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Positron emission tomography for diagnosis of Alzheimer’s disease and vascular dementia

  • Conference paper
Ageing and Dementia

Part of the book series: Journal of Neural Transmission. Supplementa ((NEURAL SUPPL,volume 53))

Summary

In mild or atypical cases of Alzheimer’s disease (AD) the differential diagnosis to other dementing diseases, such as vascular dementia (VD), may pose a difficult problem. Beside computed tomography (CT) and magnetic resonance imaging (MRI), functional neuroimaging by positron emission tomography (PET) support the clinical diagnosis by visualizing cerebral function. PET of 18F-2-fluoro-2-deoxy-D-glucose (FDG) for measurement of regional cerebral glucose metabolism (rCMRG1) has shown a typical metabolic pattern in patients with probable AD: hypometabolism in temporoparietal and frontal association areas, but relative recessing of primary cortical areas, basal ganglia and cerebellum. In VD a different pattern is seen. It consists of scattered areas with reduction of rCMRGl typically extending over cortical and subcortical structures. Severity of dementia is correlated with rCMRGl reduction in the temporoparietal association cortex, irrespective of the cause of dementia. Also the total volume of hypometabolic regions is related to severity of dementia but did not differ between AD and VD, even in patients with small lacunar infarction. This indicates that the total volume of functional tissue loss is more important, since it also includes the effects of incompletely infarcted tissue and morphologically intact but deafferented cortex. The characteristic metabolic pattern has a high diagnostic accuracy for the discrimination between probable AD, normals and VD, even in patients with mild cognitive impairment. Under clinical and therapeutic aspects the analysis of longitudinal changes of rCMRGl has shown that neuropsychological and metabolic changes are closely related in both, AD and VD.

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References

  • American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders, 3rd rev. edn. American Psychiatric Association, Washington DC

    Google Scholar 

  • Benson DF, Kuhl DE, Hawkins RA, Phelps ME, Cummings JL, Tsai SY (1983) The fluordeoxyglucose 18F scan in Alzheimer’s disease and multi-infarct dementia. Arch Neurol 40: 711–714

    Article  PubMed  CAS  Google Scholar 

  • Breitner JCS, Silverman JM, Mohs RC, Davis KL (1988) Familial aggregation in Alzheimer’s disease: comparison od risk among relatives of early-and late-onset cases, and among male and female relatives in successive generations. Neurology 38: 207–212

    Article  PubMed  CAS  Google Scholar 

  • Chase TN, Foster NL, Mansi L (1983) Alzheimer’s disease and the parietal lobe. Lancet ii: 225

    Article  Google Scholar 

  • Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R (1992) Criteria for the diagnosis of ischemic vascular dementia proposed by the state of California Alzheimer’s disease diagnostic and treatment centers. Neurology 42: 473–480

    Article  PubMed  CAS  Google Scholar 

  • DeCarli C, Kaye JA, Horwitz B, Rapoport SI (1990) Critical analysis of the use of computer assisted transverse axial tomography to study human brain in aging and dementia of the Alzheimer type. Neurology 40: 872–883

    Article  Google Scholar 

  • Duara R, Grady C, Haxby J, Sundaram M, Cutler NR, Heston L, Moore A, Schlageter N, Larson S, Rapoport SI (1986) Positron emmission tomography in Alzheimer’s disease. Neurology 36: 879–887

    Article  PubMed  CAS  Google Scholar 

  • Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental State: a practical method for grading the cognitive status of patients for the clinician. J Psychiatr Res 12: 189–198

    Article  PubMed  CAS  Google Scholar 

  • Foster NL, Chase TN, Fedio P, Patronas NJ, Brooks RA, DiChiro G (1983) Alzheimer’s disease: focal cortical changes shown by positron emission tomography. Neurology (Cleveland) 33: 961–965

    Article  CAS  Google Scholar 

  • Frackowiak RSJ, Pozzilli C, Legg NJ, du Boulay GH, Marshall J, Lenzi GL, Jones T (1981) Regional cerebral oxygen supply and utilization in dementia. Brain 104: 753–778

    Article  PubMed  CAS  Google Scholar 

  • Friedland RP, Budinger TF, Ganz E, Yano Y, Mathis CA, Koss B, Ober BA, Huesman RH, Derenzo SE (1983) Regional cerebral metabolic alterations in dementia of the Alzheimer’s type: positron emission tomography with (18F)fluordeoxyglucose. J Comput Assist Tomogr 7: 5590–598

