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  • 2022년 07월호
    [Diagnostics (Basel).] Regional Cerebral Blood Flow Correlates of Neuropsychiatric Symptom Domains in Early Alzheimer's Disease

    가톨릭대, 이화여대 / 정현석, 송인욱*, 정용안*

  • 출처
    Diagnostics (Basel).
  • 등재일
    2022 May 17
  • 저널이슈번호
    12(5):1246. doi: 10.3390/diagnostics12051246.
  • 내용

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    Abstract
    Although various neuropsychiatric symptoms are frequently accompanied with Alzheimer's disease (AD) and pose a substantial burden to both patients and caregivers, their neurobiological underpinnings remain unclear. This study investigated associations between regional cerebral blood flow (rCBF) and neuropsychiatric symptom domains in early AD. A total of 59 patients with early AD underwent brain technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) single-photon emission computed tomography (SPECT) scans. Neuropsychiatric symptoms were assessed by the Neuropsychiatric Inventory and clustered into the affective, apathy, hyperactivity, and psychotic domains. A voxel-wise multiple regression analysis was performed with four domain scores as independent variables and age, sex, and Mini-Mental State Examination scores as covariates. The affective domain score was negatively correlated with rCBF in the prefrontal cortex, thalamus, and caudate. The apathy domain score showed inverse correlations with rCBF in the prefrontal and pre/postcentral gyri and midbrain. Patients with higher hyperactivity domain scores had increased rCBF in the prefrontal and temporal lobes. The psychotic symptom domain was positively correlated with rCBF in the cuneus and negatively associated with rCBF in the prefrontal, cingulate, and occipital regions and putamen. The score of each neuropsychiatric symptom domain showed the differential correlates of brain perfusion, while altered rCBF in the prefrontal cortex was found in all domains. Although preliminary, our results may suggest common and distinct patterns of rCBF underlying neuropsychiatric symptoms in early AD. Further studies with larger samples and control participants are warranted to confirm these findings.

     

     

    Affiliations

    Hyeonseok Jeong  1   2 , Ilhyang Kang  3 , Jong-Sik Park  4 , Seung-Hee Na  4 , Seunghee Kim  1 , Sujung Yoon  3   5 , In-Uk Song  4 , Yong-An Chung  1   2
    1 Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
    2 Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
    3 Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.
    4 Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
    5 Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea.

  • 키워드
    Alzheimer’s disease; neuropsychiatric symptom; regional cerebral blood flow; single-photon emission computed tomography; statistical parametric mapping.
  • 연구소개
    이 연구는 초기 알츠하이머병 총 59명의 (평균나이=76.5±6.0세, 남자 17명, 교육수준=6.3±3.8년) 환자에서 Tc-99m HMPAO SPECT의 국소뇌혈류와(rCBF) 신경정신병 목록(정서적, 무관심, 과잉행동 및 정신병적 영역)에 의한 비교 분석을 하였으며, 4개의 영역 점수를 독립 변수로, 연령, 성별, Mini-Mental State Examination 점수로 하여, 복셀 방식 다중 회귀 분석을 수행했습니다. 결과는 정서적 영역 점수는 전전두엽 피질, 시상 및 미상에서 rCBF와 음의 상관관계가 있었습니다. 무관심 영역 점수는 전전두엽 및 전/후중심이랑 및 중뇌에서 rCBF와 역상관관계를 보였습니다. 과잉행동 영역 점수가 높은 환자는 전두엽과 측두엽에서 rCBF가 증가되었으며, 정신병적 증상 영역은 설측에서 rCBF와 양의 상관관계가 있었고 전두엽, 대상, 후두부 및 피막에서 rCBF와 음의 상관관계가 있었습니다. 본 연구 결과 초기 알츠하이머병에서 신경정신병적 증상을 기반으로 rCBF의 일반적이고 뚜렷한 패턴을 제안할 수 있는 가능성을 확인하였습니다.
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