DELUSIONS AND CEREBRAL METABOLISM IN ALZHEIMERS DISEASE

这是一个项目的修订申请，该项目审查 阿尔茨海默病妄想的病理生理学基础 疾病(AD)。妄想症在AD患者中很常见， 在很大程度上会导致行为障碍和其他 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，神经生物学 妄想症并没有得到很好的理解。拟议的项目衡量了 妄想症与脑局部功能的关系 患者在治疗前和治疗后进行干预。二 初步数据支持的假设得到了检验： 阿尔茨海默病患者妄想性思维减少 额叶皮质特定亚区的代谢率。这 这种关系在不同的治疗条件下是一致的。使用 抗精神病药治疗阿尔茨海默病的临床疗效 妄想性思维与额叶代谢率相关 去接受治疗。TOE测试这些假设，AD患者(有和 无妄想症)接受结构化评估以测量 妄想症的严重性与18F-脱氧葡萄糖正电子 放射性体层摄影术(PET)测量整体代谢率 额叶皮质，在额叶皮质的亚区，以及在其他 大脑区域。有妄想症的患者随后会接受 氟哌啶醇治疗5周。结构化临床评估与PET 治疗结束后，重复进行影像检查。两国关系 妄想症和皮质新陈代谢之间的关系 前处理和后处理条件，使用精密的 神经影像分析技术。大脑新陈代谢与 临床反应(O)的治疗也进行了探讨。结果是 这项研究将提高对脑出血患者神经生物学的理解。 阿尔茨海默病的临床症状和治疗反应。该项目适用于 先进的研究技术来解决一个重要的临床问题。Dr。 大卫·苏尔策，拟议项目的首席调查员， 目前正在完成为期5年的NIMH临床精神健康 老年精神病学学术奖。在授权期内 在加州大学洛杉矶分校工作期间，他在评估 阿尔茨海默病患者的非认知症状和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