[en] Single photon emission computed tomography (SPECT) using N-isopropyl-p-[I-123]iodoamphetamine (IMP) was performed in 3 patients with Pick's disease (PD) and one patient with Alzheimer's disease (AD). Early and delayed SPECT images were obtained at 20 min and 4 hr, respectively, after iv injection of IMP. In the group of PD patients, early images showed markedly decreased uptake of IMP in the area extending from the frontal to lateral lobes, which corresponded to atrophy as seen on concurrently available magnetic resonance imaging (MRI). On delayed images, there was a trend for slightly increased uptake of IMP when atrophy was milder on MRI. In the case of AD, markedly decreased uptake of IMP was bilaterally observed in the lateral, parietal, and occipital lobes. This was not seen as specific MRI appearance, but was consistent with previously reported features of positron emission computed tomography. The results suggest the usefulness of IMP-SPECT as an adjunctive method for differentiating PD from AD because of the two different SPECT appearances. (Namekawa, K.)

[en] In 54 patients who were diagnosed as having Alzheimer's type dementia based on the Diagnostic and Statistical Manual of Mental Disorders, III, cranial computed tomography (CT) scans were obtained before and after their follow-up study ranging from 6 to 24 months (mean 15.4 +- 4.7 months). Cerebrospinal percentage and CT density in various regions of interest were examined. Six patients died during the study. Comparison of the group of the deceased (Group I) with the group of survivors (Group II) revealed: (1) there was no difference in average age and the degree of mental disorder at first presentation; (2) Group I had decreased activities of daily living; and (3) CT density was significantly decreased in the bilateral lateral and frontal lobes in Group I. As for Group II, decreased CT numbers were noticeable during the follow-up period in the frontal lobe, parietal lobe, and caudate nucleus in the group evaluated as aggravated, as compared with the group evaluated as unchanged. (Namekawa, K.)

[en] Using positron emission computed tomography with F-18 fluoro-D-deoxyglucose, regional cerebral metabolic rate of glucose (rCMRglc) was measured in 8 patients with Alzheimer's disease and 3 healthy volunteers. A decreased rCMRglc was observed in the widespread cortex and basal ganglia of the cerebrum, but not observed in white matter, thalamus, and cerebellum. There was no bilateral difference. rCMRglc was the lowest in the parietal lobe, followed by the temporal lobe and the curvature of the frontal lobe. A decrease in rCMRglu was relatively mild in the inner part of the frontal lobe, primary sensory and motor area of the cerebral cortex, and cerebral basilar ganglia. Alzheimer's disease proved to be characterized by severe glucose metabolic disorder in the association area of the bilateral cerebral cortices. The degree of metabolic disorder was correlated with the degree of dementia in the outer part of the left frontal lobe and the curvature of the cerebral cortex. (Namekawa, K.)

[en] Single photon emission computed tomography (SPECT) with Xe-133 inhalation method was undertaken in 13 patients with mild or moderate senile dementia of Alzheimer's type (SDAT), 9 patients with multiple infarct demantia (MID), and 7 normal controls. Mean blood flow of the hemisphere was significantly decreased in both SDAT and MID groups than the control group. The decreased blood flow was correlated with the severity of SDAT, but not with MID. Regional cerebral blood flow (rCBF) of the SDAT group was significantly decreased in moderate cases than the control group, especially in the bilateral perietal areas, although this did not differ in the mild SDAT cases and the control cases. For MID, rCBF was significantly decreased in the bilateral frontal, basal nucleus, and left lateral areas. The findings led to the conclusion that SPECT is useful in the differential diagnosis of dementia and elucidation of the pathogenesis. (Namekawa, K.)

[en] The degree of dementia was examined in relation to findings of automated EEG and cranial CT in 50 demented old patients aged 51 - 86. Slow waves on EEC, and dilated ventricle and atrophied cortex on cranial CT were frequently associated with poor psychological scores. As the degree of dilated ventricle increased, the frequency and amplitude of slow waves increased and the frequency and continuity of α waves decreased. Dilated ventricle was more strongly correlated with abnormal EEG findings than atrophied cortex. This was more marked in cases of severer patients. Abnormal EEC findings associated with poor psychological scores were more frequently observed in the group of patients with vascular dementia (VD, n = 30) than the group of patients with senile dementia of Alzheimer type (SDAT, n = 20). Abnormal EEG findings were correlated with poor scores on Hasegawa test in the VD group and with those on Bender Gestalt test in the SDAT group. The degree of dilated ventricle was more correlated with abnormal EEG findings in the SDAT group than the VD group. (Namekawa, K.)