Journal of Neural Transmission

, Volume 124, Issue 9, pp 1109–1121 | Cite as

Relationships between cognitive impairment on ADAS-cog and regional cerebral blood flow using SPECT in late-onset Alzheimer’s disease

  • Michio Takahashi
  • Yasunori Oda
  • Toshiyuki Okubo
  • Yukihiko ShirayamaEmail author
Neurology and Preclinical Neurological Studies - Original Article


The aim of this study was to examine brain hypoperfusion and its relationship with cognitive dysfunction in late-onset Alzheimer’s disease (AD). Forty patients with late-onset AD and not receiving acetylcholinesterase inhibitors were recruited from outpatient clinics. We examined cognitive function using the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and brain perfusion using single-photon emission computed tomography, and analyzed classified gyrus level segments with three-dimensional stereotactic surface projection and the stereotactic extraction estimation method level 3. ADAS-cog subscales were grouped into three domains: language, memory, and praxis. Patients with late-onset AD showed an apparent reduction in regional cerebral blood flow (rCBF) with a z score >1.5 in the frontal, temporal, and limbic lobes, with lesser reduction in the parietal and occipital lobes. Although hypoperfusion in the orbital, rectal, and subcallosal gyri of the frontal lobe was prominent, rCBF in the inferior frontal gyrus of the frontal lobe was significantly correlated with ADAS-cog total and language and praxis subscale scores. The parahippocampal gyrus of the limbic lobe was also significantly correlated with the ADAS-cog total, language, and praxis subscale scores. Additionally, the cingulate of the limbic lobe was significantly related with ADAS-cog memory. In spite of lesser hypoperfusion, the posterior cingulate gyrus of the limbic lobe was significantly related with ADAS-cog total, language, and memory subscale scores. Further, each subdivision of ADAS-cog was found to be related with various brain regions.


SPECT Late-onset Alzheimer’s disease ADAS rCBF 


Compliance with ethical standards


This research received no specific Grant from any funding agency or from commercial or not-for-profit sectors.

Conflict of interest

Dr. Shirayama has received research support from Eli Lilly, Eisai, MSD, Pfizer, and Mitsubishi-Tanabe. Dr. Okubo has received research support from Eisai, Bayer, and Daiichi Sankyo. Dr. Takahashi and Dr. Oda have no competing interests.


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Michio Takahashi
    • 1
  • Yasunori Oda
    • 3
  • Toshiyuki Okubo
    • 2
  • Yukihiko Shirayama
    • 1
    Email author
  1. 1.Department of PsychiatryTeikyo University Chiba Medical CenterIchiharaJapan
  2. 2.Department of RadiologyTeikyo University Chiba Medical CenterIchiharaJapan
  3. 3.Department of PsychiatryChiba University Graduate School of MedicineChibaJapan

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