May 1992

Quantitative Changes in Mesial Temporal Volume, Regional Cerebral Blood Flow, and Cognition in Alzheimer's Disease

Author Affiliations

From the Division of Psychiatric Neuro-lmaging, Department of Psychiatry and Behavioral Sciences (Drs Pearlson, Harris, Barta, Chase, Noga, and Tune), and the Department of Radiology, Division of Nuclear Medicine (Dr Camargo), Johns Hopkins University, Baltimore Md; and the Departments of Neuropathology and Psychiatry, University of Alabama at Birmingham (Dr Powers).

Arch Gen Psychiatry. 1992;49(5):402-408. doi:10.1001/archpsyc.1992.01820050066012

• Twenty-six patients with moderately severe Alzheimer's disease (AD) and 16 normal control subjects were studied using either quantitative magnetic resonance imaging (MRI) measures of mesial temporal atrophy (15 patients with AD and 16 normal control subjects) and/or quantitative radioactive iodine 123-N-isopropyl-iodoamphetamine singlephoton emission computed tomography (SPECT) assessment of regional cerebral blood flow (20 patients with AD and eight normal control subjects). Nine individuals with AD and eight normal control subjects underwent both structural and functional imaging. On MRI, patients and controls were best discriminated using left amygdala and entorhinal cortex volumes, and on SPECT they were best discriminated by relative left temporoparietal cortex blood flow. Combining these MRI and SPECT measures yielded 100% discrimination. Relative left temporoparietal SPECT regional cerebral blood flow and left superior temporal gyral MRI volume correlated best with severity of cognitive deficit in patients with AD. Mesial temporal MRI atrophy exceeded generalized cerebral shrinkage. Both SPECT and MRI regional changes accorded with areas known to be affected by AD neuropathology.