Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.
Psychogeriatrics. 2012 Sep;12(3):200-10. doi: 10.1111/j.1479-8301.2012.00427.x.
Previous findings on neural correlates of delusion in Alzheimer's disease (AD) have been inconsistent because of methodological issues, such as treating multiple delusions as a single entity. In this retrospective study, we classified AD delusions and investigated their neural correlates by using single-photon emission computed tomography data.
We selected AD patients with delusions from our consecutive outpatients from 2004 to 2010. In this study, eight types of delusions were evaluated with Neuropsychiatric Inventory and classified by factor analysis. Twenty-five of the patients also had single-photon emission computed tomography data, which we used to assess the relationships between cerebral regions of hypoperfusion and hyperperfusion and each classified delusion. The relations were assessed using Statistical Parametric Mapping with normalization to the white matter cerebral blood flow.
The delusions were classified into three factors. Factor 1 consisted of a belief that his/her house is not his/her home, phantom boarder symptom, delusion of abandonment, and belief that one's spouse or others are not who they claim to be. Factor 1 was related to hypoperfusion in the right temporal pole and hyperperfusion in the medial frontal and precentral regions. Factor 2 consisted of delusion relating to the television and delusion of persecution. Factor 2 was related to hypoperfusion in the precuneus and hyperperfusion in the insula and thalamus. Factor 3 consisted of delusion of abandonment and delusional jealousy. Factor 3 was related to hypoperfusion in the right inferior temporal and frontal regions and hyperperfusion in the middle frontal gyrus, insula and posterior cingulate gyrus. Delusion of theft was not included in any factors, and it was related to hypoperfusion in the bilateral thalami and left posterior cingulate gyrus and hyperperfusion in the left inferior frontal regions and anterior cingulate gyrus.
Delusions in AD were classifiable, and each classified delusion was related to different neural networks.
由于方法学问题，如将多种妄想视为单一实体，先前关于阿尔茨海默病（AD）妄想的神经相关性研究结果并不一致。在这项回顾性研究中，我们通过单光子发射计算机断层扫描数据对 AD 患者的妄想进行分类，并研究其神经相关性。
我们从 2004 年至 2010 年连续的门诊患者中选择有妄想的 AD 患者。在这项研究中，使用神经精神疾病问卷评估了 8 种类型的妄想，并通过因子分析进行分类。其中 25 例患者还进行了单光子发射计算机断层扫描，我们用它来评估灌注不足和灌注过度的脑区与每种分类妄想之间的关系。使用归一化为白质脑血流的统计参数映射来评估关系。
妄想分为三个因素。因素 1 包括认为自己的家不是自己的家、幻影房客症状、被遗弃妄想和认为自己的配偶或其他人不是他们声称的人。因子 1 与右侧颞极灌注不足和内侧额极和中央前区灌注过度有关。因素 2 由与电视有关的妄想和迫害妄想组成。因子 2 与楔前叶灌注不足和岛叶和丘脑灌注过度有关。因素 3 由被遗弃妄想和妄想嫉妒组成。因子 3 与右侧颞下和额区灌注不足和中额回、岛叶和后扣带回灌注过度有关。妄想偷窃没有归入任何因子，与双侧丘脑和左后扣带回灌注不足以及左额下回和前扣带回灌注过度有关。
AD 患者的妄想是可分类的，每种分类妄想都与不同的神经网络有关。