    Article  Google Scholar 

  • Gemmel HG, Sharp PF, Besson JAO, Crawford JR, Ebmeier KP, Davidson J, Smith FW (1987) Differential diagnosis in dementia using cerebral blood flow agent TC-99m HM-PAO: a SPECT study. J Comput Assist Tomogr 11: 398–402

    Article  Google Scholar 

  • Gemmell HG, Sharp PF, Besson JAO, Ebmeier KP, Smith FW (1988) A comparison of TC-99m HM-PAO and 1–123 IMP cerebral SPECT images in Alzheimer’s disease and multi-infarct dementia. Eur J Nucl Med 14: 463–466

    Article  PubMed  CAS  Google Scholar 

  • Gemmel HG, Evans NTS, Besson JAO, Roeda D, Davidson J, Dodd MG, Sharp PF, Smith FW, Crawford JR, Newton RH, Kulkarni V, Mallard JR (1990) Regional cerebral blood flow imaging: a quantitative comparison of Technetium-99m-HMPAO SPECT with C15O2 PET. J Nucl Med 31: 1595–1600

    Google Scholar 

  • Gibbs JM, Frackowiak RSJ, Legg NJ (1986) Regional cerebral blood flow and oxygen metabolism in dementia due to vascular disease. Gerontology 32 [Suppl 1]: 84–86

    Article  PubMed  Google Scholar 

  • Grady CL, Haxby JV, Horwitz B, Berg G, Rapoport SI (1987) Neuropsychological and cerebral metabolic function in early vs late onset dementia of the Alzheimer type. Neuropsychologia 25: 807–816

    Article  PubMed  CAS  Google Scholar 

  • Grady CL, Haxby JV, Horwitz B, Sundaram M, Berg G, Schapiro M, Friedland RP, Rapoport SI (1988) Longitudinal study of the early neuropsychological and cerebral changes in dementia of the Alzheimer type. J Clin Exp Neuropsychol 10: 576–596

    Article  PubMed  CAS  Google Scholar 

  • Hachinski VC, Iliff LD, Zilhka E, DuBoulay GH, McAllister VL, Marshall J, Russell RWR, Symon L (1975) Cerebral blood flow in dementia. Arch Neurol 32: 632–637

    Article  PubMed  CAS  Google Scholar 

  • Haxby JV, Grady CL, Duara R, Schlageter N, Berg G, Rapoport SI (1986) Neocortical abnormalities precede nonmemory cognitive defects in early Alzheimer’s type dementia. Arch Neurol 43: 882–885

    Article  PubMed  CAS  Google Scholar 

  • Haxby JV, Grady CL, Koss E, Horwitz B, Heston L, Schapiro M, Friedland RP, Rapoport SI (1990) Longitudinal study of cerebral metabolic asymmetries and associated neuropsychological patterns in early dementia of the Alzheimer type. Arch Neurol 47: 753–760

    Article  PubMed  CAS  Google Scholar 

  • Heiss WD, Ilsen HW, Wagner R, Pawlik G, Wienhard K, Eriksson L (1983) Remote functional depression of glucose metabolism in stroke and its alteration by activating drugs. In: Heiss WD, Phelps ME (eds) Positron emission tomography of the brain. Springer, Berlin Heidelberg New York Tokyo, pp 162–168

    Chapter  Google Scholar 

  • Heiss WD, Hebold I, Klinkhammer P, Ziffling P, Szelies B, Pawlik G, Herholz K (1988) Effect of piracetam on cerebral glucose metabolism in Alzheimer’s disease as measured by positron emission tomography. J Cereb Blood Flow Metab 8: 613–617

    Article  PubMed  CAS  Google Scholar 

  • Heiss WD, Kessler J, Mielke R, Szelies B, Herholz K (1994) Long-term effects of Phosphatidylserine, Pyritinol, and cognitive training in Alzheimer’s disease. A neuropsychological, EEG, and PET investigation. Dementia 5: 88–98

    CAS  Google Scholar 

  • Herholz K, Adams R, Kessler J, Szelies B, Grond M, Heiss WD (1990) Criteria for the diagnosis of Alzheimer’s disease with positron emission tomography. Dementia 1: 156–164

    Google Scholar 

  • Heston LL, Mastri AR, Anderson VE, White J (1981) Dementia of the Alzheimer type. Clinical genetics, natural history and associated conditions. Arch Gen Psychiatry 38: 1085–1090

    Article  PubMed  CAS  Google Scholar 

  • Jagust WJ, Friedland RP, Budinger TF, Koss E, Ober B (1988) Longitudinal studies of regional cerebral metabolism in Alzheimer’s disease. Neurology 38: 909–912

