Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
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Brain Perfusion Correlates of Apathy in Alzheimer's Disease

  • Jeong, Hyeonseok (Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kang, Ilhyang (Ewha Brain Institute, Ewha Womans University) ;
  • Im, Jooyeon J. (Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Jong-Sik (Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Na, Seung-Hee (Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Heo, Youngje (Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Yang, YoungSoon (Department of Neurology, Veterans Hospital, Seoul Medical Center) ;
  • Chung, Yong-An (Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Song, In-Uk (Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2018.06.21
  • Accepted : 2018.06.29
  • Published : 2018.06.30
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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 (${\beta}=-0.25$; p=0.04). Conclusions: Hypoperfusion in the prefrontal, striatal, and insular areas may be neural correlates of apathy in AD patients.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF)

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