Role of single photon emission computerized tomography ( SPECT ) in diagnosis of early cognitive impairment in the elderly (original) (raw)
Related papers
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006
OBJECTIVE The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Technitium L, L-ethyl cysteinate dimer Single Photon Emission Computer Tomography (99-Tc ECD SPECT) between mild and moderate to severe dementia. MATERIAL AND METHOD The authors reported a retrospective study in the Memory Clinic, Siriraj Hospital between January 2001 and October 2003 including only patients with Alzheimer's disease, vascular dementia, and mixed dementia. Clinical dementia rating (CDR) was used to document dementia severity. Patterns of hypoperfusion were classified into no definite hypoperfusion, regional hypoperfusion, and diffused hypoperfusion. RESULTS One hundred and seven patients were included in the present study. Only mean Thai Mental State Examination (TMSE) score was different between the two groups. There was no significant correlation between pattern of hypoperfusion in brain SPECT and severity of dementia. CONCLUSION The authors cannot demonstrate t...
SPECT Predictors of Cognitive Decline and Alzheimer's Disease in Mild Cognitive Impairment
Journal of Alzheimers Disease, 2009
Baseline brain single photon emission computed tomography (SPECT) was evaluated in eighty subjects with mild cognitive impairment (MCI) who were followed for a mean of about two years, when twelve patients developed Alzheimer's disease (AD), nineteen showed memory decline (D), and forty-three had normal cognition assessment (stable: S) (six drop-out). Volumetric Regions of Interest (VROI) analysis was performed in six associative cortical areas in each hemisphere. ANOVA for repeated measures showed significant effects for both the group (S, D, and AD; p < 0.004) and VROI (p < 0.0001) factors, with significant group*region interaction (p < 0.01). At post-hoc comparison, hippocampal VROIs values were lower in AD than in D and S, while parietal VROIs values were lower in D and AD than in S. These four VROI significantly correlated with verbal delayed recall score at follow-up visit. Receiver operating characteristic (ROC) curves for the mean hippocampal VROI value showed 0.81 sensitivity with 0.86 specificity in separation of S+D from AD (p < 0.0001), and 0.69 sensitivity with 0.75 specificity in separation of S from D+AD (p < 0.0002). ROC curves for the mean parietal VROI value showed 0.62 sensitivity with 0.70 specificity in separation of S from D+AD (p < 0.0002). Baseline SPECT can support outcome prediction in subjects with MCI.
SPECT as a diagnostic test in the investigation of dementia
Journal of The Neurological Sciences, 2002
Single photon emission tomography (SPECT) permits the assessment of the decrease of regional cerebral blood flow (rCBF). The aim of this study was to assess the relationship between the different types of dementia (Alzheimer's disease (AD), vascular dementia (VaD) and frontotemporal dementia (FTD)) and the rCBF in the SPECT examination. In patients with AD, the SPECT examination showed hypoperfusion in temporoparietal regions, contrary to patients with frontotemporal dementia, where hypoperfusion was limited to the frontal area, and compared to patients with VaD, where ''patchy'' rCBF changes were observed in different regions. In mild cases of AD, perfusion deficits were observed in the frontal regions equal to those in VaD. The study shows that the SPECT examination may be useful in distinguishing between AD, VaD, and FTD; however, for proper diagnosis in the early stages of AD, additional factors must be taken into consideration. D
Imaging markers of mild cognitive impairment: Multivariate analysis of CBF SPECT
Neurobiology of Aging, 2007
This study aimed to investigate cross-sectional and longitudinal changes of regional cerebral blood flow (rCBF) in preclinical dementia using single photon emission computed tomography (SPECT). SPECT and cognitive function were investigated in 39 mild cognitive impairment (MCI) subjects and 20 age-matched controls. All subjects were followed longitudinally 19 months on average, 16 MCI subjects progressed to Alzheimer's disease (AD), who were retrospectively defined as progressive mild cognitive impairment (PMCI) at baseline and 23 MCI subjects remained stable and were defined as stable mild cognitive impairment (SMCI) at baseline. SPECT was performed both at the initial investigation and at follow-up. Image data were analyzed using multivariate analysis, SPM and volume of interest (VOI)-based analysis. Significant covariate patterns were derived, which differentiate among PMCI, SMCI and controls at baseline as well as describe the longitudinal progression of PMCI. The combined SPECT and neuropsychology increased the diagnostic accuracy of PMCI at baseline. SPECT and neuropsychological testing can be used objectively for both baseline diagnosis and to monitor changes in brain function during very early AD.
The investigation of Alzheimer's disease with single photon emission tomography
Journal of Neurology, Neurosurgery & Psychiatry, 1989
Twenty patients satisfying standard clinical criteria for Alzheimer's disease (AD) and six age-matched normal controls were studied using 9'Tc hexamethyl-propyleneamine oxime and single photon emission tomography. The AD patients had lower regional cerebral blood flow (rCBF) in the temporal and posterior parietal lobes compared to controls. AD patients with apraxia and aphasia had lower rCBF in the lateral temporal and posterior parietal lobes than AD patients without these features. Within the AD group, correlations were found between neuropsychological tests and rCBF: praxis correlated with posterior parietal activity, memory with left temporal lobe activity and language with activity throughout the left hemisphere.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2010
To examine the utility of single-photon emission computed tomography (SPECT) to predict conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD). Longitudinal, prospective study. University-based memory disorders clinic. One hundred twenty seven patients with MCI and 59 healthy comparison subjects followed up for 1-9 years. Diagnostic evaluation, neuropsychological tests, social/cognitive function, olfactory identification, apolipoprotein E genotype, magnetic resonance imaging, and brain Tc hexamethyl-propylene-aminoxime SPECT scan with visual ratings, and region of interest (ROI) analyses were done. Visual ratings of SPECT temporal and parietal blood flow did not distinguish eventual MCI converters to AD (N = 31) from nonconverters (N = 96), but the global rating predicted conversion (41.9% sensitivity and 82.3% specificity, Fisher's exact test p = 0.013). Blood flow in each ROI was not predictive, but when dichotomized at the median value of the patients with ...
Brain SPECT in dementia a clinical-scintigraphic correlation
Arquivos de Neuro-Psiquiatria, 1996
The aim of this study was to compare the accuracy of computed tomography (CT) and single photon emission computerized tomography (SPECT) in the diagnosis of dementia. Fifty-two patients with clinical diagnosis of dementia and 11 controls were studied. The scans were interpreted by one experienced neuroradiologist and one nuclear radiologist, both blinded to the clinical data. In the diagnosis of dementia, CT and SPECT showed equal sensitivity (82.7%) and statistically similar specificity (63.8 and 81.8%, respectively). The specificity of SPECT in diagnosing Alzheimer's disease (100%) was statistically superior to CT (69%). However, both methods showed similar sensitivity in detecting Alzheimer's disease. In conclusion, SPECT and CT showed similar accuracy in the diagnosis of dementia. The quite high specificity of SPECT in Alzheimer's disease may be useful for confirming that diagnosis, particularly for patients with presenile onset of the disease.