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Changes in local cerebral blood flow by neuroactivation and vasoactivation in patients with impaired cognitive function

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Abstract

Imaging of local cerebral blood flow (ICBF) may serve as an important supplementary tool in the aetiological assessment of dementias. In early or preclinical disease, however, there are less characteristic changes in ICBF. In the present study it was investigated whether vasoactivation or neuroactivation may produce more pronounced local ICBF deficits. Local CBF was investigated by using technetium-99m hexamethylpropylene amine oxime and single-photon emission tomography (SPET) in 80 patients (50 with mild cognitive impairment and 30 with dementia of Alzheimer type (DAT), all without evidence of cerebrovascular disease) at rest (baseline) and during activation. In 31 studies patients underwent vasomotor activation with acetazolamide, while 62 studies were performed under cognitive challenge (neuroactivation by labyrinth task). Cortical activity relative to that of cerebellum increased significantly in a right temporal region and tended to increase in other cortical regions upon vasoactivation. In contrast, neuroactivation reduced cortical activity relative to that of cerebellum in several left and right temporal and in left parietal regions. Visual classification of SPET images of patients with probable DAT by three observers resulted in a reduction of the number of definitely abnormal patterns from 9/12 to 4/12 by vasoactivation and an increase from 10/18 to 15/18 by neuroactivation. Correspondingly, abnormal ratings in patients with mild cognitive dysfunction were reduced from 7/19 to 5/19 by vasoactivation and were increased from 12/2I to 18/21 by neuroactivation. In conclusion, vasoactivation does not enhance local relative perfusion deficits in patients with cognitive impairment of non-vascular aetiology, whereas neuroactivation by labyrinth task produces more pronounced local flow differences and enhances abnormal patterns in ICBF imaging.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Leipzig, Germany

    Wolfram H. Knapp, Claudia Dannenberg, Berit Marschall, Simone Bettin, Henryk Barthel & Anita Seese

  2. Department of Psychiatry, University of Leipzig, Germany

    Dyrk Zedlick & Katharina Löschmanne

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Knapp, W.H., Dannenberg, C., Marschall, B. et al. Changes in local cerebral blood flow by neuroactivation and vasoactivation in patients with impaired cognitive function. Eur J Nucl Med 23, 878–888 (1996). https://doi.org/10.1007/BF01084360

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  • DOI: https://doi.org/10.1007/BF01084360

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