Skip to main content

Advertisement

SpringerLink
Log in

A comparative technetium 99m hexamethylpropylene amine oxime SPET study in different types of dementia

  • Original Article
  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPET) using technetium 99m hexamethylpropylene amine oxime (99mTc-HMPAO) as a tracer, in 13 control subjects and 44 age-matched patients suffering from dementia of the Alzheimer's type (DAT, n=19), presumed Pick's disease (n=5), idiopathic Parkinson's disease with dementia (DPD, n=15) and progressive supranuclear palsy (PSP, n=5). HMPAO uptake was measured in the superior frontal, inferior frontal, parietal, temporal and occipital cortices, and the perfusion values were expressed as cortical/cerebellar activity ratios. As compared with controls, tracer uptake ratios in the DAT group were significantly reduced over all cortical regions, with the largest defects in the parieto-temporal and superior frontal cortices. A marked hypoperfusion affecting the superior and inferior frontal cortices was found in Pick's disease, whereas a mild but significant hypoperfusion was observed only in the superior frontal cortex of patients with PSP. In the DPD group, HMPAO uptake was significantly reduced in the parietal, temporal and occipital cortices, but not in the frontal cortex. These results show that DAT and DPD share an opposite anteroposterior HMPAO uptake defect as compared with the Pick's and PSP groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Albert ML, Feldman RG, Willis AL (1974) The subcortical dementia of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 37:121–130

    Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, revised 3rd edn, (DSM-III-R). American Psychiatric Association, Washington

    Google Scholar 

  • Andersen AR, Friberg HH, Schmidt JF, Hasselbalch SG (1988) Quantitative measurements of cerebral blood flow using SPECT and (99mTc)-d, l-HMPAO compared to xenon-133. J Cereb Blood Flow Metab 8:S69-S81

    Google Scholar 

  • Barclay L, Zemcov A, Blass JP, McDowell F (1984) Rates of decrease of cerebral blood flow in progressive dementias. Neurology 34:1555–1560

    Google Scholar 

  • Baron JC, Rougemont D, Collard P, Bousser MG, Comar D (1985) Coupling between cerebral blood flow, oxygen consumption and glucose utilization: its study with positron tomography. In: Positron emission tomography. Alan R (ed) Liss, London, pp 203–218

    Google Scholar 

  • Benson DF (1984) Parkinsonian dementia: cortical or subcortical? In: Hassler RG, Christ JF (eds) Advances in neurology, vol 40. Raven, New York

    Google Scholar 

  • Blin J, Baron JC, Dubois B, Pillon B, Cambon H, Agid Y (1988) PET studies of brain energy metabolism in a model of subcortical dementia: progressive supranuclear palsy. In: Agnoli A, Kahn J, Lassen N, Mayeux R (eds) Senile dementias. John Libbey Eurotext, Paris

    Google Scholar 

  • Bowen DM, Benton JS, Spillane JA, Smith CCT, Allen SJ (1982) Choline acetyltransferase activity and histopathology of frontal neocortex from biopsies of demented patients. J Neurol Sci 57:191–202

    Google Scholar 

  • Brun A, Englund E (1981) Regional pattern of degeneration in Alzheimer's disease: neuronal loss and histopathological grading. Histopathology 5:549–564

    Google Scholar 

  • Butler RW, Dickinson WA, Katholi C, Holsey JH (1983) The comparative effect of organic brain disease on cerebral blood flow and measured intelligence. Ann Neurol 13:155–159

    Google Scholar 

  • Chase TN, Foster NL, Fedio P, Brooks R, Mansi L, Di Chiro G (1984) Regional cortical dysfunction in Alzheimer's disease as determined by positron emission tomography. Ann Neurol 15 (Suppl):S170-S174

    Google Scholar 

  • Chawluk JB, Alavi A, Dann R, Hurtig HI, Bais S, Kushner MJ, Zimmerman RA, Reivich M (1987) Positron emission tomography in aging and dementia: effect of cerebral atrophy. J Nucl Med 28:431–437

    Google Scholar 

  • Creasey H, Rapoport S (1985) The aging human brain. Ann Neurol 17:2–10

    Google Scholar 

  • Cummings JL, Benson DF (1984) Subcortical dementia: review of an emerging concept. Arch Neurol 41:874–879

    Google Scholar 

  • Cutler NR, Haxby JV, Duara R, Grady CL, Kay AD, Kessler RM, Sundaram M, Rapoport SI (1985) Clinical history, brain metabolism, and neuropsychological function in Alzheimer's disease. Ann Neurol 18:298–309

