Brain SPECT in subtypes of mild cognitive impairment. Findings from the DESCRIPA multicenter study.
The Development of Screening Guidelines and Clinical Criteria of Predementia Alzheimer's Disease (DESCRIPA) multicenter study enrolled patients with MCI or subjective cognitive complaints (SUBJ), a part of whom underwent optional brain perfusion SPECT. These patients were classified as SUBJ (n = 23), nonamnestic MCI (naMCI; n = 17) and amnestic MCI (aMCI; n = 40) based on neuropsychology. Twenty healthy subjects formed the control (CTR) group. Volumetric regions of interest (VROI) analysis was performed in six associative cortical areas in each hemisphere. ANOVA for repeated measures, corrected for age and center, showed significant differences between groups (p = 0.01) and VROI (p < 0.0001) with a significant group-region interaction (p = 0.029). In the post hoc comparison, SUBJ did not differ from CTR. aMCI disclosed reduced uptake in the left hippocampus and bilateral temporal cortex (compared with CTR) or in the left hippocampus and bilateral parietal cortex (compared with SUBJ). In the naMCI group, reduced VROI values were found in the bilateral temporal cortex and right frontal cortex. In the comparison between aMCI and naMCI, the former had lower values in the left parietal cortex and precuneus. Discriminant analysis between SUBJ/CTR versus all MCI patients allowed correct allocations in 73 % of cases. Mean VROI values were highly correlated (p < 0.0001) with the learning measure of a verbal memory test, especially in the bilateral precunei and parietal cortex and in the left hippocampus. In a subset of 70 patients, mean VROI values showed a significant correlation (p < 0.05) with the white matter hyperintensities score on MRI. In conclusion, MCI subtypes have different perfusion patterns. The aMCI group exhibited a pattern that is typical of early Alzheimer's disease, while the naMCI group showed a more anterior pattern of hypoperfusion. Instead, a homogeneous group effect was lacking in SUBJ.
Nobili
Flavio
F
Clinical Neurophysiology Unit, Dept. of Endocrinological and Medical Sciences, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy. flaviomariano.nobili@hsanmartino.it
Frisoni
Giovanni B
GB
Portet
Florence
F
Verhey
Frans
F
Rodriguez
Guido
G
Caroli
Anna
A
Touchon
Jacques
J
Calvini
Piero
P
Morbelli
Silvia
S
De Carli
Fabrizio
F
Guerra
Ugo P
UP
Van de Pol
Laura A
LA
Visser
Pieter-Jelle
PJ
D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000647:Amnesia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D019690:Technetium Tc 99m Exametazime; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014706:Verbal Learning / Q000502:physiology
D019690:Technetium Tc 99m Exametazime