A comparison of 99mTc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping
A comparison of 99mTc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping
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DOI：
10.1007/s00259-002-0778-5
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发表时间：
2002-05-01
影响因子：
9.1
通讯作者：
O'Brien, JT
中科院分区：
文献类型：
--
作者：
Colloby, SJ;Fenwick, JD;O'Brien, JT
应用统计参数图（SPM 99）研究了阿尔茨海默病（AD）、路易体痴呆（DLB）和健康志愿者局部脑血流量（rCBF）的差异。48名AD、23名DLB和20名年龄匹配的对照受试者参加了研究。使用单头旋转伽马照相机（IGE CamStar XR/T）采集每个受试者的锝-99 m六甲基丙烯胺肟（HMPAO）脑单光子发射断层扫描（SPET）。SPET图像进行空间标准化，并通过SPM 99进行组间比较。此外，以简易精神状态检查（MMSE）评分为变量，对标准化图像进行协变量分析。应用P小于或等于0.001的未校正的高度阈值，与对照组相比，在AD和DLB组中均观察到大脑顶叶和额叶区域的显著灌注缺损。此外，显着的颞顶灌注赤字被确定在AD受试者，而DLB患者有赤字的枕区。痴呆组的比较（高度阈值P小于或等于0.01，未校正）显示，与AD相比，DLB患者的顶叶[Brodmann区（BA）7]和枕叶（BA 17，18）区域均出现灌注不足。这些区域包括视觉皮层和涉及高级视觉处理和视觉空间功能的几个区域，在理解DLB的特征性幻视和视觉空间缺陷方面可能是重要的。协变量分析表明，AD和DLB之间的认知测试得分和颞顶血流量之间的正相关性的组差异。总之，我们发现AD和DLB的额叶和顶叶灌注不足的证据，而颞叶灌注不足仅见于AD和DLB的顶叶-枕叶缺陷。
Differences in regional cerebral blood flow (rCBF) between subjects with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and healthy volunteers were investigated using statistical parametric mapping (SPM99). Forty-eight AD, 23 DLB and 20 age-matched control subjects participated. Technetium-99m hexamethylpropylene amine oxime (HMPAO) brain single-photon emission tomography (SPET) scans were acquired for each subject using a single-headed rotating gamma camera (IGE CamStar XR/T). The SPET images were spatially normalised and group comparison was performed by SPM99. In addition, covariate analysis was undertaken on the standardised images taking the Mini Mental State Examination (MMSE) scores as a variable. Applying a height threshold of Pless than or equal to0.001 uncorrected, significant perfusion deficits in the parietal and frontal regions of the brain were observed in both AD and DLB groups compared with the control subjects. In addition, significant temporoparietal perfusion deficits were identified in the AD subjects, whereas the DLB patients had deficits in the occipital region. Comparison of dementia groups (height threshold of Pless than or equal to0.01 uncorrected) yielded hypoperfusion in both the parietal [Brodmann area (BA) 7] and occipital (BA 17, 18) regions of the brain in DLB compared with AD. Abnormalities in these areas, which included visual cortex and several areas involved in higher visual processing and visuospatial function, may be important in understanding the visual hallucinations and visuospatial deficits which are characteristic of DLB. Covariate analysis indicated group differences between AD and DLB in terms of a positive correlation between cognitive test score and temporoparietal blood flow. In conclusion, we found evidence of frontal and parietal hypoperfusion in both AD and DLB, while temporal perfusion deficits were observed exclusively in AD and parieto-occipital deficits in DLB.