Staff R T, Venneri A, Gemmell H G, Shanks M F, Pestell S J, Murray A D
Department of Bio-Medical Physics and Bio-Engineering, University of Aberdeen and Aberdeen Royal Infirmary, Foresterhill, Scotland, United Kingdom.
J Nucl Med. 2000 Sep;41(9):1451-5.
Delusional behavior and thinking are common symptoms in Alzheimer's disease (AD). In the past, these delusions have been considered to be psychotic complications of global neurologic dysfunction. Recently, authors have suggested that content-specific delusions in AD are associated with discrete regional abnormalities of the right hemisphere.
This study compared 99mTc-hexamethyl propyleneamine oxime (HMPAO) SPECT images of a group of AD patients with a similar autobiographic delusion with a group of AD patients without delusions and a group of AD patients with a range of delusions but without autobiographic content. The reconstructed SPECT data were compared using a statistical parametric mapping technique.
The autobiographic AD group had a significant area of hypoperfusion in the right frontal lobe when compared with the 2 other groups. The area of hypoperfusion included parts of Brodmann's areas 9 and 10. Region 9 has been identified previously as having a role in episodic memory retrieval.
This result suggests that autobiographic delusions in AD may have an identifiable neuropsychologic mechanism and that it may be possible to identify an organic cause in some patients using 99mTc-HMPAO SPECT.
妄想行为和思维是阿尔茨海默病（AD）的常见症状。过去，这些妄想被认为是整体神经功能障碍的精神并发症。最近，有作者提出AD中特定内容的妄想与右半球离散区域异常有关。
本研究比较了一组患有类似自传性妄想的AD患者、一组无妄想的AD患者以及一组有一系列妄想但无自传内容的AD患者的99m锝-六甲基丙烯胺肟（HMPAO）单光子发射计算机断层扫描（SPECT）图像。使用统计参数映射技术比较重建的SPECT数据。
与其他两组相比，自传性AD组右额叶有一个明显的灌注不足区域。灌注不足区域包括布罗德曼9区和10区的部分区域。9区先前已被确定在情景记忆检索中起作用。
该结果表明AD中的自传性妄想可能有可识别的神经心理学机制，并且使用99mTc-HMPAO SPECT有可能在一些患者中识别出器质性病因。
