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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 characteristics, PET and SPECT are also useful tools to investigate the cerebral pathophysiology of BPSD in AD, FTD, and DLB among others.

Below, PET- and SPECT-related neuroimaging in dementia spanning the last two decades has been reviewed. The common use of different PET and SPECT radioligands and other compounds which target different and unique aspects of neurodegeneration in the differential diagnosis of dementia is described. Furthermore, PET and SPECT research in BPSD with a main focus on depression, apathy, and psychosis in AD, DLB, and FTD are illustrated as well. On the whole, both PET and SPECT imaging of neuropsychiatric disturbances in dementia 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]-FP:

[123I]-fluoropropyl

[123I]-IBVM:

[123I]-iodobenzovesamicol

[123I]-IDEX:

[123I]-iododexetimide

[123I]-IMP:

N-isopropyl-p-[123I]-iodoamphetamine

[123I]-β-CIT:

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

[18F]-FDG:

[18F]-fluorodeoxyglucose

3DSRT:

3D stereotactic region of interest template

5HT:

Serotonin (5-hydroxytryptamine)

99mTc-ECD:

99mtechnetium-ethyl-cysteinate dimer

99mTc-HMPAO:

99mtechnetium-hexamethylpropyleneamine oxime

AD:

Alzheimer’s disease

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

Aβ:

Beta-amyloid

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

CMAI:

Cohen-Mansfield Agitation Inventory

COX:

Cyclooxygenase

CSDD:

Cornell Scale for Depression in Dementia

CSF:

Cerebrospinal fluid

DA:

Dopamine

DLB:

Dementia with Lewy bodies

DSM-IV-TR:

Diagnostic and Statistical Manual for Mental Disorders IV text revised

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

IAD:

Instrumental activities of daily living

IDO:

Indoleamine 2,3-dioxygenase

IMPY:

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

MAPT:

Microtubule-associated protein tau

MCI:

Mild cognitive impairment

MFS:

Middelheim Frontality Score

MMSE:

Mini-mental State Examination

MXD:

Mixed dementia

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

NSAID:

Nonsteroidal anti-inflammatory drugs

PD:

Parkinson’s disease

PDD:

Parkinson’s disease dementia

PET:

Positron emission tomography

PGRN:

Progranulin

PiB:

Pittsburgh compound-B

PSEN:

Presenilin

Py:

Person years

rCBF:

Regional cerebral blood flow

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 Fund Flanders (FWO grant G.0164.09), Interuniversity Poles of Attraction (IAP Network P7/16) of the Belgian Federal Science Policy Office, Methusalem excellence grant of the Flemish Government, agreement between Institute Born-Bunge and University of Antwerp, the Medical Research Foundation Antwerp, the Thomas Riellaerts research fund, and Neurosearch Antwerp. DVD is a postdoctoral fellow of the FWO.

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  1. Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium

    Yannick Vermeiren & Debby Van Dam

  2. Department of Biomedical Sciences, Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium

    Peter Paul De Deyn

  3. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Lindendreef 1, 2020, Antwerp, Belgium

    Peter Paul De Deyn

  4. Department of Neurology, Alzheimer Research Center, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    Peter Paul De Deyn

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  1. Yannick Vermeiren
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Correspondence to Peter Paul De Deyn .

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

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, 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. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (UMCG), Groningen, The Netherlands

    Johan A. den Boer

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Vermeiren, Y., Van Dam, D., De Deyn, P.P. (2014). Psychiatric Disorders in Dementia. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., den Boer, J. (eds) PET and SPECT in Psychiatry. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40384-2_11

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