title: Dissociating behavioral disorders in early dementia-An FDG-PET study.
abstract: Behavioral impairments occur frequently in dementia. Studies with magnetic resonance imaging, measuring atrophy, have systematically investigated their neural correlates. Such a systematic approach has not yet been applied to imaging with [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET), although regional hypometabolism may precede and exceed atrophy in dementia. The present study related all behavioral disorders as assessed with the Neuropsychiatric Inventory to reductions in brain glucose utilization as measured by FDG-PET with Statistical Parametric Mapping (SPM5). It included 54 subjects mainly with early Alzheimer's disease, frontotemporal lobar degeneration, and subjective cognitive impairment. Apathy, disinhibition and eating disorders - most frequent in frontotemporal lobar degeneration - correlated significantly with regional brain hypometabolism. Whereas a single regressor analysis and conjunction analysis revealed largely overlapping frontomedian regions that were associated with all three behavioral domains, a disjunction analysis identified three specific neural networks for each behavioral disorder, independent of dementia severity. Apathy was related to the ventral tegmental area, a component of the motivational dopaminergic network; disinhibition to both anterior temporal lobes including the anterior hippocampi and left amygdala, caudate head, orbitofrontal cortex and insulae; and eating disorders to the right lateral (orbito) frontal cortex/insula. Our study contributes to the understanding of behavioral deficits in early dementia and suggests specific diagnostic and therapeutic approaches.
authors: Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. Electronic address: schroet@cbs.mpg.de.
authors: Matthias L
authors: ML
authors: Schroeter
authors: Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany.
authors: Barbara
authors: B
authors: Vogt
authors: Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany.
authors: Stefan
authors: S
authors: Frisch
authors: Department of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany.
authors: Georg
authors: G
authors: Becker
authors: Department of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany.
authors: Anita
authors: A
authors: Seese
authors: LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany.
authors: Henryk
authors: H
authors: Barthel
authors: Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.
authors: Karsten
authors: K
authors: Mueller
authors: Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
authors: Arno
authors: A
authors: Villringer
authors: LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany.
authors: Osama
authors: O
authors: Sabri
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001526:Behavioral Symptoms / Q000000981:diagnostic imaging* / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001931:Brain Mapping; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D003704:Dementia / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis
chemical_list: D019788:Fluorodeoxyglucose F18