Psychiatric symptoms associated with cortical-subcortical dysfunction in Alzheimer's disease

J Neuropsychiatry Clin Neurosci. 2001 Winter;13(1):56-60. doi: 10.1176/jnp.13.1.56.

Abstract

Positron emission tomography was used to evaluate 3 Alzheimer's disease (AD) patients: 1 with major depression, 1 with emotional lability, and 1 with apathy. Compared with 5 non-mood-disordered AD patients, the patient with depression had diminished relative regional cerebral blood flow (rel-CBF) in the anterior cingulate and superior temporal cortices, bilaterally. This patient also showed diminished rel-CBF in the left dorsolateral prefrontal and right medial temporal and parietal cortices. The patient with emotional lability had diminished rel-CBF in the anterior cingulate and dorsolateral prefrontal cortices, bilaterally, and left basal ganglia. The patient with apathy had diminished rel-CBF in the basal ganglia and dorsolateral prefrontal cortex, bilaterally. Results are consistent with the hypothesis of a common frontal-temporal-subcortical substrate (e.g., involving aminergic nuclei) in the etiology of depression in AD. Frontal-subcortical dysfunction may also be associated with emotional lability and apathy in AD, although these may be related to a greater involvement of frontal-basal ganglia circuits.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Affect / physiology
  • Affective Symptoms / diagnostic imaging
  • Affective Symptoms / physiopathology*
  • Affective Symptoms / psychology
  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / physiopathology*
  • Alzheimer Disease / psychology
  • Basal Ganglia / diagnostic imaging
  • Basal Ganglia / physiopathology
  • Brain Mapping
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology*
  • Depressive Disorder / diagnostic imaging
  • Depressive Disorder / physiopathology*
  • Dominance, Cerebral / physiology
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / physiopathology
  • Humans
  • Motivation
  • Prefrontal Cortex / diagnostic imaging
  • Prefrontal Cortex / physiopathology
  • Regional Blood Flow / physiology
  • Tomography, Emission-Computed