Quantitative analysis of brain perfusion SPECT in Alzheimer's disease using a fully automated regional cerebral blood flow quantification software, 3DSRT.
OBJECTIVE
The clinical symptoms of Alzheimer's disease (AD) show great diversity depending on the clinical stage. We investigated the correlation of regional cerebral blood flow (rCBF) changes and the clinical severity of AD patients.


METHODS
Thirty-nine AD patients and 16 normal subjects participated in this study. AD patients were divided into three subgroups by clinical severity. Quantitative brain perfusion SPECT analyses were performed using a rCBF quantification software, 3DSRT.


RESULTS
In mild AD, significant decreases of rCBF were detected in the bilateral parietal, angular gyrus, pericallosal, thalamus, right temporal and left hippocampal regions. Moderate AD patients showed significantly lower blood flow than those with mild AD only to the right hippocampus. Analysis of the severe AD group revealed a nearly diffuse decrease of rCBF throughout the cerebral cortex except for part of the frontal lobe compared with moderate patients.


CONCLUSIONS
These results were consistent with previous findings demonstrated by qualitative analysis of CBF. The decreased thalamic blood flow was noteworthy as this finding has rarely been reported. In consideration of the structure and function of the Papez circuit, which connects the medial temporal lobe and thalamus, a remote metabolic effect might be the cause of lower rCBF in the thalamus.
Kobayashi
Seiju
S
Department of Psychiatry, Sunagawa City Medical Center, Hokkaido, Japan.
Tateno
Masaru
M
Utsumi
Kumiko
K
Takahashi
Akira
A
Saitoh
Masaki
M
Morii
Hidetoshi
H
Fujii
Kazuki
K
Teraoka
Masatoshi
M
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000639:trends; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000639:trends; D008297:Male; D009434:Neural Pathways / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012984:Software / Q000639:trends*; D012986:Software Validation; D013788:Thalamus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*