AIM To evaluate usefulness of single photon emission computed tomography(SPECT) with three-dimensional stereotactic surface projection(3D-SSP) in distinguishing between Alzheimer's disease(AD) and depression.METHO...AIM To evaluate usefulness of single photon emission computed tomography(SPECT) with three-dimensional stereotactic surface projection(3D-SSP) in distinguishing between Alzheimer's disease(AD) and depression.METHODS We studied 43 patients who presented with both depressive symptoms and memory disturbance. Each subject was evaluated using the following:(1) the Minimal Mental State Examination;(2) the Hamilton Rating Scale for Depression;(3) Clinical Global Impression-Severity scale(CGI-S); and(4) SPECT imaging with 3D-SSP.RESULTS The MMSE scores correlated significantly with the maximum Z-scores of AD-associated regions. CGI-S scores correlated significantly with the maximum Z-scores of depression-associated regions. Factor analysis identified three significant factors. Of these, Factor 1 could be interpreted as favouring a tendency for AD, Factor 2 as favouring a tendency for pseudo-dementia, and Factor 3 as favouring a depressive tendency.CONCLUSION We investigated whether these patients could be categorized as types: Type A(true AD), Type B(pseudodementia), Type C(occult AD), and Type D(true depression). The factor scores in factor analysis supported the validity of this classification. Our results suggest that SPECT with 3D-SSP is highly useful for distinguishing between depression and depressed mood in the early stage of AD.展开更多
文摘AIM To evaluate usefulness of single photon emission computed tomography(SPECT) with three-dimensional stereotactic surface projection(3D-SSP) in distinguishing between Alzheimer's disease(AD) and depression.METHODS We studied 43 patients who presented with both depressive symptoms and memory disturbance. Each subject was evaluated using the following:(1) the Minimal Mental State Examination;(2) the Hamilton Rating Scale for Depression;(3) Clinical Global Impression-Severity scale(CGI-S); and(4) SPECT imaging with 3D-SSP.RESULTS The MMSE scores correlated significantly with the maximum Z-scores of AD-associated regions. CGI-S scores correlated significantly with the maximum Z-scores of depression-associated regions. Factor analysis identified three significant factors. Of these, Factor 1 could be interpreted as favouring a tendency for AD, Factor 2 as favouring a tendency for pseudo-dementia, and Factor 3 as favouring a depressive tendency.CONCLUSION We investigated whether these patients could be categorized as types: Type A(true AD), Type B(pseudodementia), Type C(occult AD), and Type D(true depression). The factor scores in factor analysis supported the validity of this classification. Our results suggest that SPECT with 3D-SSP is highly useful for distinguishing between depression and depressed mood in the early stage of AD.
基金Preparation of this report was supported by grants from the Shanghai Clinical Center for Mental Disorders(2014)by the National Key Clinical Disciplines program at the Shanghai Mental Health Center(Office of Medical Affairs,Ministry of Health,2011-873+1 种基金OMAMH,2011-873)by the Science and Technology Commission of Shanghai’s Medical Guide Project(No.15411961400)