Abstract
AbstractThirty‐eight patients with mild to moderate Alzheimer's disease (AD) underwent a neuropsychological test battery and 18‐fluoro‐2‐deoxyglucose (FDG) positron emission tomography (PET) before beginning and at the end of a randomized double‐blind study of an experimental treatment. Twelve of the patients took placebo. In the placebo patients, Mini‐Mental State (MMS) score decreased and cortical metabolism increased significantly over the 6‐month course of the study. Correlations of metabolism with neuropsychological performance were stable over time in the placebo group. Cortical metabolism correlated significantly with performance on the Blessed Information Subtest and the MMS and showed trend correlations with performance on the WAIS Digit Symbol and Word Fluency. Patients with high relative occipital metabolism tended to do poorly on word fluency. Low baseline relative metabolism in right frontal cortex and high baseline relative metabolism in left parietal and temporal cortices and in right occipital cortex predicted more 6‐month deterioration on the World Fluency Test, suggesting that frontal metabolic deficits may precede neuropsychological deficits. Correlations of 6‐month change in MMS, Blessed and Digit Symbol performance with initial glucose metabolism were not significant.
Highlights
Longitudinal changes in cognitivefunction and metabolism t-tests revealed a significant change in score on the Mini-Mental State (MMS), but on none of the other cognitive tests (Table 1)
Exploratory t-test analyses of subregions revealed a decrease in the region of the lower half of the left Brodmann’s area 17 of the occipital cortex
The significant correlations of neuropsychological performance with cortical metabolism are consistent with SPECT cerebral blood flow (CBF) studies and with positron emission tomography (PET) FDG studies (Cutler et al, 1985; Duara et al, 1986)
Summary
All of whom had a clinical diagnosis of probable AD, by referral and through advertisements. Diagnosis was confirmed by NINCDS-ADRDA criteria by a neurologist (AS). The patient group consisted of 38 elderly adults (19 men, 19women, mean age 5 SD = 73 k 9, range 52-91). All patients were in good health based on medical history, physical examination and laboratory analyses. We excluded patients with any history of seizure disorder, requirement for neuroleptics, psychotic or major mood disorder, substance abuse or stroke. Patients selected for the study were early in the course of the illness, with a
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