Comparison between cerebral glucose metabolism and late evoked potentials in patients with Alzhemmer's disease (original) (raw)

1989

Abstract

Patients with dementia of the Alzheimer type (DAT) have been studied with many brain imaging procedures. The results demonstrated the superiority of Positron Emission Tomography (PET) over structural imaging in the separation of DAT patients and controls. The P 300 being another functional parameter is also reported to be highly specific and sensitive in dementia. We present the preliminary results of an ongoing 2-year-prospective study. The first 17 consecutive patients (13 females, 4 males; mean age 66, range 52-76 years) with probable Alzheimer's disease using NINCDS-ADRDA criteria were examined. Based upon the 7point Global Deterioration Scale (GDS), the severity ranged from mild to moderate (GDS 3-6). The regional cerebral glucose metabolism (rCMRGlu) was studied with 18 F-2-fluoro2-deoxyglucose and PET. Standardized regional quantitation was achieved using an interactive mapping program. The P 300 was elicited within a two-tone auditory "oddball" paradigm according to Maurer et al. using a Biologic Brain Atlas System III. Two identical runs were presented. Amplitude, latency and spatial distribution of P 300 were analyzed in comparison with an age matched control group. 16 patients showed a pattern of rCMRGlu which is supposed to be typical for Alzheimer's disease: a predominantly regional hypometabolism in the posterior parietal and temporal cortex. In one patient there was the main decrease of glucose utilization in the frontal association area. The overall reduction of global metabolism was 9%. The P 300 showed a considerable variability of all parameters not only inter- but also intraindividually regardless of the severity of the dementia. A possible explanation for the discrepancy of PET and P 300 might be the influence of the affective state of the patients (anxiety, tension, uneasiness) on the P 300 component.

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