Skip to main content
SpringerLink
Log in

Vascular dementia: perfusional and metabolic disturbances and effects of therapy

  • Conference paper
Book cover New Trends in the Diagnosis and Therapy of Non-Alzheimer’s Dementia

Part of the book series: Journal of Neural Transmission Supplement ((NEURAL SUPPL,volume 47))

Summary

Positron emission tomography (PET) has elucidated basic pathophysiological mechanism that produce the cognitive decline in vascular dementia (VD). The typical pattern of glucose metabolism seen in VD with scattered areas of focal cortical and subcortical hypometabolism differs from that in AD with marked hypometabolism affecting the association areas. The total volume of metabolically inactive tissue is significantly related to severity of dementia. Rather than the quantity of tissue destruction, the critical effect may be the quantity of cortical hypometabolism caused by subcortically induced disconnection. Studies with HMPAO SPECT have shown focal deficits in VD and AD patients that are comparable to those seen with FDG PET. In mildly demented patients performance for the classification AD versus VD is much better by PET because it might be more sensitive for imaging small functional pathological changes. A longitudinal analysis of rCMRGl in VD showed that the progression of dementia can be delayed by the adenosine uptake blocker propentofylline and that neuropsychological and metabolic changes are closely related.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Benson DF, Kuhl DE, Hawkins RA, Phelps ME, Cummings JL, Tsai SY (1981) The fluorodeoxyglucose 18F scan in Alzheimer’s disease and multiinfarct dementia. Arch Neurol 40: 711–714

    Article  Google Scholar 

  • DeLeo J, Toth L, Schubert P, Rudolphi K, Kreutzberg GW (1987) Ischemia-induced neuronal cell death, calcium accumulation, and glial response in the hippocampus of the mongolian gerbil and protection by propentofylline (HWA 285). J Cereb Blood Flow Metab 7: 745–751

    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 

  • 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 

  • 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 I-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-99mHMPAO 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 

  • 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 

  • 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

    Google Scholar 

  • Heiss WD, Huber M, Fink GR, Herholz K, Pietrzyk U, Wagner R, Wienhard K (1992) Progressive derangement of periinfarct viable tissue in ischemic stroke. J Cereb Blood Flow Metab 12: 193–203

    Article  PubMed  CAS  Google Scholar 

  • Heiss WD, Mielke R, Kessler J, Ghaemi M, Szelies B, Kittner B, Herholz K, Pietrzyk U (1995) Longitudinal study of propentofyllin in vascular dementia. J Cereb Blood Flow Metab 15: 106

    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 

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

    Article  PubMed  CAS  Google Scholar 

  • Kessler J, Schaaf A, Mielke R (1993) Fragmentierter Bildertest — ein Wahrnehmungs-und Gedächtnistest. Hogrefe, Göttingen Bern Toronto Seattle

    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 DE, Metter EJ, Riege WH, Hawkins 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: 494–495

    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 

  • 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

    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-18FDG PET. J Nucl Med 35: 210–216

    PubMed  CAS  Google Scholar 

  • Mielke R (1994) Pathophysiologie and Diagnostik von vaskulären Demenzen — Untersuchungen zur Hirndurchblutung and zum Hirnstoffwechsel. Thesis, Köln

    Google Scholar 

  • Mielke R, Herholz K, Grond M, Kessler J, Heiss WD (1992) Severity of vascular dementia is related to volume of metabolically impaired tissue. Arch Neurol 49: 909–913

    Article  PubMed  CAS  Google Scholar 

  • Mielke R, Pietrzyk U, Jacobs A, Fink GR, Ichimiya A, Kessler J, Herholz K, Heiss WD (1994) HMPAO SPECT 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, Grond 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 

  • Neary D, Snowdon JS, Shields RA, Burjan AWI, Northen B, Macdermott N, Prescott MC, Testa HJ (1987) Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia. J Neurol Neurosurg Psychiatry 50: 1101–1109

    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 

  • 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, Bogousslaysky J, Hartmann A, Scheinberg P (1993) Vascular dementia: diagnostic criteria for research studies. Neurology 43: 250–260

    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 

  • Skoog I, Nilsson L, Palmertz B, Andreasson LA, Svanborg A (1993) A population-based study of dementia in 86-year-olds. N Engl J Med 328: 153–158

    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 

  • 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 10Kp V (F). Klinisch-diagnostische Leitlinien. Huber, Bern

    Google Scholar 

Download references

Author information

Authors and Affiliations

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

    R. Mielke, J. Kessler, B. Szelies, K. Herholz, K. Wienhard & W.-D. Heiss M.D.

Authors
  1. R. Mielke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Kessler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Szelies
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Herholz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Wienhard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W.-D. Heiss M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. L. Boltzmann Institute of Clinical Neurobiology, Lainz-Hospital, Vienna, Austria

    Kurt A. Jellinger

  2. EBEWE-Research Initiative, Graz, Austria

    Manfred Windisch

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag

About this paper

Cite this paper

Mielke, R., Kessler, J., Szelies, B., Herholz, K., Wienhard, K., Heiss, WD. (1996). Vascular dementia: perfusional and metabolic disturbances and effects of therapy. In: Jellinger, K.A., Windisch, M. (eds) New Trends in the Diagnosis and Therapy of Non-Alzheimer’s Dementia. Journal of Neural Transmission Supplement, vol 47. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6892-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-6892-9_12

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-82823-6

  • Online ISBN: 978-3-7091-6892-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation