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Cerebral correlates of psychotic symptoms in Alzheimer's Disease
Source: Journal of Neurology, Neurosurgery, and Psychiatry 2000 Aug;69(2):167-171.
Author: Mega MS, Lee L, Dinov ID, Mishkin F, Toga AW, Cummings JL.
PubMed ID: 10896687
Abstract:
Background: Psychotic symptoms are produced by distributed neuronal dysfunction. Abnormalities of reality testing and false inference implicate frontal lobe abnormalities. Objectives: To identify the functional imaging profile of Alzheimer's disease (AD) patients manifesting psychotic symptoms as measured by single photon emission computed tomography (SPECT). Methods: Twenty AD patients who had SPECT and clinical evaluations were divided into two equal groups with similar Mini Mental Status Examination (MMSE), age, sex, and the spectrum of behaviors documented by the Neuropsychiatric Inventory (NPI) except delusions and hallucinations. SPECT studies, registered to a probabilistic anatomic atlas, were normalized across the combined group mean intensity level, and subjected to a voxel by voxel subtraction of Nonpsychotic minus Psychotic groups. Sub-Volume Thresholding (SVT) corrected random lobar noise to produce a 3D functional significance map. Results: The 3D significance map revealed lower regional perfusion in the right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex, in the psychotic versus nonpsychotic group. Conclusion: Functional imaging is the best tool to explore the neuronal basis of neuropsychiatric disorders in life. We found significant hypoperfusion in the dorsolateral frontal cortex bilaterally, the left anterior cingulate, ventral striatum, pulvinar, and dorsolateral parietal cortex in psychotic patients with AD. AD patients who manifest psychosis may have disproportionate dysfunction of frontal lobes and realted subcortical and parietal structures.
Source: Journal of Neurology, Neurosurgery, and Psychiatry 2000 Aug;69(2):167-171.
Author: Mega MS, Lee L, Dinov ID, Mishkin F, Toga AW, Cummings JL.
PubMed ID: 10896687
Abstract:
Background: Psychotic symptoms are produced by distributed neuronal dysfunction. Abnormalities of reality testing and false inference implicate frontal lobe abnormalities. Objectives: To identify the functional imaging profile of Alzheimer's disease (AD) patients manifesting psychotic symptoms as measured by single photon emission computed tomography (SPECT). Methods: Twenty AD patients who had SPECT and clinical evaluations were divided into two equal groups with similar Mini Mental Status Examination (MMSE), age, sex, and the spectrum of behaviors documented by the Neuropsychiatric Inventory (NPI) except delusions and hallucinations. SPECT studies, registered to a probabilistic anatomic atlas, were normalized across the combined group mean intensity level, and subjected to a voxel by voxel subtraction of Nonpsychotic minus Psychotic groups. Sub-Volume Thresholding (SVT) corrected random lobar noise to produce a 3D functional significance map. Results: The 3D significance map revealed lower regional perfusion in the right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex, in the psychotic versus nonpsychotic group. Conclusion: Functional imaging is the best tool to explore the neuronal basis of neuropsychiatric disorders in life. We found significant hypoperfusion in the dorsolateral frontal cortex bilaterally, the left anterior cingulate, ventral striatum, pulvinar, and dorsolateral parietal cortex in psychotic patients with AD. AD patients who manifest psychosis may have disproportionate dysfunction of frontal lobes and realted subcortical and parietal structures.