    Google Scholar 

  • D'Antona R, Baron JC, Samson Y, Serdaru M, Viader F, Agid Y, Cambier J (1985) Subcortical dementia: frontal cortex hypometabolism detected by positron tomography in patients with progressive supranuclear palsy. Brain 108:785–799

    Google Scholar 

  • Deutsch G, Tweedy JR (1987) Cerebral blood flow in severity-matched Alzheimer and multi-infarct patients. Neurology 37:431–438

    Google Scholar 

  • Fazekas F, Alavi A, Chawluk JB, Zimmerman RA, Hackney D, Bilaniuk L, Rosen M, Alves WM, Hurtig HI, Jamieson DG, Kushner MJ, Reivich M (1989) Comparison of CT, MR and PET in Alzheimer's dementia and normal aging. J Nucl Med 30:1607–1615

    Google Scholar 

  • Forno LS (1982) Pathology of Parkinson's disease. In: Marsden CD, Fahn S (eds) Movement disorders. Butterworth Scientific, London, pp 25–40

    Google Scholar 

  • Foster NL, Chase TN, Fedio P, Patronas NJ, Brooks RA, Di Chiro G (1983) Alzheimer's disease: focal cortical changes shown by positron emission tomography. Neurology 33:961–965

    Google Scholar 

  • Foster NL, Chase TN, Mansi L, Brook R, Fedio P, Patronas NJ, Dichiro G (1984) Cortical abnormalities in Alzheimer's disease. Ann Neurol16:649–654

    Google Scholar 

  • Frackowiak RSJ, Pozzilli C, Legg NJ, Du Boulay GH, Marshall J, Lenzi GL, Jones T (1981) Regional cerebral oxygen supply and utilization in dementia: a clinical and physiological study with oxygen-15 and positron tomography. Brain 104:753–778

    Google Scholar 

  • Friedland RP, Budinger TF, Ganz E, Yano Y, Mathis CA, Koss B, Ober BA, Huesman RH, Derenzo SE (1983) Regional cerebral metabolic alterations in dementia of the Alzheimer type: positron emission tomography with (18 F) fluorodeoxyglucose. J Comput Assist Tomogr 7:590–598

    CAS  PubMed  Google Scholar 

  • Garron DC, Klawans HL, Narin F (1972) Intellectual functioning of persons with idiopathic parkinsonism. J Nerv Ment Dis 154:445–452

    Google Scholar 

  • Gemmel HG, Sharp PF, Benson JAO, Crawford JR, Ebmeier KP, Davidson J, Smith FW (1987) Differential diagnosis in dementia using the cerebral blood flow agent 99mTc HM-PAO: a SPECT study. J Comput Assist Tomogr 11:398–402

    Google Scholar 

  • Gibb WR (1989) Dementia and Parkinson's disease. Br J Psychiatry 154:596–614

    Google Scholar 

  • Globus M, Mildorf B, Melamed E (1985) rCBF Changes in Parkinson's disease: correlation with dementia. J Cereb Blood Flow Metab 3 [Suppl 1]:S508-S509

    Google Scholar 

  • Hachinski VC, Ilif LD, Zihka E, Du Boulay GH, McAllister VL, Marshall J, Ross Russel RW, Symon L (1975) Cerebral blood flow in dementia. Arch Neurol 32:632–637

    Google Scholar 

  • Haxby JV, Grady CL, Cutler NR, Rapoport SI (1985) Relations between neuropsychological and cerebral metabolic asymmetries in early Alzheimer's disease. J Cereb Blood Flow Metab 5:193–200

    Google Scholar 

  • Haxby JV, Grady CL, Koss E, Horwitz B, Schapiro M, Friedland RP, Rapoport SI (1988) Heterogeneous anterior-posterior metabolic patterns in dementia of the Alzheimer type. Neurology 38:1853–1863

    Google Scholar 

  • Henriksen L, Boas J (1985) Asymmetric cerebral blood flow in hemiparkinsonian patients: tomography of inhaled xenon 133 before and after levodopa treatment. In: Hartmann A, Hoyer S (eds) Cerebral blood flow and metabolism measurement. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Heston LL (1980) Dementia associated with Parkinson's disease: a genetic study. J Neurol Neurosurg Psychiatry 43:846–848

    Google Scholar 

  • Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:952–960

    Google Scholar 

  • Hornykiewicz O, Kish SJ (1984) Neurochemical basis of dementia in Parkinson's disease. Can J Neurol Sci 11:185–190

