Dement Neurocogn Disord.  2018 Sep;17(3):90-99. 10.12779/dnd.2018.17.3.90.

FDG PET Findings according to Wandering Patterns of Patients with Drug-naïve Alzheimer's Disease

• Yang Y
• Kwak YT

• KMID: 2442798
• DOI: http://doi.org/10.12779/dnd.2018.17.3.90

Abstract

BACKGROUND AND PURPOSE
To explore anatomic substrate of specific wandering patterns in patients with Alzheimer's disease (AD) by performing positron emission tomography with 18F fluorodeoxyglucose positron emission tomography (FDG PET).
METHODS
Drug-naïve AD patients with wandering (n=80) and without wandering (n=262) were recruited. First, the specific pattern of wandering type was operationally classified according to specific wandering score and clinical assessment. Second, brain FDG PET was performed and fluorodeoxyglucose (FDG) uptake differences of specific brain regions according to wandering patterns were compared to those of non-wanderers.
RESULTS
In patients with pacing pattern, FDG PET showed significant lower FDG uptake in both middle cingulum and left putamen cluster compared to non-wanderers. The right precuneus and supplementary motor area in patients with random pattern and left calcarine sulcus, right calcarine sulcus, right middle cingulum, and right post central gyrus in patients with lapping pattern had significantly lower FDG uptake compared to non-wanderers.
CONCLUSIONS
This study showed that wandering in patients with AD had three distinct patterns. These specific patterns showed significant lower FDG uptake in specific brain areas compared to non-wanderers.

Keyword

Alzheimer's disease; Fluorodeoxyglucose F18; Positron emission tomography; Wandering

MeSH Terms

Alzheimer Disease*
Brain
Fluorodeoxyglucose F18
Humans
Motor Cortex
Occipital Lobe
Parietal Lobe
Positron-Emission Tomography
Putamen
Somatosensory Cortex
Fluorodeoxyglucose F18

Figure

• 

  Fig. 1 Schematic showing wandering patterns of patients with Alzheimer's disease.

Reference

1. Synder LH, Rupprecht P, Pyrek J, Brekhus S, Moss T. Wandering. Gerontologist. 1978; 18:272–280.

2. Dawson P, Reid DW. Behavioral dimensions of patients at risk of wandering. Gerontologist. 1987; 27:104–107.

3. Algase DL, Kupferschmid B, Beel-Bates CA, Beattie ER. Estimates of stability of daily wandering behavior among cognitively impaired long-term care residents. Nurs Res. 1997; 46:172–178.

4. Carr D, Muschert GW, Kinney J, Robbins E, Petonito G, Manning L, et al. Silver alerts and the problem of missing adults with dementia. Gerontologist. 2010; 50:149–157.

5. Monsour N, Robb SS. Wandering behavior in old age: a psychosocial study. Soc Work. 1982; 27:411–416.

6. Martino-Saltzman D, Blasch BB, Morris RD, McNeal LW. Travel behavior of nursing home residents perceived as wanderers and nonwanderers. Gerontologist. 1991; 31:666–672.

7. Cumming J, Cumming E, Titus J, Schmelzle E, MacDonald J. The episodic nature of behavioural disturbances among residents of facilities for the aged. Can J Public Health. 1982; 73:319–322.

8. Gurwitz JH, Sanchez-Cross MT, Eckler MA, Matulis J. The epidemiology of adverse and unexpected events in the long-term care setting. J Am Geriatr Soc. 1994; 42:33–38.

9. Hussian RA. Stimulus control in the modification of problematic behavior in elderly institutionalized patients. Int J Behav Geriatr. 1982; 1:33–42.

10. Liu L, Gauthier L, Gauthier S. Spatial disorientation in persons with early senile dementia of the Alzheimer type. Am J Occup Ther. 1991; 45:67–74.

11. Yang YS, Hwang I, Kwak YT. Neuropsychological characteristics of wandering in patients with drug-naïve Alzheimer's disease. Dement Neurocogn Disord. 2014; 13:74–78.

12. Hope T, Tilling KM, Gedling K, Keene JM, Cooper SD, Fairburn CG. The structure of wandering in dementia. Int J Geriatr Psychiatry. 1994; 9:149–155.

13. Klein DA, Steinberg M, Galik E, Steele C, Sheppard JM, Warren A, et al. Wandering behaviour in community-residing persons with dementia. Int J Geriatr Psychiatry. 1999; 14:272–279.

14. Sink KM, Covinsky KE, Newcomer R, Yaffe K. Ethnic differences in the prevalence and pattern of dementia-related behaviors. J Am Geriatr Soc. 2004; 52:1277–1283.

15. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984; 34:939–944.

16. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination(K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–308.

17. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982; 140:566–572.

18. Mahoney FI, Barthel DW. Functional evaluation: Barthel index. Md State Med J. 1965; 14:61–65.

19. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004; 57:297–305.

20. Song JA. Relationship of premorbid personality and behavioral responses to stress to wandering behavior of residents with dementia in long term care facilities [dissertation]. Ann Arbor (MI): University of Michigan;2003.

21. Algase DL, Beattie ER, Bogue EL, Yao L. The Algase Wandering Scale: initial psychometrics of a new caregiver reporting tool. Am J Alzheimers Dis Other Demen. 2001; 16:141–152.

22. Phillips VL, Diwan S. The incremental effect of dementia-related problem behaviors on the time to nursing home placement in poor, frail, demented older people. J Am Geriatr Soc. 2003; 51:188–193.

23. Tetewsky SJ, Duffy CJ. Visual loss and getting lost in Alzheimer's disease. Neurology. 1999; 52:958–965.

24. McShane R, Gedling K, Keene J, Fairburn C, Jacoby R, Hope T. Getting lost in dementia: a longitudinal study of a behavioral symptom. Int Psychogeriatr. 1998; 10:253–260.

25. Rowe MA, Bennett V. A look at deaths occurring in persons with dementia lost in the community. Am J Alzheimers Dis Other Demen. 2003; 18:343–348.

26. Kavcic V, Duffy CJ. Attentional dynamics and visual perception: mechanisms of spatial disorientation in Alzheimer's disease. Brain. 2003; 126:1173–1181.

27. Benton AL. Disorders of spatial orientation. In : Vinken PJ, Bruyn GW, editors. Handbook of Clinical Neurology. New York (NY): Wiley;1969. p. 212–228.

28. Chiu YC, Algase D, Whall A, Liang J, Liu HC, Lin KN, et al. Getting lost: directed attention and executive functions in early Alzheimer's disease patients. Dement Geriatr Cogn Disord. 2004; 17:174–180.

29. Passini R, Rainville C, Marchand N, Joanette Y. Wayfinding in dementia of the Alzheimer type: planning abilities. J Clin Exp Neuropsychol. 1995; 17:820–832.

30. Rolland Y, Payoux P, Lauwers-Cances V, Voisin T, Esquerré JP, Vellas B. A SPECT study of wandering behavior in Alzheimer's disease. Int J Geriatr Psychiatry. 2005; 20:816–820.

31. Meguro K, Yamaguchi S, Yamazaki H, Itoh M, Yamaguchi T, Matsui H, et al. Cortical glucose metabolism in psychiatric wandering patients with vascular dementia. Psychiatry Res. 1996; 67:71–80.

32. Lai CK, Arthur DG. Wandering behaviour in people with dementia. J Adv Nurs. 2003; 44:173–182.

33. Griffiths PD, Perry RH, Crossman AR. A detailed anatomical analysis of neurotransmitter receptors in the putamen and caudate in Parkinson's disease and Alzheimer's disease. Neurosci Lett. 1994; 169:68–72.

34. Koenraadt KL, Roelofsen EG, Duysens J, Keijsers NL. Cortical control of normal gait and precision stepping: an fNIRS study. Neuroimage. 2014; 85:415–422.

35. Sahyoun C, Floyer-Lea A, Johansen-Berg H, Matthews PM. Towards an understanding of gait control: brain activation during the anticipation, preparation and execution of foot movements. Neuroimage. 2004; 21:568–575.

36. Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates. Brain. 2006; 129:564–583.

37. Selemon LD, Goldman-Rakic PS. Common cortical and subcortical targets of the dorsolateral prefrontal and posterior parietal cortices in the rhesus monkey: evidence for a distributed neural network subserving spatially guided behavior. J Neurosci. 1988; 8:4049–4068.

38. Nagahama Y, Okada T, Katsumi Y, Hayashi T, Yamauchi H, Sawamoto N, et al. Transient neural activity in the medial superior frontal gyrus and precuneus time locked with attention shift between object features. Neuroimage. 1999; 10:193–199.

39. Sarlegna FR, Mutha PK. The influence of visual target information on the online control of movements. Vision Res. 2015; 110:144–154.

40. Prosperini L, Leonardi L, De Carli P, Mannocchi ML, Pozzilli C. Visuo-proprioceptive training reduces risk of falls in patients with multiple sclerosis. Mult Scler. 2010; 16:491–499.