DELUSIONS AND CEREBRAL METABOLISM IN ALZHEIMERS DISEASE

这是一个项目的修改后的应用程序， 阿尔茨海默病妄想的病理生理基础 疾病（AD）。AD患者中， 对行为障碍和其他 疾病的病态方面。尽管人们越来越认识到 非认知症状在AD中的重要性 妄想症还不太清楚拟议项目衡量了 妄想与脑局部功能的关系 患者在治疗前和治疗后。两 初步数据支持的假设进行了测试： AD患者，妄想性思维与减少 额叶皮层特定分区的代谢率。这 这种关系在所有治疗条件下都是一致的。与 抗精神病药治疗AD妄想的临床改善 妄想性思维与前额叶代谢率相关 接受治疗Toe检验这些假设，AD患者（伴和 没有妄想症）进行结构化评估，以衡量 妄想严重程度与18F-氟脱氧葡萄糖正电子 发射断层扫描（PET）测量整体代谢率 额叶皮层，在额叶皮层的子区域，以及在其他区域， 大脑区域患有妄想症的患者， 氟哌啶醇5周。结构化临床评估和PET 在治疗期后重复成像。的关系 妄想症和皮质代谢之间的联系， 预处理和后处理条件，使用先进的 神经影像分析技术。大脑代谢相关 临床反应（或治疗）也进行了探讨。的结果 这项研究将提高对神经生物学的理解， AD的临床症状和治疗反应。本工程采用 先进的研究技术，以一个重要的临床问题。博士 大卫苏尔茨，首席研究员在拟议的项目， 目前正在完成为期5年的NIMH临床心理健康 老年精神病学学术奖。在授标期间， 加州大学洛杉矶分校，他已经开发了相当大的技能，在评估 AD的非认知症状和PET成像，

This is the revised application for a project that examines the pathophysiologic basis for delusional thought in Alzheimer's disease (AD). Delusions are common in patients with AD and contribute substantially to behavioral disturbances and other morbid aspects of the illness. Despite increased recognition of the importance of noncognitive symptoms in AD, the neurobiology Of delusions is not well understood. The proposed project measures the relationship between delusions and regional brain function in patients both before and after a treatment intervention. Two hypotheses, supported by preliminary data, are tested: Among patients with AD, delusional thought is associated with reduced metabolic rate in specific subregions of the frontal cortex. This relationship is consistent across treatment conditions. With neuroleptic treatment for delusions in AD, clinical improvement in delusional thought is associated with frontal metabolic rate prior to treatment. Toe test these hypotheses, patients with AD (with and without delusions) undergo structured assessment to measure the severity of delusional thought and 18F-fluorodeoxyglucose positron emission tomography (PET) to measure metabolic rate in the whole frontal cortex, in subregions of the frontal cortex, and in other brain areas. Patients with delusions are then treated with haloperidol for 5 weeks. The structured clinical assessment and PET imaging are repeated after the treatment period. The relationship between delusions and cortical metabolism is examined in the pretreatment and posttreatment conditions, using sophisticated neuroimage analysis techniques. The cerebral metabolic correlates of clinical response (o treatment are also explored. The results of the study will improve understanding of the neurobiology of clinical symptoms and treatment response in AD. The project applies advanced research techniques to an important clinical problem. Dr. David Sultzer, the Principal investigator in the proposed project, is currently completing the 5-year NIMH Clinical Mental Health Academic Award in Geriatric Psychiatry. During the award period at UCLA, he has developed considerable skills in the assessment of noncognitive symptoms and PET imaging in AD that will