Kotrla K J, Chacko R C, Harper R G, Jhingran S, Doody R
Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA.
Am J Psychiatry. 1995 Oct;152(10):1470-5. doi: 10.1176/ajp.152.10.1470.
This study examined whether psychosis in Alzheimer's disease is associated with cerebral perfusion patterns appreciable by single photon emission computed tomography (SPECT) scans.
All cooperative outpatients enrolled in an Alzheimer's disease research center with the diagnosis of probable Alzheimer's disease and a Clinical Dementia Rating of mild or moderate were interviewed with their primary caregivers. Current and past psychiatric functioning was assessed by using the Hamilton Depression Rating Scale, the Structured Clinical Interview for DSM-III-R, and the Behavioral Pathology in Alzheimer's Disease Rating Scale. Patients without premorbid psychosis received SPECT scans, and the scans of the patients with delusions or hallucinations (N = 30) were compared to the scans of patients without these symptoms (N = 16).
The patients with delusions (N = 29) had hypoperfusion of the left frontal lobe in relation to the right frontal lobe. The patients with hallucinations (N = 10) had hypoperfusion in the parietal lobe.
Psychotic patients with Alzheimer's disease had a pattern of cerebral blood flow deficits significantly different from that of nonpsychotic patients. This suggests that patterns of cerebral dysfunction may be expressed symptomatically as psychosis.
本研究旨在探讨阿尔茨海默病中的精神病症状是否与单光子发射计算机断层扫描（SPECT）可检测到的脑灌注模式相关。
所有参与阿尔茨海默病研究中心的合作门诊患者，其诊断为可能的阿尔茨海默病且临床痴呆评定为轻度或中度，均与其主要照顾者进行访谈。使用汉密尔顿抑郁评定量表、DSM-III-R结构化临床访谈和阿尔茨海默病行为病理学评定量表评估当前和过去的精神功能。无病前精神病的患者接受SPECT扫描，并将有妄想或幻觉的患者（N = 30）的扫描结果与无这些症状的患者（N = 16）的扫描结果进行比较。
有妄想的患者（N = 29）左额叶相对于右额叶灌注不足。有幻觉的患者（N = 10）顶叶灌注不足。
患有阿尔茨海默病的精神病患者的脑血流缺陷模式与非精神病患者显著不同。这表明脑功能障碍模式可能以精神病症状的形式表现出来。
