Department of Psychiatry, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, 299-0111, Japan.
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
J Neural Transm (Vienna). 2017 Sep;124(9):1109-1121. doi: 10.1007/s00702-017-1734-7. Epub 2017 May 16.
The aim of this study was to examine brain hypoperfusion and its relationship with cognitive dysfunction in late-onset Alzheimer's disease (AD). Forty patients with late-onset AD and not receiving acetylcholinesterase inhibitors were recruited from outpatient clinics. We examined cognitive function using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and brain perfusion using single-photon emission computed tomography, and analyzed classified gyrus level segments with three-dimensional stereotactic surface projection and the stereotactic extraction estimation method level 3. ADAS-cog subscales were grouped into three domains: language, memory, and praxis. Patients with late-onset AD showed an apparent reduction in regional cerebral blood flow (rCBF) with a z score >1.5 in the frontal, temporal, and limbic lobes, with lesser reduction in the parietal and occipital lobes. Although hypoperfusion in the orbital, rectal, and subcallosal gyri of the frontal lobe was prominent, rCBF in the inferior frontal gyrus of the frontal lobe was significantly correlated with ADAS-cog total and language and praxis subscale scores. The parahippocampal gyrus of the limbic lobe was also significantly correlated with the ADAS-cog total, language, and praxis subscale scores. Additionally, the cingulate of the limbic lobe was significantly related with ADAS-cog memory. In spite of lesser hypoperfusion, the posterior cingulate gyrus of the limbic lobe was significantly related with ADAS-cog total, language, and memory subscale scores. Further, each subdivision of ADAS-cog was found to be related with various brain regions.
本研究旨在探讨晚发性阿尔茨海默病（AD）患者脑灌注不足及其与认知功能障碍的关系。从门诊招募了 40 名未接受乙酰胆碱酯酶抑制剂治疗的晚发性 AD 患者。我们使用阿尔茨海默病评估量表认知子量表（ADAS-cog）评估认知功能，使用单光子发射计算机断层扫描评估脑灌注，并使用三维立体定向表面投影和立体定向提取估计方法 3 级分析分类脑回水平节段。ADAS-cog 子量表分为语言、记忆和动作三个领域。晚发性 AD 患者表现出明显的区域性脑血流（rCBF）减少，额、颞和边缘叶的 z 分数>1.5，顶叶和枕叶的减少较少。虽然额叶眶回、直肠回和胼胝下回的灌注明显减少，但额叶下额回的 rCBF 与 ADAS-cog 总分以及语言和动作子量表评分显著相关。边缘叶的海马旁回也与 ADAS-cog 总分、语言和动作子量表评分显著相关。此外，边缘叶的扣带回与 ADAS-cog 记忆也有显著关系。尽管灌注减少较少，但边缘叶的后扣带回与 ADAS-cog 总分、语言和记忆子量表评分显著相关。此外，ADAS-cog 的每个细分都与不同的大脑区域有关。
