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KMID : 0960920020010010022
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Dementia and Neurocognitive Disorders
2002 Volume.1 No. 1 p.22 ~ p.28
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Analysis of Cerebral Blood Flow of Subcortial Vascular Dementia with Single Photon Emission Computed Tomography: Adaptation of Statistical Parametric Mapping
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Yang Dong-Won
Kim Beum-Saeng
Kim Euy-Neyng
Sohn Hyung-Sun
Kim Sang-Yun
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Abstract
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Background: Subcortical vascular dementia(SVaD) is a relatively homegeneous subtype of VaD, but the mechanisms of congnitive dysfunction of subcortical VaD are not completely undersood yet. This study investigated the changes of cerebral blood flow(CBF) in patients with SVaD and the contribution of the white matter hyperintensity(WMHI) and clinical severity to CBF changes.
Methods: 99mTc-ethyl cysteinate dimer single photon emission computed tomography(SPECT) was preformed to measure the regional CBF and statistical parametric mapping(SPM)99 software was applicated to automated and objective analysis of the SPECT image data. Twently three patients (male 12, female 11) of mild to moderate dementia who met both the criteria of the DSM-Ⅳ and probable or possible NINDS-AIREN for VaD and have subcortical white matter changes and lacunar infarctions on brain MRI and seventeen normal control subjects (male 7, female 10) were evaluated. The severity of the WMHI was measured by semi-quantitative scale method proposed by Mantyla. The severity of dementia was measured by clinical dementia rating(CDR)scale.
Results: SPM analysis of SPEC image revealed significantly reduced regional CBF in the right thalamus, left caudate nucleus, cingulate, bilateral superior temporal, and left ventral subcallosal gyri in SVaD patients when is compared to normal controls(corrected p<0.001). Among four WMHIs, only the deep WMHI was associated with the small CBF reduction in the left superior temporal gyrus(uncorrected p<0.01). The reduction of CBF according to the severity of dementia was noted in the anterior and posterior association areas(uncorrected p<0.01).
Conclusions: Our study suggests that congnitive dysfunction of SVaD may be related with CBF reduction in the above mentioned brain areas, which probably are not associated with the severity of periventricular WMHI and ementia.
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KEYWORD
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Subcortical vascular dementia, SPECT, Statistical parametric mapping, White matter lesion
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