Ohnishi T, Hoshi H, Nagamachi S, Jinnouchi S, Flores L G, Futami S, Watanabe K
Department of Radiology, Miyazaki Medical College, Japan.
J Nucl Med. 1995 Jul;36(7):1163-9.
The purpose of this study is to clarify the changes of hippocampal perfusion in neuropsychiatric diseases, including dementia, compared with control subjects, and to correlate hippocampal perfusion with the dementia rating scale and the severity of memory disturbance in patients with these diseases.
A total of 45 right-handed patients were investigated (13 with dementia of Alzheimer type, 6 with multi-infarct dementia, 4 with progressive dementia with motor neuron disease (MND), 3 with transient global amnesia, 5 with other diseases and 14 control subjects). Regional cerebral blood flow (rCBF) in the parietal cortex and hippocampus was evaluated by high-resolution SPECT technique with HMPAO in all subjects.
The rCBF measurements in the bilateral parietal cortices and hippocampus were lower in dementia of Alzheimer type and multi-infarct dementia patients than in controls. Hypoperfusion in the hippocampus was a more sensitive marker than hypoperfusion in the parietal cortex in diagnosing dementia of Alzheimer type. Hippocampal hypoperfusion was observed in demented patients regardless of etiology and in patients having memory disturbance without dementia, such as transient global amnesia. Finally, hippocampal hypoperfusion reflected the severity of dementia and memory disturbance regardless of etiology.
The rCBF image with high-resolution SPECT system may be useful in assessing the extent of dementia and memory disturbance in patients with neuropsychiatric diseases.
本研究的目的是阐明与对照组相比，包括痴呆症在内的神经精神疾病中海马灌注的变化，并将海马灌注与这些疾病患者的痴呆评定量表及记忆障碍严重程度相关联。
共对45名右利手患者进行了研究（13例阿尔茨海默病型痴呆、6例多发梗死性痴呆、4例伴有运动神经元病（MND）的进行性痴呆、3例短暂性全面性遗忘症、5例其他疾病患者以及14名对照者）。所有受试者均采用高分辨率单光子发射计算机断层扫描（SPECT）技术及六甲基丙烯胺肟（HMPAO）评估顶叶皮质和海马的局部脑血流量（rCBF）。
阿尔茨海默病型痴呆和多发梗死性痴呆患者双侧顶叶皮质和海马的rCBF测量值低于对照组。在诊断阿尔茨海默病型痴呆时，海马灌注不足比顶叶皮质灌注不足是更敏感的指标。无论病因如何，痴呆患者以及无痴呆但有记忆障碍的患者，如短暂性全面性遗忘症患者，均观察到海马灌注不足。最后，无论病因如何，海马灌注不足均反映了痴呆和记忆障碍的严重程度。
高分辨率SPECT系统的rCBF图像可能有助于评估神经精神疾病患者的痴呆程度和记忆障碍。
