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Psychiatric Disorders in Dementia

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PET and SPECT in Psychiatry

Abstract

Alzheimer’s disease (AD) is the most common form of dementia, a neurodegenerative disorder which is characterized not only by cognitive deterioration but also by a diversity of behavioral and psychological signs and symptoms of dementia (BPSD). BPSD in AD or other dementia subtypes such as frontotemporal dementia (FTD) or dementia with Lewy bodies (DLB) consist of delusions, hallucinations, activity disturbances, aggression/agitation, diurnal rhythm disturbances, mood disorders, apathy, and anxieties/phobias. Neuroimaging modalities such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are very essential and useful imaging tools to differentially diagnose between AD and non-AD or healthy control subjects or between different dementia subtypes, such as AD and DLB or FTD. Besides their diagnostic utility, PET and SPECT are useful tools to investigate the cerebral pathophysiology of BPSD in dementia.

Below, PET and SPECT neuroimaging research in dementia spanning the last three decades has been systematically reviewed. The most commonly used PET and SPECT radioligands, as well as new developments in the field, all targeting different and unique aspects of neurodegeneration, are described. Furthermore, PET and SPECT research in BPSD with a main focus on depression, apathy, and psychosis in AD, DLB, and FTD are discussed in detail. On the whole, both PET and SPECT have demonstrated that depending on the behavioral phenomenon and dementia subtype, BPSD are the fundamental expression of very regional cerebral pathological events rather than a diffuse brain illness.

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Abbreviations

11C-DASB:

11C-3-amino-4-(2-dimethylaminomethylphenylsulfanyl)-benzonitrile

11C-PMP:

11C-methylpiperidin-4-yl propionate

11C-RAC:

11C-raclopride

123I-β-CIT:

123I-2beta-carbomethoxy-3beta-(4-iodophenyl)tropane

123I-IBVM:

123I-iodobenzovesamicol

123I-IDEX:

123I-iododexetimide

123I-FP:

123I-fluoropropyl

123I-IMP:

N-isopropyl-p-123I-iodoamphetamine

18F-FDG:

18F-fluorodeoxyglucose

99mTc-ECD:

99mTechnetium-ethyl-cysteinate dimer

99mTc-HMPAO:

99mTechnetium-hexamethylpropyleneamine oxime

3DSRT:

3-D stereotactic region of interest template

5-HT:

Serotonin (5-hydroxytryptamine)

Aβ:

Beta-amyloid

ABS-score:

Abe’s BPSD score

AD:

Alzheimer’s disease

ADAS-(non)cog:

Alzheimer’s Disease Assessment Scale, (non)cognitive portion

AD+CVD:

Alzheimer’s disease with cerebrovascular disease

ADRDA:

Alzheimer’s Disease and Related Disorders (see NINCDS)

ALS:

Amyotrophic lateral sclerosis

ANCOG:

Antwerp cognition

APOE:

Apolipoprotein E

APP:

Amyloid precursor protein

BA:

Brodmann area

BADL:

Basic activities of daily living

Behave-AD:

Behavioral pathology in Alzheimer’s disease rating scale

BPSD:

Behavioral and psychological signs and symptoms of dementia

BPSD-DS:

Behavioral and psychological signs and symptoms of dementia in Down syndrome

bvFTD:

Behavioral variant frontotemporal dementia

CBD:

Corticobasal degeneration

CC:

Cingulate cortex

CIS:

Cingulate island score

COX:

Cyclooxygenase

CMAI:

Cohen-Mansfield agitation inventory

CSDD:

Cornell Scale for Depression in Dementia

CSF:

Cerebrospinal fluid

CVD:

Cerebrovascular disease

DA:

Dopamine

DAT:

Dopamine transporter

DLB:

Dementia with Lewy bodies

DSM-5:

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition

EPS:

Extrapyramidal symptoms

ERDA:

Epidemiology research on dementia in Antwerp

eZIS:

Easy Z-score imaging system

FDDNP:

