A SPECT study of wandering behavior in Alzheimer's disease.
BACKGROUND
Among behavior disturbance during Alzheimer's disease (AD), wandering is one of the most common. Different psychological processes have been suggested to explain the wandering behavior. The aim of this study was to examine whether wandering during AD was associated with cerebral perfusion patterns measured by (99 m)Tc-labeled bicisate (ECD) brain SPECT.


METHODS
We compared SPECT scans of 13 AD subjects with wandering behavior (sex ratio M/F, 4/9; age, 73.1 years, SD 7.4; Mini Mental Status Examination score, median 20 interquartile range [16-23]), 13 AD subjects without wandering behavior (matched for age [ +/- 2 years], sex and MMSE score [ +/- 2 points]) and 13 healthy controls (matched for age [ +/- 2 years] and sex) without cognitive impairment. Wandering was defined on the Neuro-Psychiatric Inventory. Score of leukoaraiosis, assessed with the scale of Blennow and number of lacuna infarction were compared on CT scan. SPECT imaging was compared using statistical parametric mapping (SPM 2).


RESULTS
There were no significant differences between the groups in term of educational level and CT scan analysis. SPECT imaging was consistent with the diagnosis of AD in both wanderers and AD subjects without wandering behavior. Despite similar clinical dementia severity, wanderers had more severely reduced regional cerebral blood flow (rCBF) in the left parietal-temporal lobe than AD subjects without wandering behavior.


CONCLUSIONS
Wandering behavior could be facilitated by a specific patterns of cerebral blood flow. Wandering, as a physical activity, could also enhance the recruitment of the cortical network.
Rolland
Yves
Y
Service de Médecine Interne et de Gérontologie Clinique, Hôpital La Grave-Casselardit, 170 avenue de Casselardit, 31300 Toulouse, France. yves.rolland@9online.fr
Payoux
Pierre
P
Lauwers-Cances
Valérie
V
Voisin
Thierry
T
Esquerré
Jean Paul
JP
Vellas
Bruno
B
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D002560:Cerebrovascular Circulation; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000000981:diagnostic imaging / Q000209:etiology*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed