Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece.
Nuclear Medicine Department, "Alexandra" General Hospital, Athens, Greece.
Int J Psychiatry Clin Pract. 2022 Mar;26(1):14-22. doi: 10.1080/13651501.2020.1846752. Epub 2020 Nov 18.
To explore differences of apathy perfusion correlates between Alzheimer's disease (AD) and Frontotemporal dementia (FTD) using perfusion SPECT.
We studied 75 FTD and 66 AD patients. We evaluated apathy using Neuropsychiatric Inventory (NPI). We compared perfusion of BAs on left (L) and right (R) hemisphere in AD and FTD.
Apathy in AD was significantly and negatively correlated with dorsolateral prefrontal cortex bilaterally, right anterior prefrontal cortex, inferior frontal cortex bilaterally, especially on the right, orbital part of inferior frontal gyrus bilaterally, left dorsal anterior cingulate cortex, right primary and secondary visual cortex, and with bilateral anterior and dorsolateral prefrontal cortex, inferior frontal cortex and orbital part of inferior frontal gyrus, bilaterally, bilateral anterior -ventral and dorsal- cingulate cortex, left posterior ventral cingulate cortex, right inferior, middle and anterior temporal gyri, entorhinal and parahippocampal cortex in FTD.
Significant overlapping of apathy perfusion correlates between AD and FTD is seen in frontal areas and anterior cingulate. Right occipital cortex is also involved in AD, while right temporal cortex and left posterior cingulate are involved in FTD. Nuclear imaging could be a useful biomarker for revealing apathy underlying mechanisms, resulting in directed treatments.KEYPOINTSUnderlying neural networks and clinical manifestation of apathy may differ between AD and FTD.Apathy in AD is correlated with hypoperfusion in bilateral frontal areas, more prominent on the right, left anterior cingulate and right occipital cortex.Apathy in FTD is correlated with hypoperfusion in bilateral frontal areas, bilateral anterior cingulate, left posterior cingulate and right temporal cortex.Brain perfusion SPECT with automated BAs analysis and comparison with normal healthy subjects may provide significant information for apathy mechanisms in neurodegenerative disorders, affecting patients' treatment.
利用灌注 SPECT 探讨阿尔茨海默病（AD）和额颞叶痴呆（FTD）患者淡漠的灌注相关性差异。
我们研究了 75 例 FTD 患者和 66 例 AD 患者。我们使用神经精神问卷（NPI）评估淡漠。我们比较了 AD 和 FTD 患者左侧（L）和右侧（R）半球 BA 的灌注情况。
AD 患者的淡漠与双侧背外侧前额叶皮质、右侧额前皮质、双侧额下回、右侧眶部额下回、双侧左侧背侧前扣带回皮质、右侧初级和次级视觉皮质显著负相关，与双侧额前皮质、额下回和眶部额下回、双侧额前腹侧和背侧扣带回、左侧后腹侧扣带回、右侧颞下回、中颞回和前颞回、内嗅皮质和海马旁皮质显著相关。
AD 和 FTD 患者的淡漠灌注相关性存在显著重叠，主要位于额叶和前扣带回。右侧枕叶皮质也与 AD 有关，而右侧颞叶皮质和左侧后扣带回与 FTD 有关。核成像可能是揭示淡漠潜在机制的有用生物标志物，从而实现有针对性的治疗。
AD 和 FTD 患者淡漠的潜在神经网络和临床表现可能不同。AD 患者的淡漠与双侧额叶、右侧更明显、左侧前扣带回和右侧枕叶皮质灌注不足相关。FTD 患者的淡漠与双侧额叶、双侧前扣带回、左侧后扣带回和右侧颞叶皮质灌注不足相关。使用自动 BA 分析和与正常健康受试者比较的脑灌注 SPECT 可能为神经退行性疾病的淡漠机制提供重要信息，从而影响患者的治疗。
Zotero 插件