p = 0.001 and p = 0.002 respectively). Age was not significantly correlated to global MMSE or any of its subtest components.


CONCLUSIONS
MMSE score has no linear correlation to SPECT perfusion findings. In cases of abnormal orientation score subgroup SPECT imaging is not recommended. In most instances, a combination of both methods should be employed by the general practitioner for further evaluation of dementia.
Lampl
Yair
Y
Department of Neurology, Edith Wolfson Medical Center, Holon and Sackler Faculty of Medicine, Tel Aviv University, Israel. y_lampl@hotmail.com
Sadeh
Menahem
M
Laker
Olga
O
Lorberboym
Mordechai
M
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019690:Technetium Tc 99m Exametazime