    Google Scholar 

  • Jagust WJ, Budinger TF, Reed BR (1987) The diagnosis of dementia with single photon emission computed tomography. Arch Neurol 44:258–262

    Google Scholar 

  • Kamo H, McGeer PL, Harrop R, McGeer EG, Calne DB, Martin WRW, Pate BD (1987) Positron emission tomography and histopathology in Pick's disease. Neurology 37:439–445

    Google Scholar 

  • Kuhl DE, Metter EJ, Benson DF, Ashford JW, Riege WH, Fujikawa DG, Markham CH, Mazziota JC, Maltese A, Dorsey DA (1985) Similarities of cerebral glucose metabolism in Alzheimer's and Parkinsonian dementia. J Cereb Blood Flow Metab 5 [Suppl 1]: S 169-S 170

    Google Scholar 

  • Kushner M, Tobin M, Alavi A, Chawluk J, Rosen M, Fazekas F, Alavi J, Reivich M (1987) Cerebellar glucose consumption in normal and pathologic states using fluorine-FDG and PET. J Nucl Med 28:1667–1670

    Google Scholar 

  • Lear JL (1988) Initial cerebral HM-PAO distribution compared to rCBF: use of a model which considers cerebral HM-PAO trapping kinetics. J Cereb Blood Flow Metab 8:531–537

    Google Scholar 

  • Leazak MD (ed) (1983) Neuropsychological assessment, 2nd edn. Oxford University Press, New York

    Google Scholar 

  • Leenders KL, Wolfson L, Jones T (1985) Positron emission tomography in the study of Parkinson's disease. In: Hartmann A, Hoyer S (eds) Cerebral blood flow and metabolism measurement. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Lenzi GL, Jones T, Reid JL, Moss S (1979) Regional impairment of cerebral oxidative metabolism in Parkinson's disease. J Neurol Neurosurg Psychiatry 42:59–62

    Google Scholar 

  • Lou HC, Edvinsson L, MacKenzie ET (1987) The concept of coupling blood flow to brain function: revision required? Ann Neurol 22:289–297

    Google Scholar 

  • Matsui T, Hirano A (1978) An atlas of the human brain for computed tomography. Igaku-Shoin Medical, New York

    Google Scholar 

  • Mayeux R, Stern Y, Rosen J, Benson DF (1983) Is “subcortical dementia” a recognizable clinical entity? Ann Neurol 14:278–283

    Google Scholar 

  • Mazziota JC, Phelps ME, Carson RE, Kuhl DE (1982) Tomographic mapping of human cerebral metabolism: sensory deprivation. Ann Neurol 12:435–444

    Google Scholar 

  • McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services task force on Alzheimer's disease. Neurology 34:939–944

    CAS  PubMed  Google Scholar 

  • Montaldi D, Brooks DN, McColl JH, Wyper D, Patterson J, Barron E, McCulloch J (1990) Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease. J Neurol Neurosurg Psychiatry 53:33–38

    Google Scholar 

  • Montastruc JL, Celsis P, Agniel A, Demonet JF, Doyon B, Puel M, Marc-Vergnes JP, Rascol A (1987) Levodopa induced regional cerebral blood flow changes in normal volunteers and patients with Parkinson's disease. Mov Disord 4:279–289

    Google Scholar 

  • Neary D, Snowden JS, Shields RA, Burjan AWI Northen B, Mac Dermott N, Prescott MC, Testa HJ (1987) Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia. J Neurol Neurosurg Psychiatry 50:1101–1109

    Google Scholar 

  • Neirinck RD, Canning LR, Piper IM, Nowotnik DP, Pickett RD, Holmes RA, Volkert WA, Forster AM, Weisner PS, Morriott JA, Chaplin SB (1987) Technetium-99m spd,l-HM-PAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. J Nucl Med 28:191–202

    Google Scholar 

  • Perani D, Di Piero V, Vallar G, Cappa S, Messa C, Bottini G, Berti A, Passafiume D, Scarlato G, Gerundini P, Lenzi GL, Fazio F (1988) Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease. J Nucl Med 29:1507–1514

    Google Scholar 

  • Pillon B, Dubois B, Lhermitte F, Agid Y (1986) Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease, and Alzheimer's disease. Neurology 36:1179–1185

