Alzheimer病、血管性痴呆和健康老年人神经心理学与脑血流灌注的相关性研究

Neuropsychology andits correlation with cerebralbloodflow in patients with Alzheimer’s disease,vascu lar dementia and normalsineors

目的 研究Ａｌｚｈｅｉｍｅｒ 病（ＡＤ） 、血管性痴呆（ＶＤ） 和健康老年人（ＮＡ） 的神经心理学和功能性影像学特征及两者的相关性。方法 对３６ 例ＡＤ、３５ 例ＶＤ 患者和３７ 名ＮＡ 进行神经心理学评定和脑血流灌注显像。结果 ＡＤ 和ＶＤ 患者各量表成绩显著低于ＮＡ，ＡＤ 的物品记忆测验成绩（ＦＯＭ）显著低于ＶＤ。ＡＤ 和ＶＤ患者大部分脑区放射性计数比值（ＲＡＲ）明显低于ＮＡ，ＡＤ右顶叶和双额叶的ＲＡＲ明显低于ＶＤ。ＮＡ的ＦＯＭ 与多个脑区的ＲＡＲ 相关，ＡＤ 多项量表成绩与右顶叶ＲＡＲ相关，ＶＤ多项量表成绩与左顶叶ＲＡＲ相关。结论 左、右顶叶血流灌注下降分别对ＶＤ 和ＡＤ 的认知缺损有较大影响，提示ＶＤ 和ＡＤ分别具有不同的左。

Objective To study the psychological,functionalimaging findings and the relationship be tweenthem in patients with Alzheimer’s disease (AD),vascular dementia (VD) and normal sineors (NS)- Methods Psychologicalevaluation withratingscalesandfunctionalimagingexamination withsingle photonemis sion computedtomography were conductedto AD,VD (both metthe DSM Ⅳdiagnostic criteria) and NS- Re sults In psychologicalexamination,ADand VDshowedsignificantlylowerscoresin everyscalethan NS,andin Fuld goods memorytest(FOM) ,ADappeared even worsethan VD- Infunctionalimaging examination,at most brain areas,radioactiveratio (RAR)in ADand VDwere obviouslylowerthanthatin NS- Whileinrightparietal lobe and bilateralfrontallobes,RARin ADshowedsignificantlylowerthanin VD- FOMscoreof NSwascorrelat ed with RARin severalbrain areas- RARsofrigntparietallobein ADand ofleftparietallobein VDshowedcor relation with scores of mostrating scales- Conclusions Hypoperfusion in right parietallobe of ADand in left parietallobe of VDcontributes mainlytotheircognitive deficiency,this mayfurthersuggestthe differentrightor lefthemisphere mechanism in ADand VD-