    Article  PubMed  CAS  Google Scholar 

  • Kamo H, McGeer P, Harrop R, McGeer E, Calne D, Martin W, Pate B (1987) Positron emission tomography and histopathology in Pick’s disease. Neurology 37: 439

    Article  PubMed  CAS  Google Scholar 

  • Kase CS (1991) Epidemiology of multi-infarct dementia. Alz Dis Assoc Disord 5: 71–76

    Article  CAS  Google Scholar 

  • Kennedy AM, Newman S, Clegg F, Tyrrell P, Warrington EK, Roques P, Hardy J, Rossor MN, Frackowiak RSJ (1992) Imaging in dementia: longitudinal studies using positron emission tomography. Neurobiol Aging 13: S13

    Article  Google Scholar 

  • Kessler J, Herholz K, Heiss WD (1991) Impaired metabolic activation in Alzheimer’s disease: a PET study during continous visual recognition. Neuropsychologia 29: 229–243

    Article  PubMed  CAS  Google Scholar 

  • Klinkhammer P, Szelies B, Heiss WD (1990) Effect of phosphatidylserine on cerebral glucose metabolism in Alzheimer’s disease. Dementia 1: 197–201

    Google Scholar 

  • Kraepelin E (1910) Psychiatrie, ein Lehrbuch für Studierende und Ärzte, 8th edn, vol II/1. Barth, Leipzig

    Google Scholar 

  • Kuhl DE, Phelps ME, Kowell AP, Metter EJ, Selin C, Winter J (1980) Effects of stroke on local cerebral metabolism and perfusion: mapping by emission computed tomography of 18FDG and 13NH3. Ann Neurol 8: 47–60

    Article  PubMed  CAS  Google Scholar 

  • Kuhl D, Phelps M, Markham C (1982) Cerebral metabolism and atrophy in Huntington’s disease determined by 18-FDG and computed tomographic scan. Ann Neurol 12: 425–434

    Article  PubMed  CAS  Google Scholar 

  • Kuhl DE, Metter EJ, Riege WH, Hawkings RA, Mazziotta JC, Phelps DE, Kling AS (1983) Local cerebral glucose utilization in elderly patients with depression, multiple infarct dementia and Alzheimer’s disease. J Cereb Blood Flow Metab 3: S494–S495

    Google Scholar 

  • Kuhl D, Metter E, Benson F, Ashford JW, Riege WH, Fujikawa DG, Markham CH, Mazziotta JC, Maltese A, Dorsey DA (1985) Similarities of cerebral glucose metabolism in Alzheimer’s and Parkinson’s dementia. J Cereb Blood Flow Metab 5: 169–170

    Google Scholar 

  • Kuwert T, Lange HW, Langen KJ, Herzog H, Aulich A, Feinendegen LE (1990) Cortical and subcortical glucose consumption measured by PET in patients with Huntington’s disease. Brain 113: 1405–1423

    Article  PubMed  Google Scholar 

  • Mann DMA, Yates PO, Marcyniuk B (1984) Alzheimer’s presenile dementia, senile dementia of Alzheimer type and Down’s syndrome in middle age from an age related continuum of pathological changes. Neuropathol Appl Neurobiol 10: 185–207

    Article  PubMed  CAS  Google Scholar 

  • McGeer PL, Kamo H, Harrop R, Li DK, Tuokko H, McGeer EG, Adam MJ, Ammann W, Beattie BL, Calne DB (1986) Positron emission tomography in patients with clinical diagnosed Alzheimer’s disease. Can Med Assoc J 134: 597–607

    CAS  Google Scholar 

  • McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 19: 939–944

    Article  Google Scholar 

  • Messa C, Perani D, Lucignani G, Zenorini A, Zito F, Rizzo G, Grassi F, Del Sole A, Franceschi M, Gilardi MC, Fazio F (1994) High-resolution technetium-99m-HMPAO SPECT in patients with probable Alzheimer’s disease: comparison with fluorine-18-FDG PET. J Nucl Med 35: 210–216

    PubMed  CAS  Google Scholar 

  • Mielke M, Ghaemi J, Kessler B, Kittner B, Szelies B, Herholz K, Heiss WD (1998) Propentofylline enhances cerebral metabolic response to auditory memory stimulation in Alzheimer’s disease. J Neurol Sci (in press)

