Mothers' Preference in Confinement

Abstract

<b>1222</b> <b>Objectives</b>: Alzheimer’s disease (AD) is the most common cause of dementia in the elderly. Many studies revealed that early intervention may be helpful in the clinical course. Therefore, early detection is of particular importance as strategies for the management of AD. The clinical role of Single Photon Emission Tomography (SPECT) in the diagnosis and prognostication of dementing illnesses has been confirmed by many studies. The typical abnormality in AD is bilateral posterior temporal/parietal hypoperfusion, which often correlates with mental status, and can be asymmetrical. The question has been arisen whether SPECT would be also helpful in subjects with mild cognitive impairment (MCI) to predict who will progress to dementia. The aim of this SPECT study was to determine the initial abnormality in regional cerebral blood flow (rCBF) in questionable dementia (QD) using statistical parametric mapping (SPM). <b>Methods</b>: Sixty patients with questionable dementia (QD) and 17 normal volunteers were matched with age, education, and sex. Each patient received the test of mini-mental state examination (MMSE) and the Tc-99m HMPAO SPECT examination. SPECT acquisitions were performed at 30 minutes after injection of iv injection of 740 MBq of freshly prepared Tc-99m HMPAO. Parametric images were generated by grand mean scaling each scan to 50 ml/min/dL. The images were then transformed into standard stereotactic space using statistical parametric mapping 2 (SPM 2). The regional cerebral blood flow (rCBF) images were analyzed by SPM2. <b>Results</b>: There was no significantly statistical difference between two groups in age, education, and and sex. And there was no correlation between duration of illness, MMSE scores and rCBF in patients with questionable dementia. As compared to normal volunteers, the rCBF of patients with questionable dementia was diffusely decreased in bilateral hemispheres, significantly. The first involving region was bilateral insula (Brodmann area 13). The second decreased rCBF region was located at bilateral parietal and temporal lobes. The third area was located at precental gyrus and middle frontal gyrus of bilateral frontal lobe (Brodmann area 4 and 6). The thalamus area passed the criteria at voxel level but failed at cluster level. There was no increased rCBF area in patients with QD as compared to normal volunteers. <b>Conclusions</b>: In the current study, we prospectively demonstrated the pattern of defective rCBF of questionable dementia. Although it can not be detected visually, we can make the diagnosis as early as possible by measuring the changes of rCBF of certain brain area using SPM.