Correlation of Neuropsychiatric Symptoms in Dementia with Brain Perfusion: A 99mTc-SPECT-HMPAO Study with Brodmann Areas Analysis

Varvara Valotassiou; Nikolaos Sifakis; Chara Tzavara; Evi Lykou; Niki Tsinia; Vasiliki Kamtsadeli; Dimitra Sali; George Angelidis; Dimitrios Psimadas; Ioannis Tsougos; Sokratis G Papageorgiou; Panagiotis Georgoulias; John Papatriantafyllou

doi:10.2174/1567205019666211220130505

Correlation of Neuropsychiatric Symptoms in Dementia with Brain Perfusion: A 99mTc-SPECT-HMPAO Study with Brodmann Areas Analysis

Curr Alzheimer Res. 2021;18(12):970-983. doi: 10.2174/1567205019666211220130505.

Affiliations

¹ Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece.
² Nuclear Medicine Department, "Alexandra" General Hospital, Athens, Greece.
³ 3rd Age Day Care Center, IASIS, Athens, Greece.
⁴ 1st University Psychiatric Department, Aeginition Hospital, Athens, Greece.
⁵ Neurology Department, Evrokliniki, Athens, Greece.
⁶ Nuclear Medicine Department, University Hospital of Larissa, Thessaly,Greece.
⁷ Medical Physics Department, Medical School, University of Thessaly, Greece.
⁸ 2nd University Department of Neurology, Attikon Hospital, Athens, Greece.
⁹ 3rd Age Day Care Center, IASIS, Athens,Greece | Memory Disorders Clinic, Medical Center, Athens, Greece.

PMID: 34931963
DOI: 10.2174/1567205019666211220130505

Abstract

Background: Neuropsychiatric symptoms (NPSs) are common in dementia. Their evaluation is based on Neuropsychiatric Inventory (NPI). Neuroimaging studies have tried to elucidate the underlying neural circuits either in isolated NPSs or in specific forms of dementia.

Objective: The objective of this study is to evaluate the correlation of NPS in the NPI with Brodmann areas (BAs) perfusion, for revealing BAs involved in the pathogenesis of NPSs in dementia of various etiologies.

Methods: We studied 201 patients (82 with Alzheimer's disease, 75 with Frontotemporal dementia, 27 with Corticobasal Syndrome, 17 with Parkinson Disease/Lewy Body Dementia). Exploratory factor analysis was carried out to evaluate underlying groups of BAs, and Principal Component analysis was chosen as extraction method using Varimax rotation. Partial correlation coefficients were computed to explore the association of factors obtained from analysis and NPI items controlling for age, educational yeas, and ACE-R.

Results: We found 6 BAs Factors(F); F1 (BAs 8,9,10,11,24,32,44,45,46,47, bilaterally), F2 (BAs 4,5,6,7,23,31, bilaterally), F3 (BAs 19,21,22,37,39,40, bilaterally), F4 (BAs 20,28,36,38, bilaterally), F5 (BAs 25, bilaterally) and F6 (BAs 17,18, bilaterally). Significant and negative correlation was found between NPI1 (delusions) and F3,F6, NPI2 (hallucinations) and F6, NPI7 (apathy) and F1,F4,F5, NPI3 (agitation) - NPI10 (aberrant motor behavior) - NPI12 (eating disorders) and F1. We did not find any significant correlation for NPI4,5,6,8,9,11 (depression, anxiety, euphoria, disinhibition, irritability, sleep disorders, respectively).

Conclusion: Several NPSs share the same BAs among different types of dementia, while the manifestation of the rest may be attributed to different neural networks. These findings may have an impact on patients' treatment.

Keywords: Neuropsychiatric symptoms; SPECT; brodmann areas; dementia; neuropsychiatric inventory.; perfusion.

MeSH terms

Alzheimer Disease* / diagnostic imaging
Alzheimer Disease* / psychology
Cerebral Cortex
Humans
Neuropsychological Tests
Perfusion
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon

Substances

Technetium Tc 99m Exametazime