    Google Scholar 

  • Mielke R, Herholz K, Grand M, Kessler J, Heiss WD (1992) Differences of regional cerebral glucose metabolism between presenile and senile dementia of Alzheimer type. Neurobiol Aging 13: 93–98

    Article  PubMed  CAS  Google Scholar 

  • Mielke R, Pietrzyk U, Jacobs A, Fink GR, Ichimiya A, Kessler J, Herholz K, Heiss WD (1994) HMPAO SPET and FDG PET in Alzheimer’s disease and vascular dementia: comparison of perfusion and metabolic pattern. Eur J Nucl Med 21: 1052–1060

    Article  PubMed  CAS  Google Scholar 

  • Mielke R, Herholz K, Grand M, Kessler J, Heiss WD (1994) Clinical deterioration in probable Alzheimer’s disease correlates with progressive metabolic impairment of association areas. Dementia 5: 36–41

    PubMed  CAS  Google Scholar 

  • Mielke R, Jacobs A, Kessler J, Pietrzyk U, Herholz K, Heiss WD (1995) Diagnostic accuracy of FDG PET and HMPAO SPECT for the differentiation between Alzheimer’s disease and vascular dementia depends on severity of disease. J Neurol 241: 35

    Google Scholar 

  • Mielke R, Schröder R, Fink G, Kessler J, Herholz K, Heiss WD (1996) Regional cerebral glucose metabolism and postmortem pathology in Alzheimer’s disease. Acta Neuropathol 91: 174–179

    Article  PubMed  CAS  Google Scholar 

  • Mielke R, Ghaemi M, Kittner B, Kessler J, Szelies B, Herholz K, Heiss WD (1996) Propentofylline improves regional cerebral glucose metabolism and neuropsy-chological performance in vascular dementia. J Neurol Sci 141: 59–64

    Article  PubMed  CAS  Google Scholar 

  • Morris JC, McKeel Jr DW, Fulling K, Torack RM, Berg L (1988) Validation of clinical diagnostic criteria for Alzheimer’s disease. Ann Neurol 24: 17–22

    Article  PubMed  CAS  Google Scholar 

  • Nordberg A, Lilja A, Lundqvist H, Hartvig P, Amberla K, Viitanen M, Warpman U, Johansson M, Hellstrom-Lindahl E, Bjurling P (1992) Tacrine restores cholinergic nicotinic receptors and glucose-metabolism in Alzheimer patients as visualized by positron emission tomography. Neurobiol Aging 13: 747–758

    Article  PubMed  CAS  Google Scholar 

  • Podreka I, Suess E, Goldenberg G, Steiner M, Brücke T, Müller CH, Lang W, Neirinckx RD, Deecke L (1987) Initial experience with Technetium-99m HM-PAO brain SPECT. J Nucl Med 28: 1657–1666

    PubMed  CAS  Google Scholar 

  • Rapoport SI, Hatanpää K, Brady DR, Chandrasekaran K (1996) Brain energy metabolism, cognitive function and down-regulated oxidative phosphorylation in Alzheimer’s disease. Neurodegeneration 5: 473–476

    Article  PubMed  CAS  Google Scholar 

  • Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozzo JM, Brun A, Hofman A, Moody DM, O’Brien MD, Yamaguchi T, Grafman J, Drayer BP, Bennett DA, Fisher M, Ogata J, Kokmen E, Bermejo F, Wolf PA, Gorelick PB, Bick KL, Pajeau AK, Bell MA, DeCarli C, Culebras A, Korczyn AD, Bogousslavsky J, Hartmann A, Scheinberg P (1993) Vascular dementia: diagnostic criteria for research studies. Neurology 43: 250–260

    Article  PubMed  CAS  Google Scholar 

  • Rossor MN, Iversen LL, Reynolds GP, Mountjoy CQ, Roth M (1984) Neurochemical characteristics of early and late onset type of Alzheimer’s disease. Br Med J 288: 961–964

    Article  CAS  Google Scholar 

  • Roth MN (1986) The association of clinical and neurobiological findings and its bearing on the classification and aetiology of Alzheimer’s disease. Br Med Bull 42: 42–50

    PubMed  CAS  Google Scholar 

  • Sacquegna T, DeCarolis P, Daidone R, Dondi M (1988) Single-photon emission tomography with technetium Tc 99m hexamethylpropylene amine oxime in Binswanger’s disease. Arch Neurol 45: 603–604

    Article  PubMed  CAS  Google Scholar 

  • Small GW. Kuhl DE, Riege WH, Fujikawa DG, Ashford JW, Metter EJ, Mazziotta JC (1989) Cerebral glucose metabolic patterns in Alzheimer’s disease. Effect of gender and age at dementia onset. Arch Gen Psychiat 46: 527–532

