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Vascular risk factors and the relationships between cognitive impairment and hypoperfusion in late-onset Alzheimer’s disease

Published online by Cambridge University Press:  22 August 2018

Michio Takahashi ,
Yasunori Oda ,
Koichi Sato  and
Yukihiko Shirayama
Michio Takahashi
Affiliation:
Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan
Yasunori Oda
Affiliation:
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
Koichi Sato
Affiliation:
Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan
Yukihiko Shirayama*
Affiliation:
Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan
*
*Author for correspondence: Yukihiko Shirayama, Department of Psychiatry, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara 299-0111, Japan. Tel: +81 436 62 1211; Fax: +81 436 62 1511; E-mail: shirayama@rapid.ocn.ne.jp
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Abstract

Objective

Our recent single-photon emission computed tomography (SPECT) study of patients with late-onset Alzheimer’s disease (AD) revealed that regional cerebral blood flow (rCBF) was reduced in the frontal, temporal, and limbic lobes, and to a lesser degree in the parietal and occipital lobes. Moreover, these patients’ scores on the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) were significantly correlated with rCBF in some gyri of the frontal, parietal, and limbic lobes. Our present study aimed to understand how vascular factors and metabolic disease influenced the relationship between rCBF and ADAS-cog scores.

Methods

We divided late-onset AD patients into two groups according to their Hachinski Ischemic Score (HIS), low vascular risk patients had values of ≤4 (n=25) and high vascular risk patients had scores ≥5 (n=15). We examined rCBF using brain perfusion SPECT data.

Results

The degrees and patterns of reduced rCBF were largely similar between late-onset AD patients in both groups, regardless of HIS values. Cognitive function was significantly associated with rCBF among late-onset AD patients with low vascular risk (HIS≤4), but not among those with high vascular risk (HIS≥5). Furthermore, metabolic diseases, such as hypertension and diabetes mellitus, disrupted the relationships between hypoperfusion and cognitive impairments in late-onset AD patients.

Conclusion

Factors other than hypoperfusion, such as hypertension and diabetes mellitus, could be involved in the cognitive dysfunction of late-onset AD patients with high vascular risk.

Keywords

cognitive functiondementiametabolic diseaseSPECT
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 30 , Issue 6 , December 2018 , pp. 350 - 358
Copyright
© Scandinavian College of Neuropsychopharmacology 2018 

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