    Google Scholar 

  • Pizzolato G, Dam M, Borsato N, Saitta B, Da Col C, Perlotto N, Zanco P, Ferlin L, Battistin L (1988) (99mTc)-HM-PAO SPECT in Parkinson's disease. J Cereb Blood Flow Metab 8:S101-S108

    Google Scholar 

  • Risberg J (1985) Application of the nontraumatic xenon 133 method in neuropsychiatry. In: Hartmann A, Hoyer S (eds) Cerebral blood flow and metabolism measurement. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Rouzaud M, Degiovanni E, Jobard P, Gray F, Durand JP (1974) L'ophthamoplegie supra-nucleaire progressive — nouvelle observation anatomo-clinique. Revue Neurol 130:143–164

    Google Scholar 

  • Schlageter NL, Horwitz B, Creasey H, Carson R, Duara R, Berg GW, Rapoport SI (1987) Relation of measured brain glucose utilisation and cerebral atrophy in man. J Neurol Neurosurg Psychiatry 50:779–785

    Google Scholar 

  • Sharp PF, Smith FW, Gemmell HG, Lyall D, Evans NTS, Gvozdanovic D, Davidson J, Tyrrell DA, Pickett RD, Neirincks RD (1986a) Technetium-99m HM-PAO stereoisomers as potential agents for imaging regional cerebral blood flow: human volunteer studies. J Nucl Med 27:171–177

    Google Scholar 

  • Sharp P, Gemmel H, Cherryman G, Besson J, Crawford J, Smith F (1986b) Application of iodine-123-labeled isopropylamphetamine imaging to the study of dementia. J Nucl Med 27:761–768

    Google Scholar 

  • Smith FW, Besson JAO, Gemmell HG, Sharp PF (1988) The use of technetium 99m-HM-PAO in the assessment of patients with dementia and other neuropsychiatric conditions. J Cereb Blood Flow Metab 8:S116-S122

    Google Scholar 

  • Taylor AE, Saint-Cyr JA, Lang AE (1986) Frontal lobe dysfunction in Parkinson's disease: the cortical focus of neostriatal outflow. Brain 109:845–883

    Google Scholar 

  • Weschler AF, Verity MA, Rosenschein S, Fried I, Scheibel AB (1982) Pick's disease. A clinical computed tomographic, and histologic study with Golgi impregnation observations. Arch Neurol 39:287–290

    Google Scholar 

  • Whitehouse PJ (1986) The concept of subcortical and cortical dementia: another look. Ann Neurol 19:1–6

    Google Scholar 

  • Wilcock GK, Esiri MM (1983) Age and Alzheimer's disease. Lancet 1:346

    Google Scholar 

  • Winer BJ (1962) Statistical principles in experimental design. McGraw Hill, New York

    Google Scholar 

  • Yates CM, Simpson J, Gordon A, Maloney AF, Allison Y, Ritchie IM, Urquhart A (1983) Catecholamines and cholinergic enzymes in the pre-senile and senile Alzheimer-type dementia and Down's syndrome. Brain Res 280:119–126

    Google Scholar 

  • Yoshii F, Barker WW, Chang JY, Loewenstein D, Apicella A, Smith D, Boothe T, Ginsberg MD, Pascal S, Duara R (1988) Sensitivity of cerebral glucose metabolism to age, gender, brain volume, brain atrophy, and cerebrovascular risk factors. J Cereb Blood Flow Metab 8:654–666

    Google Scholar 

  • Zubenco GS, Moossy J, Martinez J, Rao GR, Kopp U, Hanin I (1989) A brain regional analysis of morphologic and cholinergic abnormalities in Alzheimer's disease. Arch Neurol 46:634–638

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, F-75674, Paris Cedex 14, France

    M. O. Habert, M. L. Piketty & S. Askienazy

  2. Department of Neurology, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, F-75674, Paris Cedex 14, France

    U. Spampinato, J. L. Mast, J. de Recondo & P. Rondot

  3. Department of Psychiatry, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, F-75674, Paris Cedex 14, France

    M. C. Bourdel

Authors
  1. M. O. Habert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Spampinato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. L. Mast
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. L. Piketty
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. C. Bourdel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. de Recondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Rondot
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Askienazy
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Offprint reprints to: M.O. Habert

Rights and permissions

Reprints and permissions

About this article

Cite this article

Habert, M.O., Spampinato, U., Mast, J.L. et al. A comparative technetium 99m hexamethylpropylene amine oxime SPET study in different types of dementia. Eur J Nucl Med 18, 3–11 (1991). https://doi.org/10.1007/BF00177677

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00177677

Key words

Search

Navigation