    Article  CAS  Google Scholar 

  • StGeorge-Hyslop PH, Haines JL, Farrer LA, Polinsky R, Broeckhoven C, Goate A, McLachlan DRC, Orr H, Bruni AC, Sorbi S, Rainero I, Foncin JF, Pollen D, Cantu JM, Tupler R, Voskresenskaya N, Mayeux R, Growdon J, Fried VA, Myers RH, Nee L, Backhovens H, Martin JJ, Rossor M, Owen MJ, Mullan M, Percy ME, Karlinsky H, Rich S, Heston L, Montesi M, Mortilla M, Nacmias N, Gusella JF, Hardy JA (1990) Genetic linkage studies suggest that Alzheimer’s disease is not a single homogenous disorder. Nature 347: 194–197

    Article  CAS  Google Scholar 

  • Szelies B, Herholz K, Pawlik G, Beil C, Wienhard K, Heiss WD (1986) Zerebraler Glukosestoffwechsel bei praeseniler Demenz vom Alzheimer Typ — Verlaufskontrolle unter Therapie mit muskarinergem Cholinagonisten. Fortschr Neurol Psychiat 11: 364–373

    Article  Google Scholar 

  • Szelies B, Karenberg A (1986) Störungen des Glukosestoffwechsels bei Pickscher Erkrankung. Fortschr Neurol Psychiat 54: 393–397

    Article  PubMed  CAS  Google Scholar 

  • Tomlinson BE, Blessed G, Roth M (1968) Observations on the brains of non-demented old people. J Neurol Sci 7: 331–356

    Article  PubMed  CAS  Google Scholar 

  • Tomlinson BE, Blessed G, Roth M (1970) Observations on the brains of demented old people. J Neurol Sci 11: 205–242

    Article  PubMed  CAS  Google Scholar 

  • Tune L, Brandt J, Frost JJ, Harris G, Mayberg H, Steele C, Burns A, Sapp J, Folstein MF, Wagner HN (1991) Physostigmine in Alzheimer’s disease — effects on cognitive-functioning, cerebral glucose-metabolism analyzed by positron emission tomography and cerebral blood flow analyzed by single photon-emission tomography. Acta Psychiatr Scand 93 [Suppl 366]: 61–65

    Article  Google Scholar 

  • Weinstein HC, Haan J, van Royen EO, Derix MMA, Lanser JBK, van der Zant F, Dunnewold RJW, van Kroonenburgh MJPG, Pauwels EKJ, van der Velde EA, Hijdra A, Buruma OJS (1991) SPECT in the diagnosis of Alzheimer’s disease and multi-infarct dementia. Clin Neurol Neurosurg 93: 39–43

    Article  PubMed  CAS  Google Scholar 

  • Weltgesundheitsorganisation (1991) Dilling H, Mombour W, Schmidt MH (eds) Internationale Klassifikation psychischer Störungen ICD 10 Kp V (F). Klinischdiagnostische Leitlinien. Huber, Bern

    Google Scholar 

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Authors and Affiliations

  1. Max-Planck-Institut für neurologische Forschung and Universitätsklinik für Neurologie, Köln, Federal Republic of Germany

    R. Mielke & Dr. W.-D. Heiss

  2. Max-Planck-Institut für neurologische Forschung, Gleueler Strasse 50, D-50931, Köln, Federal Republic of Germany

    Dr. W.-D. Heiss

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  1. R. Mielke
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  2. Dr. W.-D. Heiss
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Editors and Affiliations

  1. Ludwig-Boltzmann-Institut für Klinische Neurobiologie, Wien, Österreich, Austria

    K. Jellinger (Prof. Dr.) (Prof. Dr.)

  2. Universitätsklinik für Neurologie, Graz, Österreich, Austria

    F. Fazekas (Prof. Dr.) (Prof. Dr.)

  3. Institut für Experimentelle Pharmakologie, Forschungsinitiative EBEWE, Graz, Österreich, Austria

    M. Windisch (Dr.) (Dr.)

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Mielke, R., Heiss, WD. (1998). Positron emission tomography for diagnosis of Alzheimer’s disease and vascular dementia. In: Jellinger, K., Fazekas, F., Windisch, M. (eds) Ageing and Dementia. Journal of Neural Transmission. Supplementa, vol 53. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6467-9_21

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  • DOI: https://doi.org/10.1007/978-3-7091-6467-9_21

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