Korean J Biol Psychiatry.  2013 Sep;20(3):97-103.

Association between Characteristics of Brain Magnetic Resonance Imaging and Atypical Antipsychotics Use in Dementia Patients

• Choi J
• Kim J
• Roh Y
• Rhu S
• Woo S
• Hahn S
• Hwang J

Abstract

OBJECTIVES
We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients.
METHODS
From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio.
RESULTS
There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73).
CONCLUSIONS
The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

Keyword

Dementia; Behavioral and psychological symptoms of dementia (BPSD); Brain atrophy; Atypical antipsychotics

MeSH Terms

Aging
Antipsychotic Agents*
Atrophy
Biomarkers
Brain*
Cerebrospinal Fluid
Dementia*
Humans
Logistic Models
Magnetic Resonance Imaging*
Neuroimaging
Antipsychotic Agents