The Japanese journal of neuropsychology

Full Text of this Article
in Japanese PDF (900K)

ArticleTitle	Clinical practice of neuroimaging in the dementias
Language	J
AuthorList	Haruo Hanyu
Affiliation	Department of Geriatric Medicine, Tokyo Medical University
Publication	Japanese Journal of Neuropsychology: 26 (3), 184-188, 2010
Received
Accepted
Abstract	Neuroimaging studies enable the demonstration of structural and functional abnormalities in the brains of patients with dementia, including Alzheimer's disease (AD), vascular dementia (VaD), and dementia with Lewy bodies (DLB). Medial temporal lobe atrophy on MRI and parietotemporal hypoperfusion on SPECT are characteristic features of AD, reflecting regional differences in the severity of histopathologic and neurochemical changes. These findings are demonstrated in early AD and even in mild cognitive impairment. Subcortical VaD is characterized by multiple lacunar infarctions and white matter lesions on MRI and frontal hypoperfusion on SPECT. Cognitive deficits may be related to the extent and severity of white matter lesions. A higher frequency and number of microbleeds is shown in patients with VaD using T2*-weighted MRI. The depiction of microbleeds may provide useful information in the selection of anti-platelet therapy. Changes associated with DLB include preservation of medial temporal lobe volume and medial occipital hypoperfusion and/or striatal hyperperfsuion on SPECT. Reduction in cardiac MIBG scintigraphy proves to be a highly specific and applicable diagnostic test for DLB.
Keywords	MRI, SPECT, Alzheimer's disease, vascular dementia, dementia with Lewy bodies