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SPECT for Differential Diagnosis of Dementia and Correlation of rCBF with Cognitive Impairment

Published online by Cambridge University Press:  18 September 2015

Alicia Osimani ,
Masanori Ichise ,
Dae-Gyun Chung ,
Janice M. Pogue  and
Morris Freedman
Alicia Osimani
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care Behavioral Neurology Program, Baycrest Hospital Division of Neurology, Mount Sinai Hospital, University of Toronto
Masanori Ichise
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care Department of Radiology (Division of Nuclear Medicine), Mount Sinai Hospital, University of Toronto
Dae-Gyun Chung
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care Department of Radiology (Division of Nuclear Medicine), Mount Sinai Hospital, University of Toronto
Janice M. Pogue
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care
Morris Freedman*
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care Behavioral Neurology Program, Baycrest Hospital Division of Neurology, Mount Sinai Hospital, University of Toronto
*
Baycrest Hospital, Room 4W36, 3560 Bathurst Street, Toronto, Ontario, Canada M6A 2E1
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Abstract:

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99mTc-HM-PAO single photon emission computed tomography (SPECT) was used to image 30 patients referred for the assessment of dementia. SPECT images revealed various patterns of regional cerebral perfusion (rCBF) in the subgroups of patients with the clinical diagnoses of Alzheimer's disease (AD, n = 14), Pick's disease (n = 1), and multi-infarct dementia (n = 7). In three patients, SPECT clarified the clinical differential diagnostic possibilities. Using a relative rCBF quantification technique, the relationship between specific cognitive impairments and rCBF in the AD patients was determined. There was a significant correlation between language impairment and left hemisphere hypoperfusion, whereas, apraxia correlated with hypoperfusion in the left parietal region. Thus, HMPAO SPECT is useful as an aid in the differential diagnosis of dementia and the technique of relative rCBF quantification with SPECT may contribute to the understanding of the clinico-anatomical relations of cognitive deficits in dementia.

Résumé:

RÉSUMÉ:

Nous avons utilisé la tomographie à émetteur gamma au 99mTc-HM-PAO (SPECT) pour investiguer 30 patients référés pour évaluation d'une démence. L'imagerie par le SPECT a montré différents schémas de perfusion cérébrale régionale (rCBF) chez des sous-groupes de patients avec un diagnostic clinique de maladie d'Alzheimer (AD, n = 14), maladie de Pick (n = 1) et démence par infarctus multiples (n = 7). Chez trois patients, le SPECT a clarifié les possibilités quant au diagnostic différentiel. Au moyen d'une technique de quantification relative de la rCBF, nous avons déterminé quelle est la relation entre des altérations cognitives spécifiques et la rCBF chez les patients porteurs d'une maladie d'Alzheimer. Il y avait une corrélation significative entre l'altération du langage et Γ hypoperfusion de l'hémisphère gauche, alors que l'apraxie était corrélée à Γ hypoperfusion de la région pariétale gauche. Le SPECT par HM-PAO aide au diagnostic différentiel de la démence et la technique de quantification relative de la rCBF au moyen du SPECT peut contribuer à la compréhension des relations clinico-anatomiques des déficits cognitifs dans la démence.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue 2 , May 1994 , pp. 104 - 111
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

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