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KMID : 1100220090080010021
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Dementia and Neurocognitive Disorders
2009 Volume.8 No. 1 p.21 ~ p.27
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Analysis of Regional Cerebral Blood Flow using Brain SPECT in the Patients with Mild Cognitive Impairment According to Subtypes
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Park Kyung-Won
Kim Jae-Woo
Cheon Sang-Myung
Kim Sang-Ho
Cha Jae-Kwan
Kang Ji-Hye
Park Ji-Wook
Kang Do-Young
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Abstract
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Background : There are few studies in the analysis of regional cerebral blood flow (rCBF) using HMPAO SPECT in mild cognitive impairment (MCI) patients according to their subtypes. The aim of this study is to assess the specific patterns of rCBF in patients with MCI using Tc-99m HMPAO SPECT, and to compare the differences of rCBF among the subtypes of MCI.
Methods : We recruited 192 MCI patients consecutively according to the Petersen’s clinical diagnostic criteria, who visited to the Dementia and Memory Clinic between January 1, 2005 and December 30, 2007. . Ninety seven subjects who performed the brain MRI and Tc-99m HMPAO SPECT were included in this study. They were classified by three subtypes of MCI according to their deficits in cognitive domains; amnestic single domain MCI (aMCI-s, n=23), amnestic multi-domain MCI (aMCI-m, n=58), non-amnestic MCI (naMCI, n=16). The rCBF were analysised by using statistical parameter mapping(SPM) analysis method. The SPECT data of all patients with MCI were compared with those of normal control and then the three groups of MCI were individually compared with those of control subjects.
Results: SPM analysis of the SPECT image showed significant perfusion deficits on the both parahippocampal gyrus, left insula and left sub-lobar in all MCI (uncorrected p<0.01). The patients with aMCI-s showed significant hypoperfusion on the left putamen and globus pallidus (uncorrected p<0.01). The patients with aMCI-m showed significant hypoperfusion areas on the left insula, left posterior cingulate gyrus, right parahippocampal gyrus and right cuneus (uncorrected p<0.01). The patients with naMCI revealed no significant hypoperfusion areas (uncorrected p<0.01).
Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with MCI. And, the pattern of perfusion deficits in amnestic multi-domain MCI are very similar to that of early stage of Alzheimer’s disease.
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KEYWORD
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Mild Cognitive Impairment, Tc-99m HMPAO SPECT regional cerebral blood flow, statistical parametric mapping(SPM)
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