Cerebral correlates of psychotic symptoms in Alzheimer's disease
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BACKGROUND: Psychotic symptoms are produced by distributed neuronal dysfunction. Abnormalities of reality testing and false inference implicate frontal lobe abnormalities. OBJECTIVES: To identify the functional imaging profile of patients with Alzheimer's disease manifesting psychotic symptoms as measured by single photon emission computed tomography (SPECT). METHODS: Twenty patients with Alzheimer's disease who had SPECT and clinical evaluations were divided into two equal groups with similar mini mental status examination (MMSE), age, sex, and the range of behaviours documented by the neuropsychiatric inventory (NPI), except delusions and hallucinations. SPECT studies, registered to a probabilistic anatomical atlas, were normalised across the combined group mean intensity level, and subjected to a voxel by voxel subtraction of the non-psychotic minus psychotic groups. Subvolume thresholding (SVT) corrected random lobar noise to produce a three dimensional functional significance map. RESULTS: The significance map showed lower regional perfusion in the right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex, in the psychotic versus non-psychotic group. CONCLUSION: Patients with Alzheimer's disease who manifest psychosis may have disproportionate dysfunction of frontal lobes and related subcortical and parietal structures.
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Delusions in Alzheimer's disease are associated with decreased gray matter volume, perfusion or metabolism in frontal cortex and anterior cingulate cortex.
“Delusions were associated with decreased gray matter (GM) volume, perfusion or metabolism in frontal cortex and ACC (Bruen et al., 2008; Koppel et al., 2014; Mega et al., 2000; Nakaaki et al., 2013; Rafii et al., 2011; Sultzer et al., 2003; Whitehead et al., 2012).”
From Neuropsychiatric symptoms in Alzheimer's disease: what might be associated brain circuits? (2015) · cites this paper as Mega et al., 2000
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- Authors
- Mega, M. S.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Mega, M. S
- ORCID
- Mega, M. S
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2000-08-01
- Volume
- 69
- Issue
- 2
- Pages
- 167-171
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1737034
- OpenAlex
- W2097643314
- Cited by
- 189
- References
- 53
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 11 · 2020: 8 · 2019: 4 · 2018: 1 · 2017: 4 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 12 · 2012: 6
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (9322434)
- National Institute on Aging (K08AG100784, P50AG016570, P50-AG 16570, AG 16570)
- National Institute of Mental Health (P20 MH/DA52176)
- National Institute on Drug Abuse
- National Center for Research Resources
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- Alzheimer's disease, psychotic symptoms, delusions, hallucinations, cerebral perfusion, regional cerebral blood flow, frontal lobe dysfunction, dorsolateral prefrontal cortex, anterior cingulate cortex, ventral striatum, pulvinar, parietal cortex, neuropsychiatric symptoms, neuroimaging
- MeSH terms
- Alzheimer Disease, Brain Mapping, Cerebrovascular Circulation, Corpus Striatum, Delusions, Female, Frontal Lobe, Gyrus Cinguli, Hallucinations, Humans, Male, Parietal Lobe, Psychotic Disorders, Sex Factors, Tomography, Emission-Computed, Single-Photon, Technetium Tc 99m Exametazime
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