18F-2-(1-(2-(N-(2-fluoroethyl)-N-methylamino)naphthalene-6-yl)ethylidene)malononitrile

FDG:

Fluorodeoxyglucose

FTD:

Frontotemporal dementia

FTLD:

Frontotemporal lobar degeneration

GDS:

Geriatric depression scale

HDS:

Hamilton Depression Rating Scale

IAD:

Instrumental activities of daily living

IDO:

Indoleamine 2,3-dioxygenase

IMPY:

6-Iodo-2-(4′-dimethylamino-)phenyl-imidazo[1,2]pyridine

LC:

locus coeruleus

LOAD:

Late-onset Alzheimer’s disease

MAPT:

Microtubule-associated protein tau

MCI:

Mild cognitive impairment

MFS:

Middelheim Frontality Score

MMSE:

Mini-Mental State Examination

MRB:

Methylreboxetine

MXD:

Mixed dementia

NE:

Norepinephrine

NET:

Norepinephrine transporter

NFT:

Neurofibrillary tangles

NINCDS:

National Institute of Neurological and Communicative Disorders and Stroke (see ADRDA)

NPI:

Neuropsychiatric Inventory

NPI-C:

Neuropsychiatric Inventory-Clinician

NPI-NH:

Neuropsychiatric Inventory-Nursing Home version

NPI-Q:

Neuropsychiatric Inventory Questionnaire

NPS:

Neuropsychiatric symptoms

NSAID:

Nonsteroidal anti-inflammatory drugs

PBR-TSPO:

Peripheral benzodiazepine receptor-translocator protein

PD:

Parkinson’s disease

PD-1:

Programmed death-1

PDD:

Parkinson’s disease dementia

PET:

Positron emission tomography

PGRN:

Progranulin

PiB:

Pittsburgh compound-B

PSEN:

Presenilin

PSP:

Progressive supranuclear palsy

Py:

Person years

RBD:

REM sleep behavioral disorder

rCBF:

Regional cerebral blood flow

ROI:

Regions of interest

SB-13:

4-N-methylamino-4’-hydroxystilbene

SD:

Semantic dementia

SNCA:

α-Synuclein

SPECT:

Single-photon emission computed tomography

SPM:

Statistical parametric mapping

TDP-43:

TAR DNA-binding protein 43

U:

Ubiquitin

VAD:

Vascular dementia

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Acknowledgments

This work was supported by the Research Foundation-Flanders (FWO); the Belgian Alzheimer Research Foundation—Stichting Alzheimer Onderzoek (SAO-FRA grants #2017/0025 and #2018/0027); the Joint Programming Initiative Neurodegenerative Diseases (JPND) multinational research project HEROES (ZonMw project 733051072); the agreement between the Institute Born-Bunge and the University of Antwerp; the Medical Research Foundation Antwerp; the Thomas Riellaerts research fund; and Neurosearch Antwerp.

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Authors and Affiliations

  1. Department of Biomedical Sciences, Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Wilrijk, Belgium

    Yannick Vermeiren, Debby Van Dam & Peter Paul De Deyn

  2. Department of Neurology, Alzheimer Center Groningen, University of Groningen and University Medical Center Groningen (UMCG), Groningen, The Netherlands

    Yannick Vermeiren, Debby Van Dam, Maartje de Vries & Peter Paul De Deyn

  3. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium

    Peter Paul De Deyn

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  1. Yannick Vermeiren
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  4. Peter Paul De Deyn
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Correspondence to Peter Paul De Deyn .

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Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering, Medical Engineering and Computer Science, Offenburg University, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F. J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, The Netherlands

    Iris E. Sommer

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Vermeiren, Y., Van Dam, D., de Vries, M., De Deyn, P.P. (2021). Psychiatric Disorders in Dementia. In: Dierckx, R.A., Otte, A., de Vries, E.F.J., van Waarde, A., Sommer, I.E. (eds) PET and SPECT in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-57231-0_9

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