Cerebral metabolic and cognitive studies in dementia with frontal lobe behavioral features

• Published in: Journal of psychiatric research Vol. 24; no. 2; pp. 97 - 109
• Main Authors: Kumar, Anand, Schapiro, Mark B., Haxby, James V., Grady, Cheryl L., Friedland, Robert P.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 1990; Elsevier
• Subjects: Adult and adolescent clinical studies; Aged; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - psychology; Biological and medical sciences; Blood Glucose - metabolism; Brain - diagnostic imaging; Deoxyglucose - analogs & derivatives; Deoxyglucose - metabolism; Energy Metabolism - physiology; Female; Fluorodeoxyglucose F18; Frontal Lobe - diagnostic imaging; Humans; Intellectual deficiency; Male; Medical sciences; Neuropsychological Tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Tomography, Emission-Computed; Human; Radionuclide study; Brain; Nervous system diseases; Senescence; Alzheimer disease; Cerebral hemisphere syndrome; Glucose; Metabolism; Screening; Frontal lobe syndrome; Positron emission tomography; Elderly; Positron
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/0022-3956(90)90050-Z

Three subjects with dementia of the Alzheimer type (DAT) with frontal lobe features of behavioral disinhibition were studied using positron emission tomography with [18F]2-fluoro-2-deoxy-D-glucose (18 FDG) and standardized neuropsychological tests. The three subjects showed significant decrements ( p < .05) in relative glucose metabolism (regional/mean gray metabolism) in the orbitofrontal, prefrontal and anterior cingulate regions when compared to healthy controls. Severity-matched subjects with DAT without the associated frontal lobe features did not show the relative reductions in glucose metabolism in these regions when compared to controls. However, on neuropsychological testing of frontal lobe cognitive functions the three subjects did not show decrements that were more severe than those shown by severity-matched DAT patients without the behavioral features. These data demonstrate physiologic dysfunction in specific cortical regions in subjects with behavioral aberrations attributed to these regions and an apparent dissociation between behavioral and cognitive functions of the frontal lobe.