Analysis of Cerebral Blood Flow with Single Photon Emission Computed Tomography in Mild Subcortical Ischemic Vascular Dementia

Abstract

Purpose The mechanism of cognitive dysfunction of subcortical ischemic vascular dementia (SIVaD) is not yet fully understood. The objective of this study was to investigate and compare the distribution of regional cerebral perfusion (CP) change in the mild forms of SIVaD, a relatively homogeneous subtype of vascular dementia, using statistical parametric mapping (SPM) analysis of the technetium-99m hexamethylproplyeneamineoxime (Tc-99m HMPAO) single photon emission computed tomography (SPECT). Materials and Methods A total of 28 patients with mild SIVaD and 33 healthy controls were prospectively recruited and underwent SPECT imaging studies between January 2012 and May 2013. SPECT was performed to measure the regional CP, and SPM was applied to the analysis of the SPECT data. Results The regional CP was significantly decreased in the bilateral insula, anterior and posterior cingulated gyrus, precentral gyrus, and subcallosal gyrus as well as the right inferior parietal lobule in the SIVaD patients compared to the controls (corrected p=0.01). The pattern of CP abnormality correlated well with those previously reported in later forms of SIVaD. Conclusions Reduction of CP in the brain areas mentioned was present earlier on in the natural course of SIVaD pathophysiology. Our study suggests that cognitive dysfunction of SIVaD may be related to these regional CP deficits.

Cerebral blood flow changes during aging process and in cognitive disorders: A review

“…Such knowledge about the pattern of CBF in the elderly emphasizes the opportunity for prevention by controlling risk of cardiovascular diseases. 2 32 temporal, 32,34 parietal, 32,34 insular and frontal lobes 32,33 No CBF change in subcortical areas 32 ASL-MRI; 32 PET; 33 SPECT 34 Vascular cognitive impairment Multiple regional CBF reduction with a posterior-anterior gradient, sparing occipital lobe; [63][64][65][66] extensive white matter involvement with a tendency toward subcortical circuit 44 NVU dysregulation due to a combination of hypoperfusion and BBB permeability 44 SPECT; 63,64 ASL-MRI; 65 PET; 66 DCE/DSC-MRI 44 Alzheimer's disease Asymptomatic phase…”

“…62 Compared to AD, in VCI, various brain regions are involved with a gradient from posterior to anterior brain regions (Table 1, Figure 2). 63 Blood flow may change in both gray matter [63][64][65][66] and white matter, 66 or merely white matter with a tendency toward extensive CBF changes in subcortical circuits 44 (Figure 1). While regional CBF changes could be observed with aging (Table 1), such stepwise patterns of CBF changes do not happen in VCI.…”

Neuroimaging and Machine Learning for Dementia Diagnosis: Recent Advancements and Future Prospects

“…In addition, in [69], the mechanism of cognitive dysfunction of subcortical ischemic vascular dementia (SIVaD) was investigated and compared with the distribution of regional cerebral perfusion (CP) changes in the mild forms of SIVaD, using technetium-99m hexamethylproplyeneamineoxime (Tc-99m HMPAO) SPECT analyzed by SPM. Patients were recruited to undergo SPECT imaging for a time duration.…”