Measurement of temporal regional cerebral perfusion with single-photon emission tomography predicts rate of decline in language function and survival in early Alzheimer's disease

被引:11
作者
Claus, JJ
Walstra, GJM
Hijdra, A
Van Royen, EA
Verbeeten, B
van Gool, WA
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Neurol, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Nucl Med, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands
关键词
regional cerebral blood flow; cognitive decline; survival; Alzheimer's disease;
D O I
10.1007/s002590050387
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
We determined the relationship between regional cerebral blood flow (rCBF) measured with single-photon emission tomography (SPET) and decline in cognitive function and survival in Alzheimer's disease. In a prospective follow-up study, 69 consecutively referred patients with early probable Alzheimer's disease (NI-NCDS/ADRDA criteria) underwent SPET performed at the time of initial diagnosis using technetium-99m-labelled hexamethylpropylene amine oxime. Neuropsychological function was assessed at baseline and after 6 months and survival data were available on all patients, extending to 5.5 years of follow-up. Lower left temporal (P < 0.01) and lower left parietal (P < 0.01) rCBF were statistically significantly related to decline in language function after 6 months. The association between left temporal rCBF and survival was also statistically significant (P < 0.05) using Cox proportional hazards regression analysis. Performing analysis with quartiles of the distribution, we found a threshold effect for low left temporal rCBF (rCBF < 73.7%, P < 0.01) and high risk of mortality, In this lowest quartile, median survival time was 2.7 years (follow-up to 5.2 years), compared with 4.4 years in the other quartiles (follow-up to 5.5 years). Kaplan-Meier survival curves showed statistically significant (P < 0.05, log rank test) survival curves for the lowest versus other quartiles of left temporal rCBF All results were unaffected by adjustment for age, sex, dementia severity, duration of symptoms, education and ratings of local cortical atrophy. We conclude that left temporal rCBF predicts decline in language function and survival in patients with early probable Alzheimer's disease, with a threshold effect of low rCBF and high risk of mortality.
引用
收藏
页码:265 / 271
页数:7
相关论文
共 43 条
[31]   A STUDY OF REGIONAL CEREBRAL BLOOD-FLOW AND COGNITIVE PERFORMANCE IN ALZHEIMERS-DISEASE [J].
OBRIEN, JT ;
EAGGER, S ;
SYED, GMS ;
SAHAKIAN, BJ ;
LEVY, R .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1992, 55 (12) :1182-1187
[32]   MEMORY AND REGIONAL CEREBRAL BLOOD-FLOW IN MILDLY SYMPTOMATIC ALZHEIMERS-DISEASE [J].
REED, BR ;
JAGUST, WJ ;
SEAB, JP ;
OBER, BA .
NEUROLOGY, 1989, 39 (11) :1537-1539
[33]  
Roth M., 1988, CAMDEX CAMBRIDGE EXA
[34]   Brain infarction and the clinical expression of Alzheimer disease - The nun study [J].
Snowdon, DA ;
Greiner, LH ;
Mortimer, JA ;
Riley, KP ;
Greiner, PA ;
Markesbery, WR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (10) :813-817
[35]   Neuropsychological, psychiatric, and cerebral perfusion correlates of leukoaraiosis in Alzheimer's disease [J].
Starkstein, SE ;
Sabe, L ;
Vazquez, S ;
DiLorenzo, G ;
Martinez, A ;
Petracca, G ;
Teson, A ;
Chemerinski, E ;
Leiguarda, R .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1997, 63 (01) :66-73
[36]   Predicting time to nursing home care and death in individuals with Alzheimer disease [J].
Stern, Y ;
Tang, MX ;
Albert, MS ;
Brandt, J ;
Jacobs, DM ;
Bell, K ;
Marder, K ;
Sano, M ;
Devanand, D ;
Albert, SM ;
Bylsma, F ;
Tsai, WY .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (10) :806-812
[37]   INCREASED RISK OF MORTALITY IN ALZHEIMERS-DISEASE PATIENTS WITH MORE ADVANCED EDUCATIONAL AND OCCUPATIONAL ATTAINMENT [J].
STERN, Y ;
TANG, MX ;
DENARO, J ;
MAYEUX, R .
ANNALS OF NEUROLOGY, 1995, 37 (05) :590-595
[38]  
VANGOOL WA, 1995, J NEUROL, V242, P401
[39]   EVALUATION OF [I-123] BETA-CIT BINDING WITH SPECT IN CONTROLS, EARLY AND LATE PARKINSONS-DISEASE [J].
VERMEULEN, RJ ;
WOLTERS, RC ;
TISSINGH, G ;
BOOIJ, J ;
JANSSEN, AGM ;
HABRAKEN, J ;
SOKOLEBUSEMANN, E ;
STOOF, JC ;
VANROYEN, EA .
NUCLEAR MEDICINE AND BIOLOGY, 1995, 22 (08) :985-991
[40]   HETEROGENEITY OF NEOCORTICAL CEREBRAL BLOOD-FLOW DEFICITS IN DEMENTIA OF THE ALZHEIMER-TYPE - A [TC-99M]-D,L-HMPAO SPECT STUDY [J].
WALDEMAR, G ;
BRUHN, P ;
KRISTENSEN, M ;
JOHNSEN, A ;
PAULSON, OB ;
LASSEN, NA .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1994, 57 (03) :285-295