Kitamura S, Araki T, Sakamoto S, Iio M, Terashi A
Second Department of Internal Medicine, Nippon Medical School.
Rinsho Shinkeigaku. 1990 Nov;30(11):1171-5.
This study was designed to investigate the differences in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) between patients with dementia of frontal lobe type and patients with Alzheimer's disease. Positron emission tomography (PET) using 15O steady state inhalation technique was carried out in 5 patients with a clinical diagnosis of dementia of frontal lobe type and 7 patients with a clinical diagnosis of Alzheimer's disease. CBF and CMRO2 were significantly decreased in the frontal cortex except for precentral region in patients with dementia of frontal lobe type in comparison to those values in patients with Alzheimer's disease. However, in patients with dementia of frontal lobe type CBF and CMRO2 in the parietal cortex and the occipital cortex were relatively preserved when compared with patients with Alzheimer's disease. In comparison with values for CBF and CMRO2 in the posterior part of brain [frontal or temporal/(parietal + occipital)/2 ratio], both values in the frontal cortex were markedly decreased in all 5 patients with dementia of frontal lobe type, but there was no marked reduction in the frontal cortex in patients with Alzheimer's disease. In addition, in 2 patients with dementia of frontal lobe type whose duration of the disease was more than 7 years, CBF and CMRO2 in the temporal cortex were markedly reduced in comparison with values in the posterior part of brain. These results suggested that PET findings of marked reduction in CBF and CMRO2 in the frontal cortex are useful to distinguish dementia of frontal lobe type from Alzheimer's disease.
本研究旨在调查额叶型痴呆患者与阿尔茨海默病患者之间脑血流量（CBF）和脑氧代谢率（CMRO2）的差异。对5例临床诊断为额叶型痴呆的患者和7例临床诊断为阿尔茨海默病的患者进行了使用15O稳态吸入技术的正电子发射断层扫描（PET）。与阿尔茨海默病患者相比，额叶型痴呆患者额叶皮质（中央前回区域除外）的CBF和CMRO2显著降低。然而，与阿尔茨海默病患者相比，额叶型痴呆患者顶叶皮质和枕叶皮质的CBF和CMRO2相对保留。与脑后部的CBF和CMRO2值[额叶或颞叶/（顶叶+枕叶）/2比值]相比，所有5例额叶型痴呆患者额叶皮质的这两个值均显著降低，但阿尔茨海默病患者额叶皮质无明显降低。此外，在2例病程超过7年的额叶型痴呆患者中，颞叶皮质的CBF和CMRO2与脑后部的值相比明显降低。这些结果表明，额叶皮质CBF和CMRO2明显降低的PET表现有助于区分额叶型痴呆与阿尔茨海默病。
