Cerebral blood flow changes in patients with dementia with Lewy bodies (DLB). A study of 6 cases.

BACKGROUND: The aim of this study was to show the application of cerebral blood flow SPECT (rCBF SPECT) study in dementia with Lewy bodies (DLB). MATERIAL AND METHODS: (99m)Tc-ECD regional cerebral blood flow SPECT scanning was performed using a triple head, high resolution gamma camera on a group of six patients who ful- -filled criteria for clinical diagnosis of DLB. All patients were examined neurologically by a neurologist specialized in movement disorders. Detailed neuropsychological examination was performed on each patient with a psychological tests battery by an experienced neuropsychologist. Qualitative and quantitative analysis was performed utilizing an asymmetry index for unilateral perfusion deficits and a comparison to cerebellar perfusion to assess regional cerebral perfusion. A control group of 20 patients was studied to assess normal values, utilizing an asymmetry index for unilateral perfusion deficits, and a comparison to cerebellar perfusion was performed to assess regional cerebral perfusion. RESULTS: In four cases rCBF SPECT images showed patterns of bilateral hypoperfusion of the temporal, parietal and occipital lobes. In two other cases parietal deficits were observed. CONCLUSIONS: Functional neuroimaging with the use of CBF SPECT may contribute to clinical diagnosis of DLB.

Changes in the volume of temporal lobe structures related to Alzheimer's type dementia.

We compared the volumes of the superior temporal gyrus, basolateral temporal area, parahippocampal gyrus, hippocampal head, amygdaloid body and the inferior horn of the lateral ventricle in 29 patients with dementia of Alzheimer's type (DAT) and in 14 cognitively normal controls. Measurements were performed on coronal MR images perpendicular to the long axis of the hippocampus then the raw data were normalised for intracranial volume. The volumes of all studied structures were significantly smaller in patients with DAT than in age-matched control group. The differences in the volume between DAT and age-matched control group were the largest for the amygdaloid body and the basolateral temporal area. The discriminant analysis including the volume of both the basolateral area and the left amygdaloid body allows for correct classification of 100% DAT patients and 93% controls. We conclude that the estimation of the volume of the amygdaloid body and basolateral temporal area seems to be the most important factor for DAT diagnosis.