Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Day Clinic of Cognitive Neurology, University of Leipzig, 04103 Leipzig, Germany.
Psychiatry Res. 2011 Dec 30;194(3):235-244. doi: 10.1016/j.pscychresns.2011.06.009. Epub 2011 Oct 30.
Behavioral impairments occur frequently in dementia. Studies with magnetic resonance imaging, measuring atrophy, have systematically investigated their neural correlates. Such a systematic approach has not yet been applied to imaging with [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET), although regional hypometabolism may precede and exceed atrophy in dementia. The present study related all behavioral disorders as assessed with the Neuropsychiatric Inventory to reductions in brain glucose utilization as measured by FDG-PET with Statistical Parametric Mapping (SPM5). It included 54 subjects mainly with early Alzheimer's disease, frontotemporal lobar degeneration, and subjective cognitive impairment. Apathy, disinhibition and eating disorders - most frequent in frontotemporal lobar degeneration - correlated significantly with regional brain hypometabolism. Whereas a single regressor analysis and conjunction analysis revealed largely overlapping frontomedian regions that were associated with all three behavioral domains, a disjunction analysis identified three specific neural networks for each behavioral disorder, independent of dementia severity. Apathy was related to the ventral tegmental area, a component of the motivational dopaminergic network; disinhibition to both anterior temporal lobes including the anterior hippocampi and left amygdala, caudate head, orbitofrontal cortex and insulae; and eating disorders to the right lateral (orbito) frontal cortex/insula. Our study contributes to the understanding of behavioral deficits in early dementia and suggests specific diagnostic and therapeutic approaches.
行为障碍在痴呆症中经常发生。使用磁共振成像（MRI）测量萎缩的研究系统地研究了其神经相关性。尽管在痴呆症中，局部代谢减退可能先于并超过萎缩，但这种系统的方法尚未应用于[(18)F]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）成像。本研究将神经精神病学问卷评估的所有行为障碍与通过统计参数映射（SPM5）的 FDG-PET 测量的脑葡萄糖利用率降低相关联。它包括 54 名主要患有早期阿尔茨海默病、额颞叶变性和主观认知障碍的受试者。最常见于额颞叶变性的淡漠、抑制障碍和饮食障碍与区域脑代谢减退显著相关。虽然单一回归分析和联合分析揭示了与所有三个行为领域相关的前中脑区域重叠，但分离分析确定了每种行为障碍的三个特定神经网络，与痴呆严重程度无关。淡漠与腹侧被盖区有关，这是动机多巴胺能网络的一部分；抑制障碍与包括前海马在内的两个前颞叶、尾状核头部、眶额皮质和岛叶有关；而饮食障碍与右侧外侧（眶额）皮质/岛叶有关。我们的研究有助于理解早期痴呆症中的行为缺陷，并提出了特定的诊断和治疗方法。
