Original Research Article
A SPECT Study of Apathy in Alzheimer’s DiseaseLanctôt 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
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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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