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The pattern of function-related regional cerebral blood flow investigated by single photon emission tomography with 99mTc-HMPAO in patients with presenile Alzheimer's disease and Korsakoff's psychosis

Published online by Cambridge University Press:  09 July 2009

R. Hunter ,
R. McLuskie ,
D. Wyper ,
J. Patterson ,
J. E. Christie ,
D. N. Brooks ,
J. McCulloch ,
G. Fink  and
G. M. Goodwin
R. Hunter*
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
R. McLuskie
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
D. Wyper
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
J. Patterson
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
J. E. Christie
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
D. N. Brooks
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
J. McCulloch
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
G. Fink
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
G. M. Goodwin
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh and the Wellcome Neuroscience Group, Institute of Neurological Sciences, Southern General Hospital, Glasgow
*
1Address for correspondence: Dr R. Hunter, MRC Brain Metabolism Unit. Royal Edinburgh Hospital, Morningside Park Edinburgh, EH 10 5HF.
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Synopsis

Single photon emission tomography (SPET) with the lipophilic blood flow marker 99mTc-hexamethyl propyleneamine oxime (99mTc-HMPAO) has been used to determine regional uptake of radiolabel into brain regions of patients with presenile Alzheimer's disease and Korsakoff's psychosis, and age-matched controls. Using occipital cortical uptake as reference area, the pattern of relative regional cerebral blood flow (rCBF) was determined in other cortical areas and basal ganglia. In Alzheimer's disease, reduction in rCBF occurred most strikingly in posterior temporal and parietal areas. By contrast, in Korsakoff's psychosis, posterior temporal rCBF was maintained, although there was a trend to reduced tracer uptake in other cortical areas. These impairments of flow were correlated with impairments of neuropsychological function. In Alzheimer's disease, left posterior temporal and left parietal regions in particular showed rCBF to be strongly correlated with most aspects of cognitive function. In Korsakoff's psychosis, however, impaired flow in frontal regions was correlated with impaired performance on tests of memory and orientation. The findings in Alzheimer's disease show quantitative parallels with those from studies using Positron Emission Tomography (PET), and extend our understanding of the relationship between cognition and regional brain function in dementia. The findings in Korsakoff's psychosis offer the first direct evidence linking frontal lobe dysfunction with the cognitive impairment seen in the disorder.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 4 , November 1989 , pp. 847 - 855
Copyright
Copyright © Cambridge University Press 1989

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