Gungor Hulya Aydin, Yildiz Akin, Aydin Funda, Gungor Firat, Boz Adil, Ozkaynak Sibel
Akdeniz University, School of Medicine, Department of Neurology, 07070 Antalya, Turkey.
J Neurol Sci. 2005 Jul 15;234(1-2):47-53. doi: 10.1016/j.jns.2005.03.034.
We investigated whether brain SPECT findings show any differences between patients with mild and moderate Alzheimer's disease (AD) and to compare results with event related potentials (ERPs). Twenty-two patients with mild to moderate AD diagnosed according to NINCDS-ADRDA criteria and 10 age-matched control subjects were included in this prospective study. All subjects underwent ERP recordings and Tc-99m HMPAO brain SPECT study. Cortical perfusion index (CPI) was calculated as the ratio of cortical activity to the cerebellum activity. CPI was found to be statistically lower in bilaterally posterolateral temporal cortex and precuneus in the moderate AD compared to the control group. There was no statistically significant difference between the mild AD and control groups for CPI in any cortical areas. The mean P300 latency was statistically prolonged in the mild and moderate AD compared to the control group. In addition, in moderate AD P300 latency was longer than in mild AD. While the mean P300 amplitude was statistically reduced in moderate AD compared to the control and mild AD, there was no statistically significant difference between the mild AD and control groups. There was a strong negative correlation between P300 latency and CPI in the right and left precuneus in the moderate AD group. The present study suggested that Tc-99m HMPAO SPECT study is the more appropriate technique for patients with moderate AD rather than mild AD. Our results indicated that alterations in ERPs, especially prolongation of P300 latency could be a finding that occurred earlier than the deterioration in cerebral blood flow. We thought that precuneus is closely related to cognitive function and may have an important role in the pathophysiology of AD.
我们研究了轻度和中度阿尔茨海默病（AD）患者的脑单光子发射计算机断层扫描（SPECT）结果是否存在差异，并将结果与事件相关电位（ERP）进行比较。本前瞻性研究纳入了22例根据美国国立神经疾病和中风研究所-阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）标准诊断为轻度至中度AD的患者以及10名年龄匹配的对照受试者。所有受试者均接受了ERP记录和锝-99m六甲基丙烯胺肟（Tc-99m HMPAO）脑SPECT研究。皮质灌注指数（CPI）计算为皮质活动与小脑活动的比值。结果发现，与对照组相比，中度AD患者双侧后外侧颞叶皮质和楔前叶的CPI在统计学上较低。在任何皮质区域，轻度AD组和对照组之间的CPI均无统计学显著差异。与对照组相比，轻度和中度AD患者的平均P300潜伏期在统计学上延长。此外，中度AD患者的P300潜伏期比轻度AD患者更长。与对照组和轻度AD相比，中度AD患者的平均P300波幅在统计学上降低，而轻度AD组和对照组之间无统计学显著差异。在中度AD组中，右侧和左侧楔前叶的P300潜伏期与CPI之间存在强烈的负相关。本研究表明，Tc-99m HMPAO SPECT研究对中度AD患者比对轻度AD患者更适用。我们的结果表明，ERP的改变，尤其是P300潜伏期延长可能是比脑血流恶化更早出现的发现。我们认为楔前叶与认知功能密切相关，可能在AD的病理生理学中起重要作用。
