L C Campbell Cognitive Neurology Research Unit, Neuroscience Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Neurobiol Aging. 2012 Jan;33(1):53-60. doi: 10.1016/j.neurobiolaging.2010.02.001. Epub 2010 Mar 31.
Instrumental activities of daily living (IADL) includes the integration of task-initiation, -planning, and -performance. Little is known on the cerebral perfusion correlates of these subcomponents of IADL in Alzheimer's disease (AD). In 121 AD patients, cerebral perfusion, using single-photon emission computed tomography, in 13 bilateral regions of interest (ROI) and the perfusion correlates of IADL subcomponents, rated on the Disability Assessment in Dementia scale, were explored. Significant correlations were observed between IADL initiation and multiple bilateral prefrontal-striatal-anterior cingulate ROI (p < 0.01), IADL planning and right occipital ROI (p < 0.05), and IADL performance and right parietal ROI (p < 0.05). Multiple regression, accounting for age, cognitive impairment, and depression severity, revealed significant relationship between right basal ganglia perfusion and IADL-initiation (R = 0.6, R(2) = 0.39, F(4,117) = 17.8, SE = 1.56; p < 0.001) and right occipital perfusion and IADL-planning (R = 0.6, R(2) = 0.34, F(4,117) = 19.5, SE = 1.47; p < 0.001). In AD, perfusion correlates of these subcomponents may be linked to the heterogenous cognitive processes involved in IADL.
工具性日常生活活动（IADL）包括任务启动、计划和执行的整合。关于这些 IADL 亚成分在阿尔茨海默病（AD）中的大脑灌注相关性知之甚少。在 121 名 AD 患者中，使用单光子发射计算机断层扫描（SPECT）在 13 个双侧感兴趣区域（ROI）中探索了大脑灌注以及在痴呆残疾评估量表上评定的 IADL 亚成分的灌注相关性。IADL 启动与多个双侧前额叶-纹状体-前扣带回 ROI 之间存在显著相关性（p<0.01），IADL 计划与右侧枕叶 ROI 之间存在显著相关性（p<0.05），IADL 执行与右侧顶叶 ROI 之间存在显著相关性（p<0.05）。多元回归，考虑到年龄、认知障碍和抑郁严重程度，显示右侧基底节灌注与 IADL 启动之间存在显著关系（R=0.6，R²=0.39，F（4,117）=17.8，SE=1.56；p<0.001），右侧枕叶灌注与 IADL 计划之间存在显著关系（R=0.6，R²=0.34，F（4,117）=19.5，SE=1.47；p<0.001）。在 AD 中，这些亚成分的灌注相关性可能与 IADL 中涉及的异质认知过程有关。
