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Vol. 29, No. 4, 2010
Issue release date: May 2010
Dement Geriatr Cogn Disord 2010;29:287–293

Insular Hypoperfusion Correlates with the Severity of Delusions in Individuals with Alzheimer’s Disease

Matsuoka T. · Narumoto J. · Shibata K. · Okamura A. · Nakamura K. · Okuyama C. · Nishimura T. · Fukui K.
Departments of aPsychiatry and bRadiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

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Background: The aim of this study was to identify the brain regions associated with the severity of delusions in individuals with Alzheimer’s disease (AD) using single-photon emission computed tomography. Methods: Thirty-five AD patients participated in this study. Multiple regression analysis was performed to identify a linear correlation between the delusion subscale score of the Neuropsychiatric Inventory (NPI) and regional cerebral blood flow (rCBF) in AD patients with delusions (n = 14). In addition, rCBF in patients with (n = 14) and without delusions (n = 21) was compared using a 2-sample t test. Results: The delusion subscale score of the NPI was negatively correlated with rCBF in the right anterior insula (uncorrected p < 0.01 at the voxel level and corrected p < 0.05 at the cluster level). Compared to patients without delusions, however, rCBF in the right anterior insula was not significantly decreased in patients with delusions. Conclusion: We suggest that right anterior insular dysfunction may exacerbate delusions, although it is not responsible for the onset of delusions.

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