PARIETAL AND ROLANDIC RCBF ACTIVATION IN DEMENTIA

痴呆症中顶叶和 ROLANDIC RBF 激活

• 批准号: 2049512
• 负责人: GEORG DEUTSCH
• 金额: $ 19.2万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-30 至 1997-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2049512
• 关键词: Alzheimer's disease; association cortex; biomarker; blood flow measurement; brain disorder diagnosis; carbon dioxide; cerebrovascular disorder diagnosis; diagnosis design /evaluation; early diagnosis; human subject; longitudinal human study; neural information processing; neuropsychological tests; parietal lobe /cortex; performance; sensorimotor system; single photon emission computed tomography; temporal lobe /cortex; xenon

This project pursues three main aims through the study of resting and activated regional cerebral blood flow (rCBF) in early and late stage Alzheimer's Disease (AD). The research is based on findings concerning cerebral activity and responsivity in sensory-motor and association cortex in AD. (1) A proposed quantitative marker for early AD, based on the ratio of RCBF in posterior temporal-parietal to that in sensory motor cortex will be evaluated in a prospective study of 60 suspected early AD patients, the stage most difficult to diagnose clinically. (2) These patients will also be used in studies attempting to "capture" and investigate the period of increased cerebral response to mentally demanding tasks previously noted in a subgroup of well performing AD patients. This increased activity is hypothesized to reflect successful compensation to the degenerative processes accompanying early AD. The early AD patients will undergo successive studies of cortical flow under both simple sensory-motor tasks, aimed at preserved perirolandic cortex, and more complex cognitive tasks, aimed at association cortex. Based on previous data, approximately 75% of the patients screened are expected to become well defined AD cases, thus providing a substantial database on early changes in mild AD as well as permitting a retrospective assessment and refinement of the proposed RCBF marker. It is hypothesized that, as AD progresses, there is a curvilinear relationship between changes in performance and CBF related increases in association cortex and that decline of the activation response, following the period in which a peak occurs, signals the more debilitating stage of the disease. The end of effective compensation may mark the onset of more severe psychological and social problems as well as perhaps mark the end of a critical period during which AD is most responsive to therapeutic intervention. (3) A series of 30 moderately to severely impaired patients, recruited in prior years, will be followed into later stage AD to assess the effects of severe parenchymal degeneration on CO2 tests of vascular reactivity - especially in posterior association areas where vascular reserve appears unaffected in earlier stages of AD. This data is of potential diagnostic value in assessing dementia patients with questionable etiology. Late AD patients will also have RCBF studied during simple sensory-motor tasks to further evaluate the compensatory reactivity hypothesis in a situation where AD may be affecting rolandic cortex as well. Resting state RCBF will be measured with both 133Xe clearance and 99mTc HM-PAO SPECT. Task related activation will be assessed with 133Xe cortical flow studies. Combined, the aims offer theoretical information concerning performance changes and compensatory reactivity in degenerative dementia as well as data of clinical use in confirming early AD.

该项目通过研究休息和 在早期和晚期激活的区域脑血流（RCBF） 阿尔茨海默氏病（AD）。 该研究基于有关的发现 感觉运动和关联皮层的脑活动和反应性 在广告中。 （1）基于比率的提议的定量标记 在感觉运动皮层中的后颞叶中RCBF的 在一项对60名可疑早期AD患者的前瞻性研究中进行评估， 阶段最难在临床上诊断。 （2）这些患者也将 在试图“捕获”并研究周期的研究中使用 对以前在以前指出的精神苛刻任务的大脑反应增加 表现良好的广告患者的子组。 这种增加的活动是 假设以反映退化的成功补偿 伴随着早期广告的过程。 早期的广告患者将经历 在两个简单的感觉运动任务下对皮质流的连续研究， 针对保存的周围皮层和更复杂的认知任务， 针对关联皮层。 根据以前的数据，约有75％ 预计被筛查的患者将成为明确的AD病例，因此 提供有关轻度广告早期变化以及的大量数据库 允许回顾性评估和对拟议的RCBF的完善 标记。 假设随着广告的进行，有一个曲线 性能变化与CBF相关的关系之间的关系增加 关联皮层和激活反应的下降，遵循 发生峰值的时期，信号是更令人衰弱的阶段 疾病。 有效补偿的结束可能标志着更多 严重的心理和社会问题，也许标志着 在关键时期，AD对治疗最有反应 干涉。 （3）一系列30次适度严重受损的患者， 在前几年招募，将遵循以后的广告进行评估 严重实质变性对血管二氧化碳测试的影响 反应性 - 尤其是在血管的后缔合区域 储备在AD的早期阶段似乎不受影响。 此数据是 评估痴呆症患者的潜在诊断价值 病因。 晚期的AD患者也将在简单期间研究RCBF 感觉运动任务以进一步评估补偿性反应性 在AD可能影响Rolandic Cortex的情况下，假设 出色地。 静止状态RCBF将通过133xe间隙和 99MTC HM-PAO SPECT。 与任务相关的激活将用133 x评估 皮质流量研究。 联合起来提供理论信息 关于性能变化和退化性的代偿反应性 痴呆症以及确认早期AD的临床使用数据。