Differentiation of dementia with Lewy bodies from Alzheimer's disease using Mini-Mental State Examination and brain perfusion SPECT.
To determine whether combined studies of Mini-Mental State Examination (MMSE) and brain single photon emission CT (SPECT) would provide more useful means of differentiating between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), we studied 36 patients with probable DLB and 96 patients with probable AD. DLB patients had significantly better performance on word recall, but more impaired attention and copying than AD patients. We confirmed that a weighted score derived by Ala et al. [Ala, T.A., Hughes, L.F., Kyrouac, G.A., Ghobrial, M.W., Elble, R.J. The Mini-Mental State exam may help in the differentiation of dementia with Lewy bodies and Alzheimer' disease. Int J Geriatr Psychiatry 2002;17:503-9]: (Attention-5/3.Memory+5.Construction), was helpful in discriminating between DLB and AD. SPECT study revealed that medial occipital perfusion significantly decreased in DLB patients than AD patients. Combined studies of MMSE and brain SPECT achieved a high discrimination between DLB and AD with a sensitivity of 81% and a specificity of 85%, suggesting that there is a useful and practical approach to differentiate DLB from AD. Our findings will need to be substantiated in an independent and prospective study sample.
Hanyu
Haruo
H
Department of Geriatric Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. h-hanyu@tokyo-med.ac.jp
Shimizu
Soichiro
S
Hirao
Kentaro
K
Kanetaka
Hidekazu
H
Sakurai
Hirofumi
H
Iwamoto
Toshihiko
T
Koizumi
Kiyoshi
K
Abe
Kimihiko
K
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D009778:Occipital Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*