Title:Correlation of Neuropsychiatric Symptoms in Dementia with Brain Perfusion:
A 99mTc-SPECT-HMPAO Study with Brodmann Areas Analysis
Volume: 18
Issue: 12
Author(s): Varvara Valotassiou, Nikolaos Sifakis, Chara Tzavara, Evi Lykou, Niki Tsinia, Vasiliki Kamtsadeli, Dimitra Sali, George Angelidis, Dimitrios Psimadas, Ioannis Tsougos, Sokratis G. Papageorgiou, Panagiotis Georgoulias and John Papatriantafyllou
Affiliation:
Keywords:
Neuropsychiatric symptoms, dementia, perfusion, SPECT, brodmann areas, neuropsychiatric inventory.
Abstract:
Background: Neuropsychiatric symptoms (NPSs) are common in dementia. Their evaluation
is based on Neuropsychiatric Inventory (NPI). Neuroimaging studies have tried to elucidate
the underlying neural circuits either in isolated NPSs or in specific forms of dementia.
Objective: The objective of this study is to evaluate the correlation of NPS in the NPI with Brodmann
areas (BAs) perfusion, for revealing BAs involved in the pathogenesis of NPSs in dementia
of various etiologies.
Methods: We studied 201 patients (82 with Alzheimer's disease, 75 with Frontotemporal dementia,
27 with Corticobasal Syndrome, 17 with Parkinson Disease/Lewy Body Dementia). Exploratory
factor analysis was carried out to evaluate underlying groups of BAs, and Principal Component
analysis was chosen as extraction method using Varimax rotation. Partial correlation coefficients
were computed to explore the association of factors obtained from analysis and NPI items controlling
for age, educational yeas, and ACE-R.
Results: We found 6 BAs Factors(F); F1 (BAs 8,9,10,11,24,32,44,45,46,47, bilaterally), F2 (BAs
4,5,6,7,23,31, bilaterally), F3 (BAs 19,21,22,37,39,40, bilaterally), F4 (BAs 20,28,36,38, bilaterally),
F5 (BAs 25, bilaterally) and F6 (BAs 17,18, bilaterally). Significant and negative correlation
was found between NPI1 (delusions) and F3,F6, NPI2 (hallucinations) and F6, NPI7 (apathy) and
F1,F4,F5, NPI3 (agitation) - NPI10 (aberrant motor behavior) - NPI12 (eating disorders) and F1.
We did not find any significant correlation for NPI4,5,6,8,9,11 (depression, anxiety, euphoria, disinhibition,
irritability, sleep disorders, respectively).
Conclusion: Several NPSs share the same BAs among different types of dementia, while the manifestation
of the rest may be attributed to different neural networks. These findings may have an impact
on patients’ treatment.