title: Neural basis of three dimensions of agitated behaviors in patients with Alzheimer disease.
abstract: BACKGROUND
  Agitated behaviors are frequently observed in patients with Alzheimer disease (AD). The neural substrate underlying the agitated behaviors in dementia is unclear. We hypothesized that different dimensions of agitated behaviors are mediated by distinct neural systems.
  
  
  METHODS
  All the patients (n=32) underwent single photon emission computed tomography (SPECT). Using the Agitated Behavior in Dementia scale, we identified the relationships between regional cerebral blood flow (rCBF) patterns and the presence of each of three dimensions of agitated behavior (physically agitated behavior, verbally agitated behavior, and psychosis symptoms) in AD patients. Statistical parametric mapping (SPM) software was used to explore these neural correlations.
  
  
  RESULTS
  Physically agitated behavior was significantly correlated with lower rCBF values in the right superior temporal gyrus (Brodmann 22) and the right inferior frontal gyrus (Brodmann 47). Verbally agitated behavior was significantly associated with lower rCBF values in the left inferior frontal gyrus (Brodmann 46, 44) and the left insula (Brodmann 13). The psychosis symptoms were significantly correlated with lower rCBF values in the right angular gyrus (Brodmann 39) and the right occipital lobe (Brodmann 19).
  
  
  CONCLUSIONS
  Our results support the hypothesis that three different agitated behaviors may represent distinct neural networks in AD patients.
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Banno
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Shutaro
authors.initials: S
authors.lastname: Nakaaki
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Torii
authors.affiliation: Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.
authors.forename: Jin
authors.initials: J
authors.lastname: Narumoto
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyata
authors.affiliation: Department of Psychology, Kobe Gakuin University; Hyogo, Japan.
authors.forename: Nobutsugu
authors.initials: N
authors.lastname: Hirono
authors.affiliation: Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Toshi A
authors.initials: TA
authors.lastname: Furukawa
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Mimura
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
keywords: SPECT; physically agitated behavior; psychosis; verbally agitated behavior