Niwa Fumitoshi, Kondo Masaki, Sakurada Kumi, Nakagawa Masanori, Imanishi Jiro, Mizuno Toshiki
Department of Neurology and Gerontology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.
Intern Med. 2016;55(24):3571-3578. doi: 10.2169/internalmedicine.55.6725. Epub 2016 Dec 15.
Objective Regional cerebral blood flow (rCBF) imaging with single-photon emission computed tomography (SPECT) is useful in the early diagnosis of dementia. We aimed to investigate the association between the rCBF and various domains related to the memory function in elderly subjects with subjective cognitive impairment (SCI). Methods Thirty-two subjects with SCI were included in the present study. Patients with dementia and mild cognitive impairment (MCI) were excluded based on the presence of logical memory impairment. N-isopropyl-p-[I]-iodoamphetamine SPECT was performed and Wechsler Memory Scale-Revised (WMS-R) was administered to all subjects (mean age, 68.4 years; average Mini-Mental State Examination score, 27.6). The SPECT results were analyzed using the easy Z-score imaging system and the voxel-based stereotactic extraction estimation method. Correlation analyses were performed to investigate the correlation between the mean positive Z-scores in the decrease of the rCBF and the WMS-R indices. Results The SPECT study indicated marked hypoperfusion in some areas, including the bilateral temporal areas, the caudate, and the thalamus, in these subjects in comparison to the normal database. The decrease in the rCBF that was observed in several regions, including the left precuneus and left inferior frontal gyrus (LIFG), showed a significant negative correlation with several indices of the memory function, particularly visual memory. Conclusion The regional hypoperfusion observed in the study using the voxel-based stereotactic extraction estimation method suggest that the regional cerebral dysfunction is associated with the memory function of patients with SCI, even though the subjects in the present study were cognitively intact. The correlation analysis with the WMS-R suggested the contribution of the LIFG to the memory function and indicated the significance of visual memory dysfunction in the neuropsychological assessment to determine the stage of SCI.
目的 采用单光子发射计算机断层扫描（SPECT）进行局部脑血流（rCBF）成像对痴呆的早期诊断很有用。我们旨在研究主观认知障碍（SCI）老年受试者的rCBF与记忆功能相关的各个领域之间的关联。方法 本研究纳入了32名SCI受试者。根据是否存在逻辑记忆障碍排除了痴呆和轻度认知障碍（MCI）患者。对所有受试者（平均年龄68.4岁；简易精神状态检查表平均得分27.6）进行了N-异丙基-p-[I]-碘安非他明SPECT检查，并实施了韦氏记忆量表修订版（WMS-R）测试。使用简易Z评分成像系统和基于体素的立体定向提取估计方法对SPECT结果进行分析。进行相关性分析以研究rCBF降低时平均阳性Z评分与WMS-R指标之间的相关性。结果 SPECT研究表明，与正常数据库相比，这些受试者的某些区域存在明显灌注不足，包括双侧颞叶区域、尾状核和丘脑。在包括左侧楔前叶和左侧额下回（LIFG）在内的几个区域观察到的rCBF降低与记忆功能的几个指标，特别是视觉记忆，呈显著负相关。结论 使用基于体素的立体定向提取估计方法进行的研究中观察到的局部灌注不足表明，即使本研究中的受试者认知功能完好，局部脑功能障碍也与SCI患者的记忆功能相关。与WMS-R的相关性分析表明LIFG对记忆功能有贡献，并表明视觉记忆功能障碍在神经心理学评估以确定SCI阶段中的重要性。
