Document Detail

The ratio of mesial to neocortical temporal lobe blood flow as a predictor of dementia.
MedLine Citation:
PMID:  9063279     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The hypothesis tested was that an increased ratio of cerebral blood flow (rCBF) in the mesocortical temporal lobe to that of the neocortical temporal lobe (MES/ NEO ratio) would be related to clinical measures of dementia severity and would help distinguish Alzheimer's patients from normal controls. DESIGN: The rCBF of nine Alzheimer's patients (5 males and 4 females; age = 65.9 +/- 6.0 years, range 55-71; Folstein Mini-Mental Status Examination = 18.6 +/- 7.4, range 9-28) and 10 age-matched normal controls (7 males, 3 females; age = 66.0 +/- 5.7 years, range 58-75) was determined by positron emission tomography (PET) using H2(15)0 and the method of Alpert et al. RESULTS: Alzheimer's disease patients had a significantly higher MES/NEO ratio (1.19 +/- .17) than the age-matched normal controls (.854 +/- .14; t = .-4.74, df = 17, P = .0002). Using a MES/NEO ratio of 1 as the cutoff point for discrimination between Alzheimer's patients and normal controls, the ratio demonstrated 100% sensitivity (no. of correctly identified Alzheimer's patients/no. of Alzheimer's patients) and 90% specificity (no. of correctly identified unaffected subjects/no. of unaffected subjects). Further, those patients with the highest MES/NEO ratios had the lowest overall measures of cognitive function (Folstein Mini-Mental Status Examination: r = -.75, P < .02, 1-tail; Mattis Dementia Rating Scale: r = -0.655, P = .028, 1-tail) scores. CONCLUSIONS: The findings are consistent with other in vivo and postmortem studies, suggesting that functional and structural changes of the lateral temporal lobe in Alzheimer's disease occur relatively early in the disease process and appear to be distinguishable from those changes accompanying normal aging. In contrast, the memory loss and pathology of the mesial temporal lobe that is characteristic of the early stages of Alzheimer's patients do not appear to be associated with a reduction in cerebral blood flow in the resting Alzheimer's patient. Nevertheless, the clinical significance of the results must await findings of longitudinal studies of larger numbers of Alzheimer's patients and controls.
R M Cohen; P J Andreason; T Sunderland
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  45     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-07     Completed Date:  1997-04-07     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  329-33     Citation Subset:  IM    
Laboratory of Cerebral Metabolism, National Institute of Mental Health, National Institute of Health, Bethesda, MD 20892-4030, USA.
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MeSH Terms
Alzheimer Disease / metabolism,  physiopathology,  radionuclide imaging*
Analysis of Variance
Case-Control Studies
Cerebrovascular Circulation*
Geriatric Assessment
Mental Status Schedule
Middle Aged
Sensitivity and Specificity
Severity of Illness Index
Temporal Lobe / blood supply*
Tomography, Emission-Computed / standards*

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