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A comparison of Tc-99m-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping

Lookup NU author(s): Dr Sean Colloby, Dr John Fenwick, Professor David Williams, Dr Sean Paling, Dr Clive Ballard, Professor Ian McKeith, Professor John O'Brien

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Abstract

Differences in regional cerebral blood flow (rCBF) between subjects with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and healthy volunteers were investigated using statistical parametric mapping (SPM99). Forty-eight AD, 23 DLB and 20 age-matched control subjects participated. Technetium-99m hexamethylpropylene amine oxime (HMPAO) brain single-photon emission tomography (SPET) scans were acquired for each subject using a single-headed rotating gamma camera (IGE CamStar XR/T). The SPET images were spatially normalised and group comparison was performed by SPM99. In addition, covariate analysis was undertaken on the standardised images taking the Mini Mental State Examination (MMSE) scores as a variable. Applying a height threshold of Pless than or equal to0.001 uncorrected, significant perfusion deficits in the parietal and frontal regions of the brain were observed in both AD and DLB groups compared with the control subjects. In addition, significant temporoparietal perfusion deficits were identified in the AD subjects, whereas the DLB patients had deficits in the occipital region. Comparison of dementia groups (height threshold of Pless than or equal to0.01 uncorrected) yielded hypoperfusion in both the parietal [Brodmann area (BA) 7] and occipital (BA 17, 18) regions of the brain in DLB compared with AD. Abnormalities in these areas, which included visual cortex and several areas involved in higher visual processing and visuospatial function, may be important in understanding the visual hallucinations and visuospatial deficits which are characteristic of DLB. Covariate analysis indicated group differences between AD and DLB in terms of a positive correlation between cognitive test score and temporoparietal blood flow. In conclusion, we found evidence of frontal and parietal hypoperfusion in both AD and DLB, while temporal perfusion deficits were observed exclusively in AD and parieto-occipital deficits in DLB.

Publication metadata

Author(s): Colloby SJ, Fenwick JD, Williams ED, Paling SM, Lobotesis K, Ballard C, McKeith I, O'Brien JT

Publication type: Article

Publication status: Published

Journal: European Journal of Nuclear Medicine and Molecular Imaging

Year: 2002

Volume: 29

Issue: 5

Pages: 615-622

ISSN (print): 1619-7070

ISSN (electronic): 1619-7089

Publisher: Springer

URL: http://dx.doi.org/10.1007/s00259-002-0778-5

DOI: 10.1007/s00259-002-0778-5

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