Dement Neurocogn Disord.  2018 Jun;17(2):50-56. 10.12779/dnd.2018.17.2.50.

Brain Perfusion Correlates of Apathy in Alzheimer's Disease

• Jeong H
• Kang I
• Im JJ
• Park JS
• Na SH
• Heo Y
• Yang Y
• Chung YA
• Song IU

• KMID: 2442808
• DOI: http://doi.org/10.12779/dnd.2018.17.2.50

Abstract

BACKGROUND AND PURPOSE
Apathy is one of the most common neuropsychiatric symptoms in patients with Alzheimer's disease (AD). It may have adverse impacts on the progression of AD. However, its neurobiological underpinnings remain unclear. The objective of this study was to investigate differences in regional cerebral blood flow (rCBF) between AD patients with apathy and those without apathy.
METHODS
Sixty-six apathetic AD patients and 66 AD patients without apathy completed Neuropsychiatric Inventory (NPI) and underwent technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT) scans. Voxel-wise differences in rCBF between the 2 groups were examined. Association between rCBF and levels of apathy in the apathetic group was also assessed.
RESULTS
AD patients with apathy showed lower rCBF in the bilateral orbitofrontal cortex, left putamen, left nucleus accumbens, left thalamus, and bilateral insula than those without (all p < 0.005). Mean perfusion across all significant clusters showed a negative linear correlation with NPI apathy score in AD patients with apathy (β = −0.25; p = 0.04).
CONCLUSIONS
Hypoperfusion in the prefrontal, striatal, and insular areas may be neural correlates of apathy in AD patients.

Keyword

Alzheimer's Disease; Apathy; Tomography, Emission-Computed, Single-Photon; Regional Blood Flow

MeSH Terms

Alzheimer Disease*
Apathy*
Brain*
Cerebrovascular Circulation
Humans
Nucleus Accumbens
Perfusion*
Prefrontal Cortex
Putamen
Regional Blood Flow
Thalamus
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon

Figure

• 

  Fig. 1 Differences in regional cerebral blood flow between AD patients with apathy and those without apathy. At each voxel, decreases in brain perfusion in AD patients with apathy appear in blue-green. The height threshold is set at p<0.005 and extent threshold is 100 or more contiguous voxels. Images are shown in neurological convention. Color bar represents voxel-level t-values. AD: Alzheimer's disease.

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