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A SPECT Study of Apathy in Alzheimer’s Disease

Lanctôt K.L.a, b, d, e, h · Moosa S.b, d · Herrmann N.a, e, h · Leibovitch F.S.f, g · Rothenburg L.a, d · Cotter A.f, g · Black S.E.c, f-h
Departments of aPsychiatry and bPharmacology and cMedicine (Neurology) , University of Toronto, dNeuropharmacology Research Program, Departments of ePsychiatry, fMedicine (Neurology), gMedical Imaging and hNeuroscience Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada Dement Geriatr Cogn Disord 2007;24:65–72 (DOI:10.1159/000103633)

Abstract

Background/Aims: To assess the association between regional cerebral blood flow (rCBF) and apathy in Alzheimer’s Disease (AD). Methods: SPECT and MRI scans were obtained from 51 nondepressed outpatients meeting criteria for probable AD (age 77.6 ± 6.6 years; MMSE 22.3 ± 5.1; 23 apathetic, 28 nonapathetic) and 23 healthy elderly (75.6 ± 3.8 years) controls. The following regions of interest (ROIs) were compared between apathetic and nonapathetic AD patients and then referenced against aged controls: anterior cingulate, orbitofrontal cortex, middle medial temporal cortex, hippocampus, medial superior temporal cortex, thalamus/hypothalamus and pons. Results: Apathetic and nonapathetic patients had significant differences in rCBF. Relative to nonapathetic AD patients, apathetic AD patients had lower perfusion in 2 ROIs (right orbitofrontal cortex and left anterior cingulate) and higher perfusion in 5 ROIs (right and left hippocampi, left medial superior temporal gyrus, and right and left middle medial temporal cortex). Comparison of rCBF in these 7 ROIs to healthy elderly controls confirmed hypoperfusion in the left anterior cingulate and right orbitofrontal cortex and suggested a relative sparing of perfusion among apathetic AD patients in the remaining 5 ROIs. Conclusions: In this group of nondepressed patients with AD, apathetic subjects displayed significant perfusion differences compared to nonapathetic subjects.

 

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