technetium-tc-99m-exametazime and Cognitive-Dysfunction

Mini Mental State Examination's (MMSE's) sensitivity in its upper level is questioned, hence we investigated cognitive abnormalities and defects in regional cerebral blood flow (rCBF) in elderly with MMSE scores ≥24.. One hundred and four men at age 81 with MMSE scores ≥24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with neuropsychological test battery, and their rCBF was estimated using. MMSE was very sparsely correlated with rCBF. Instead, visuo-spatial tests were correlated with rCBF in parietal and occipital lobe, verbal tests with rCBF in frontal and temporal-parietal lobes, and most of all between Digit Symbol and all rCBF regions, especially in subcortical gray and white matter. In a cluster of low achievers, test of Synonyms, followed by Digit Symbol and Benton test, had highest discriminatory importance. Low achievers had generalized rCBF changes especially in subcortical areas. Only lower scores on two MMSE items, figure drawing and calculation, could discriminate the clusters.. A substantial number of octogenarian men with MMSE ≥ 24p have widespread rCBF changes corresponding to a decreased speeded performance and verbal capacity.

Topics: Aged, 80 and over; Brain; Cerebrovascular Circulation; Cognition; Cognitive Dysfunction; Cohort Studies; Humans; Independent Living; Male; Neuropsychological Tests; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

The regions of significant correlation between cerebral hypoperfusion and neuropsychological assessment scores were evaluated using (99m)Tc-HMPAO SPECT in patients with mild cognitive impairment (MCI) on the basis of its three subtypes, namely, single-domain amnestic MCI (aMCI-s), multiple-domain amnestic MCI (aMCI-m), and nonamnestic MCI (naMCI), following which comparisons were made among the three subtypes of MCI.. Regions of hypoperfusion were determined by comparing the three groups with the normal group. Neuropsychological assessment included tests to evaluate attention, language and related functions, visuospatial function, memory, frontal-executive function, and mini-mental state examination and depression scores. Regions of cerebral hypoperfusion were identified by comparing the three groups of MCI patients with the normal group (P<0.05, uncorrected). One-way analysis of variance was used to examine differences across groups, and post-hoc a-priori pairwise comparisons were used for between-group analyses. The regions of significant correlation, related to the neuropsychological assessment scores, were identified by simple regression of SPM8 within the masking image of the area of cerebral hypoperfusion (P<0.05, uncorrected).. The regions of cerebral hypoperfusion were identified by comparing members of the normal group with patients with aMCI-s, aMCI-m, and naMCI. The patients with aMCI-m showed significant correlation with all neuropsychological assessment scores, but the patients with aMCI-s correlated with four neuropsychological assessment scores of attention. The patients with naMCI revealed no significantly correlated regions (P<0.05, uncorrected). The regions that correlated with neuropsychological assessment scores in patients with aMCI-s were very small compared with those in patients with aMCI-m. The correlated regions in patients with aMCI-m were restricted to the left cerebrum and cerebellum. Brain areas showed significant correlation between neuropsychological assessment scores and hypoperfusion, which was evaluated by simple regression with the threshold being P less than 0.05, uncorrected. Rey complex figure test 20 min delayed, Korean-color word stroop test word reading, and Korean mini-mental state examination scores correlated more strongly with cerebral hypoperfusion compared with other assessment scores.. The specific pattern of significant correlation of cerebral hypoperfusion with neuropsychological assessment scores was classified into three subtypes (aMCI-s, aMCI-m, and naMCI) according to the patients' deficits in their cognitive domains.

Topics: Aged; Amnesia; Brain; Case-Control Studies; Cognitive Dysfunction; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Statistical analysis of brain perfusion SPECT images has shown mild to severe abnormalities, consistent with cortical dysfunctions in the brain. Recently, functional brain imaging such as fMRI, PET and SPECT is increasingly used for diagnosis of MCI. In this study, we calculate the correlation with perfusion of brain SPECT and neuropsychological test scores of patients by SPM analysis to evaluate the relationship with cerebral hypoperfusion and cognitive dysfunction in MCI patients. Anatomical labeling was performed automatically using the Talairach Daemon (TD) and xjView.. Ninety-three patients (mean age 67.2 ± 7.42 years; 59 women and 34 men) with MCI were selected and examined by the comprehensive neuropsychological test. Tc-99m-HMPAO brain SPECT images were acquired on the patients using a two-head gamma camera. We analyzed the brain image of MCI patients by SPM8 software, and observed the anatomical correlated region, between the neuropsychological tests and cerebral hypoperfusion. The SPM8 tool provided correlation between neuropsychological score and brain perfusion by simple regression method. The neuropsychological test included attention, language function, visuospatial function, memory, frontal executive function, depression score and general cognitive function.. Percentage of voxels with correlated area to the whole brain was calculated and the values by Rey complex figure test (CFT) copy score, MMSE score, Seoul verbal learning test (SVLT) immediate recall score and Rey CFT delayed recall score were 15.3, 12.33, 10.59 and 8.45 %, respectively. Rey CFT copy score was correlated with perfusion in the left middle temporal gyrus (BA 21), right inferior frontal gyrus (BA 45), right lingual gyrus, left lingual gyrus (BA 18), right postcentral gyrus (BA 40), right cingulate gyrus (BA 31) and left thalamus (pulvinar) with p < 0.01 FDR. The correlation related to MMSE included left parahippocampal gyrus, right fusiform gyrus and right middle frontal gyrus (BA 46). SVLT immediate recall score was correlated with left superior temporal gyrus and Rey CFT delayed recall score was correlated with left inferior frontal gyrus (BA 47), right inferior frontal gyrus, and left lentiform nucleus. Visuospatial and general cognitive dysfunctions in the patients with MCI were most correlated with cerebral hypoperfusion.. Rey CFT copy and MMSE scores were more strongly correlated with blood perfusion of the brain than with other neuropsychological test scores. xjView was a useful tool to find out the anatomical name of the selected voxel or clusters and to display the cluster's anatomical information and list all cluster information and could be used instead of TD Client.

Topics: Aged; Brain; Cerebrovascular Circulation; Cognitive Dysfunction; Female; Humans; Male; Neuropsychological Tests; Regional Blood Flow; Software; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon