Summary
Cerebral perfusion patterns in 18 cases with vascular dementia of Binswanger type (VDBT) (8 moderate and 10 severe cases) were compared with 25 cases with senile dementia of Alzheimer type (SDAT) (16 moderate and 9 severe cases) and 14 controls by single photon emission computed tomography usingN-isopropyl-p-123I iodoamphetamine (IMP) as a tracer. The cerebral: cerebellar IMP uptake ratio (%) (CCR) was used as a measure of relative cerebral perfusion. The CCRs were about 85–90% in all areas in controls. Moderate VDBT patients showed a remarkable decrease of CCRs in the basal grey region (thalamus and basal ganglia) (right 79%, left 77%) and in the frontal area (right 79%, left 80%) (P<0.01). In severe VDBT patients a significant decrease of the CCR was noted in all regions (P<0.01). The decrease of mean CCRs in the hemispheres was significantly correlated with the severity of disease determined by psychometric testing. Patients with SDAT showed a significant decrease of the CCR in the parietal (right 71%, left 74%) and right temporal (78%) areas in the moderate stage (P<0.01), and further progression of dementia was associated with low perfusion areas extending to the frontal areas (78%,P<0.01). These differences in the perfusion patterns and their changes with progression of the illnesses may be reflected in characteristic clinical features.
Article PDF
Avoid common mistakes on your manuscript.
References
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders. 3rd edn, revised. APA, Washington, DC, pp 21–23
Benson DF (1982) The use of positron emission scanning technique in the diagnosis of Alzheimer's disease. In: Corkin S, Davis KL, Growdon JH, Usdin E, Wurtman RJ (eds) Alzheimer's disease: a report of progress. (Aging, vol 19) Raven Press, New York, pp 79–82
Bonte FJ, Ross ED, Chehabi HH, Devous MD Sr (1986) SPECT study of regional cerebral blood flow in Alzheimer disease. J Comput Assist Tomogr 10:579–583
Brun A (1983) An overview of light and electron microscopic changes. In: Reisberg B (ed) Alzheimer's disease: the standard reference. Free Press, New York, pp 37–47
Butler RW, Dickinson WA, Katholi C, Halsey JH (1983) The comparative effects of organic brain disease on cerebral blood flow and measured intelligence. Ann Neurol 13:155–159
Carpenter MB, Sutin J (1983) Human neuroanatomy, 8th edn. Williams & Wilkins, Baltimore, p 536
Celsis P, Agniel A, Puel M, Rascol A, Marc-Vergnes J-P (1987) Focal cerebral hypoperfusion and selective cognitive deficit in dementia of the Alzheimer type. J Neurol Neurosurg Psychiatry 50:1602–1612
Chase TN, Foster NL, Mansi L (1983) Alzheimer's disease and the parietal lobe. Lancet II:225
Cohen MB, Graham LS, Lake R, Metter EJ, Fitten J, Kulkarni MK, Sevrin R, Yamada L, Chang CC, Woodruff N, Kling AS (1986) Diagnosis of Alzheimer's disease and multiple infarct dementia by tomographic imaging of iodine-123 IMP. J Nucl Med 27:769–774
Ferris SH, De Leon MJ, Wolf AP, Farkas T, Christman DR, Reisberg B, Fowler JS, MacGregor R, Goldman A, George AE, Rampal A (1980) Positron emission tomography in the study of aging and senile dementia. Neurobiol Aging 1:127–131
Fisher CM (1965) Lacunes: small deep cerebral infarcts. Neurology 15:774–784
Fisher CM (1982) Lacunar strokes and infarcts: a review. Neurology 32:871–876
Folstein MF, Folstein SE, McHugh PR (1975) Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Foster NL, Chase TN, Fedio P, Patronas NJ, Brooks RA, Di Chiro G (1983) Alzheimer's disease: focal cortical changes shown by positron emission tomography. Neurology 33:961–965
Frackowiak RSJ, Pozzilli C, Legg NJ, Du Boulay GH, Marshall J, Lenzi GL, Jones T (1981) Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain 104:753–778
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 type: positron emission tomography with [18F]fluorodeoxyglucose. J Comput Assist Tomogr 7:590–598
Grubb RL, Raichle ME, Gado MH, Eichling JO, Huges CP (1977) Cerebral blood flow, oxygen utilization, and blood volume in dementia. Neurology 27:905–910
Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, Ross Russell RW, Symon L (1975) Cerebral blood flow in dementia. Arch Neurol 32:632–637
Hachinski VC, Potter P, Merskey H (1987) Leuko-araiosis. Arch Neurol 44:21–23
Hagberg B, Ingvar DH (1976) Cognitive reduction in presenile dementia related to regional abnormalities of the cerebral blood flow. Br J Psychiatry 128:209–222
Hasegawa K, Inoue K, Moriya K (1974) A study on dementia scaling in the elderly (in Japanese). Clin Psychiatry 16:965–969
Ingvar DH, Risberg J, Schwartz MS (1975) Evidence of subnormal function of association cortex in presenile dementia. Neurology 25:964–974
Ishii N, Nishihara Y, Imamura T (1986) Why do frontal lobe symptoms predominate in vascular dementia with lacunes? Neurology 36:340–345
Jagust WJ, Friedland RP, Budinger TF (1985) Positron emission tomography with [18F]fluorodeoxyglucose differentiates normal pressure hydrocephalus from Alzheimer-type dementia. J Neurol Neurosurg Psychiatry 48:1091–1096
Jagust WJ, Budinger TF, Reed BR (1987) The diagnosis of dementia with single photon emission computed tomography. Arch Neurol 4:258–262
Judd BW, Meyer JS, Rogers RL, Gandhi S, Tanahashi N, Mortel KF, Tawaklna (1986) Cognitive performance correlates with cerebrovascular impairments in multi-infarct dementia. J Am Geriatr Soc 34:355–360
Kievit J, Kuypers HGJM (1977) Organization of the thalamocortical connections to the frontal lobe in the rhesus monkey. Exp Brain Res 29:299–322
Kitagawa Y, Meyer JS, Tanahashi N, Rogers RL, Tachibana H, Kandula P, Dowell RE, Mortel KF (1985) Cerebral blood flow and brain atrophy correlated by xenon contrast CT scanning. Comput Radiol 9:331–340
Lavy S, Melamed E, Bentin S, Cooper G, Rinto Y (1978) Bihemispheric decreases of regional cerebral blood flow in dementia: correlation with age-matched normal controls. Ann Neurol 4:445–450
Luxenberg JS, May C, Haxby JV, Grady C, Moore A, Berg G, White BJ, Robinette D, Rapoport SI (1987) Cerebral metabolism, anatomy, and cognition in monozygotic twins discordant for dementia of the Alzheimer type. J Neurol Neurosurg Psychiatry 50:333–340
Mathew NT, Meyer JS, Hartmann A, Ott EO (1975) Abnormal cerebrospinal fluid-blood flow dynamics. Implications in diagnosis, treatment, and prognosis in normal pressure hydrocephalus. Arch Neurol 32:657–664
Matsui T, Hirano A (1978) An atlas of the human brain for computerized tomography. Igaku-Shoin, New York
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 34:939–944
Melamed E, Lavy S, Siew F, Bentin S, Cooper G (1978) Correlation between regional cerebral blood flow and brain atrophy in dementia. J Neurol Neurosurg Psychiatry 41:894–899
Meneghetti G, Vorstrup S, Mickey B, Lindewald H, Lassen NA (1984) Crossed cerebellar diaschisis in ischemic stroke: a study of regional cerebral blood flow by133Xe inhalation and single photon emission computerized tomography. J Cereb Blood Flow Metab 4:235–240
Meyer JS, Rogers RL, Judd BW, Mortel KF, Sims P (1988) Cognition and cerebral blood flow fluctuate together in multi-infarct dementia. Stroke 19:163–169
Neary D, Snowden JS, Shields RA, Burjan AW, Northen B, MacDermott N, Prescott MC, Testa HJ (1987) Single photon emission tomography using99mTc-HM-PAO in the investigation of dementia. J Neurol Neurosurg Psychiatry 50:1101–1109
Obrist WD, Chivian E, Cronqvist S, Ingvar DH (1970) Regional cerebral blood flow in senile and presenile dementia. Neurology 20:315–322
Pantano P, Baron JC, Samson Y, Bousser MG, Derouesne C, Comar D (1986) Crossed cerebellar diaschisis: further studies. Brain 109:677–694
Procter AW, Lowe SL, Palmer AM, Francis PT, Esiri MM, Stratmann GC, Najlerahim A, Patel AJ, Hunt A, Bowen DM (1988) Topographical distribution of neurochemical changes in Alzheimer's disease. J Neurol Sci 84:125–140
Risberg J (1980) Regional cerebral blood flow measurements by133Xe-inhalation: methodology and applications in neuropsychology and psychiatry. Brain Lang 9:9–34
Rogers RL, Meyer JS, Mortel KF, Mahurin RK, Judd BW (1986) Decreased cerebral blood flow precedes multi-infarct dementia, but follows senile dementia of Alzheimer's type. Neurology 36:1–6
Rosvold HE (1972) The frontal lobe system: cortical-subcortical interrelationships. Acta Neurobiol Exp 32:439–452
Sharp P, Gemmell H, Cherryman G, Besson J, Crawford J, Smith F (1986) Application of iodine-123-labeled isopropylamphetamine imaging to the study of dementia. J Nucl Med 27:761–768
Skinner JE, Lindsley DR (1973) The nonspecific mediothalamic-frontocortical system: its influence on electrocortical activity and behaviour. In: Pribram KH, Luria AR (eds) Psychophysiology of the frontal lobes. Academic Press, New York, pp 185–234
Tachibana H, Meyer JS, Okayasu H, Shaw T, Kandula P, Rogers RL (1984) Xenon contrast CT-CBF scanning of the brain differentiates normal age related changes from multi-infarct dementia (MID) and senile dementia of Alzheimer type (SDAT). J Gerontol 39:415–423
Wilkinson IMS, Bull JWD, Du Boulay GH, Marshall J, Ross Russell RW, Symon L (1969) Regional blood flow in the normal cerebral hemisphere. J Neurol Neurosurg Psychiatry 32:367–378
Wolfe N, Linn R, Babikian VL, Knoefel JE, Albert ML (1990) Frontal systems impairment following multiple lacunar infarcts. Arch Neurol 47:129–132
Yamaguchi F, Meyer JS, Yamamoto M, Sakai F, Shaw T (1980) Noninvasive regional cerebral blood flow measurements in dementia. Arch Neurol 37:410–418
Yao H, Sadoshima S, Kuwabara Y, Ichiya Y, Fujishima M (1990) Cerebral blood flow and oxygen metabolism in patients with vascular dementia of the Binswanger type. Stroke 21:1694–1699
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tohgi, H., Chiba, K., Sasaki, K. et al. Cerebral perfusion patterns in vascular dementia of Binswanger type compared with senile dementia of Alzheimer type: a SPECT study. J Neurol 238, 365–370 (1991). https://doi.org/10.1007/BF00319853
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00319853