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Single Photon Emission Computerised Tomography in Elderly Patients with Alzheimer's Disease and Multi-infarct Dementia

Regional Uptake of Technetium-Labelled HMPAO Related to Clinical Measurements

Published online by Cambridge University Press:  02 January 2018

Julia Cook
Affiliation:
University Department of Psychiatry of Old Age, Brighton Clinic, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE
Ruth Adams
Affiliation:
University Department of Psychiatry of Old Age, Brighton Clinic, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE
E. Marjorie Irvine
Affiliation:
Regional Department of Medical Physics, Newcastle General Hospital
Alan E. S. Simpson
Affiliation:
Regional Department of Medical Physics, Newcastle General Hospital
Peter H. Bartholomew
Affiliation:
Regional Department of Medical Physics, Queen Elizabeth Hospital, Gateshead NE9 6SX

Abstract

Single photon emission computerised tomography (SPECT) was used to measure regional brain uptake of technetium-99m hexamethyl-propyleneamine oxine (Tc99m-HMPAO) in elderly patients with Alzheimer's disease (AD), multi-infarct dementia (MID) and normals (n = 20 in each group). Different patterns of uptake were found between groups when cortical uptake was normalised to cerebellar uptake. Reductions occurred in all regions in AD, being most marked in temporal and posterior parietal areas. Significant correlations were found in AD between memory impairment and decreased temporal uptake bilaterally, and between duration of illness and reduced uptake in most brain regions. MID patients showed higher uptake in the anterior parietal region than did the other groups. A variable comparing anterior to posterior uptake significantly discriminated the two patient groups.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: American Psychiatric Association.Google Scholar
Besson, J. A. O., Crawford, J. R., Parker, D. M., et al (1990) Multimodal imaging in AD: the relationship between MRI, SPECT; cognitive and pathological changes. British Journal of Psychiatry, 157, 216220.CrossRefGoogle Scholar
Burns, A., Philpot, M. P., Costa, D. C., et al (1989) The investigation of Alzheimer's disease with single photon emission tomography. Journal of Neurology, Neurosurgery and Psychiatry, 52, 248253.Google Scholar
Chase, T. N., Foster, N. L., Fedio, P., et al (1984) Regional cortical dysfunction in Alzheimer's disease as determined by positron emission tomography. Annals of Neurology, 15 (suppl.), 170174.Google Scholar
Erkinjuntti, T., Keetonen, L., Sulkava, R., et al (1987a) Do white matter changes on MRI and CT differentiate vascular dementia from Alzheimer's disease? Journal of Neurology, Neurosurgery and Psychiatry, 50, 3742.CrossRefGoogle ScholarPubMed
Erkinjuntti, T., Keetonen, L., Sulkava, R. (1987b) CT in the differential diagnosis between Alzheimer's disease and vascular dementia. Acta Neurologica Scandinavica, 75, 262270.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini-Mental State” - A practical guide for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Frackowiack, R. S. J., Pozzilli, C., Legg, N. J., et al (1981) Regional cerebral oxygen supply and utilisation in dementia. Brain, 104, 753778.Google Scholar
Gemmell, M., Sharp, P. F., Besson, J. A. O., et al (1987) Differential diagnosis in dementia using the cerebral blood flow agent 99mTc-HMPAO: A SPECT study. Journal of Cerebral Blood Flow and Metablism, 11, 398402.Google Scholar
Hachinski, V. C., Illiff, L. D., Zilcha, I. E., et al (1975) Cerebral blood flow in dementia. Archives of Neurology, 32, 632637.Google Scholar
Hunter, R., McLuskie, R., Wyper, D., et al (1989) The pattern of function related regional cerebral blood flow investigated by single photon emission tomography with Tc99m-HMPAO in patients with presenile AD and Korsakoff's psychosis. Psychological Medicine, 19, 847855.Google Scholar
Launes, J., Sulkava, R., Erkinjuntti, T., et al (1991) 99mTc-HMPAO SPECT in suspected dementia. Nuclear Medicine Communications, 12, 757765.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., et al (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Montaldi, D., Brooks, D. N., McColl, J. H., et al (1990) Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 53, 3338.CrossRefGoogle ScholarPubMed
Neary, D., Snowden, J., Shields, R., et al (1987) SPECT using 99mTc-HMPAO in the investigation of dementia. Journal of Neurology, Neurosurgery and Psychiatry, 50, 11011109.Google Scholar
Roth, M., Huppert, F. A., Tym, E., et al (1988) CAMDEX. The Cambridge Examination for Mental Disorders in the Elderly. Cambridge: Cambridge University Press.Google Scholar
Roth, M. & Wischik, C. M. (1985) The heterogeneity of Alzheimer's disease and its implications for scientific investigations of the disorder. In Recent Advances in Psychogeriatrics (ed. Arie, T.). Edinburgh: Churchill Livingstone.Google Scholar
Thompson, P. & Blessed, G. (1987) Correlation between the 37 item mental test score and abbreviated 10 item mental test score by psychogeriatric day patients. British Journal of Psychiatry, 151, 206209.Google Scholar
Wilson, R. S., Fox, J. H., Huckman, M. S., et al (1982) Computed tomography in dementia. Neurology, 32, 10541057.Google Scholar
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