Decreased cerebral blood flow and prognosis of Alzheimer's disease: A multicenter HMPAO-SPECT study
Decreased cerebral blood flow and prognosis of Alzheimer's disease: A multicenter HMPAO-SPECT study
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DOI：
10.1007/bf03033995
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Kubo, Atsushi
中科院分区：
文献类型：
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作者：
Nishimura, Tsunehiko;Hashikawa, Kazuo;Kubo, Atsushi
目的：探讨脑灌注SPECT在评估阿尔茨海默病（AD）严重程度和进展中的价值。方法：84例AD患者。入院时，对所有84例患者进行tc -99m- hpao - spect、迷你精神状态检查（MMSE）、精神功能损害量表（MENFIS）和Raven彩色进展矩阵（RCPM）。在随访期间，34例患者进行了两次单独的MMSE评估，30例患者进行了两次MENFIS评估，20例患者进行了两次RCPM评估。根据SPECT 3D-SSP图像显示的脑血流减少区域，将病例分为A型（无血流减少）、B型（顶叶或颞叶血流减少）、C型（额叶和顶叶或颞叶血流减少）、Pc型（仅扣带回后血流减少）和“其他类型”。分析血流量减少的类型、神经心理评估评分和症状进展。结果：C型患者入院时MENFIS、MMSE和RCPM评分最低。在随访期间，这些评分的下降程度在c型中也最大。轻度AD患者（MMSE评分>= 24）的SPECT数据中，有和没有快速进展的患者之间差异最大的是额叶。结论：AD患者额叶血流量减少不仅与评估时认知功能下降有关，而且与随后临床病程中的快速进展有关。
Purpose: To determine the usefulness of brain perfusion SPECT for evaluating the severity and progression of Alzheimer's disease (AD). Methods: Eighty-four AD patients were included. At entry, Tc-99m-HMPAO-SPECT, the Mini Mental State Examination (MMSE), Mental Function Impairment Scale (MENFIS), and the Raven Colored Progression Matrix (RCPM) were performed for all 84 patients. During the follow-up periods, two individual MMSE evaluations in 34 patients, two MENFIS evaluations in 30 patients, and two RCPM evaluations in 20 patients were performed. Based on the regions of decreased cerebral blood flow demonstrated on 3D-SSP images of SPECT, the cases were classified as type A (no decrease), type B (decreased blood flow in the parietal or temporal lobe), type C (decreased blood flow in the frontal lobe and parietal or temporal lobe), type Pc (decreased blood flow in posterior cingulate gyrus only), and "other types". The types of decreased blood flow, scores on neuropsychological evaluations, and symptom progression were analyzed. Results: The MENFIS, MMSE, and RCPM scores were poorest in type C patients at entry. The degree of decrease of these scores during the follow-up periods was also greatest in type C. The greatest difference between patients with and without rapid progression in SPECT data of the mild AD patients (MMSE score >= 24) was in the frontal lobe. Conclusion: Decreased blood flow in the frontal lobe of AD patients is correlated not only with reduced cognitive function at the time of the evaluation but with rapid progression in the subsequent clinical course.