Decreased cerebral blood flow and prognosis of Alzheimer's disease: a multicenter HMPAO-SPECT study.
OBJECTIVE
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 > or = 24) was in the frontal lobe.


CONCLUSIONS
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.
Nishimura
Tsunehiko
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi Hirokoji Sagaru, Kamigyo-ku, Kyoto 602-8566, Japan.
Hashikawa
Kazuo
K
Fukuyama
Hidenao
H
Kubota
Takao
T
Kitamura
Shin
S
Matsuda
Hiroshi
H
Hanyu
Haruo
H
Nabatame
Hidehiko
H
Oku
Naohiko
N
Tanabe
Hirotaka
H
Kuwabara
Yasuo
Y
Jinnouchi
Seishi
S
Kubol
Atsushi
A
D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010091:Oximes; D011379:Prognosis; D012720:Severity of Illness Index; D013687:Telencephalon / Q000098:blood supply*; D015899:Tomography, Emission-Computed, Single-Photon
D010091:Oximes; C068296:hexamethylpropyleneamine oxime