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Aim: It was recently reported that theory of mind is disturbed in mild Alzheimer's disease dementia (ADD). Some studies have reported reduced scores of ADD patients on false belief tests, even on first‐order false belief tests. However, few studies have pursued the neural substrate of false belief tests in patients with ADD in a real‐world setting. Methods: Sixty‐three patients with ADD from outpatient units took the Sally–Anne test and underwent brain single‐photon emission computed tomography. Of these patients, 29 answered the Sally–Anne test correctly (successful group) and 34 incorrectly (unsuccessful group). We compared the regional cerebral blood flow between the successful and unsuccessful groups. Results: A comparison of the two groups showed a significantly lower uptake in the bilateral posterior cingulate gyrus in the unsuccessful group than in the successful group. Conclusions: The posterior cingulate gyrus is known to be particularly activated when individuals remember personal events and infer the mental states of others. We suppose that memory or mentalization in the posterior cingulate gyrus—or both—is essential for patients with ADD to be able to pass the Sally–Anne test. [ABSTRACT FROM AUTHOR]

Background: This study examined regional cerebral blood flow (rCBF) in Alzheimer's disease (AD) patients with and without subclinical hypothyroidism (SCH). Methods: Eleven AD patients with SCH and 141 AD patients without SCH underwent brain perfusion single photon emission computed tomography (SPECT). The SPECT data were analyzed by statistical parametric mapping (SPM8) and FineSRT. Results: AD patients with SCH showed a significantly decreased rCBF mainly in the temporal lobe and thalamus, whereas those without SCH showed a significantly decreased rCBF in the parietotemporal lobe and cingulate gyrus as well as the frontal lobe. Conclusion: Our findings suggest that SCH may affect cerebral perfusion in regions associated with the memory function. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aim: Although several researchers have examined the effect of age on disease progression in patients with Alzheimer's disease (AD), the results are controversial. We investigated the effect of age on the rate of progression of cognitive impairment and on regional cerebral blood flow (rCBF) deficits using longitudinal single photon emission computed tomography (SPECT) studies. Methods: We divided 75 patients with AD who were followed up for 24-90 months into the younger AD group ( n = 32, age at initial examination ≤75 years) and the older AD group ( n = 43, age at initial examination >75 years). We assessed changes in Mini-Mental State Examination (MMSE) scores and rCBF between initial and final examinations. Results: The change in the annual MMSE score was greater in the younger AD group than in the older AD group. The mean annual MMSE score changes correlated significantly with age at the initial examination. The initial and follow-up SPECT studies showed more severe and extensive rCBF deficits in the younger AD group than in the older AD group. Conclusion: Our longitudinal SPECT study showed that the rate of progression of cognitive impairment and the rCBF deficits were higher in younger patients with AD than in older patients with AD. Therefore, age is an important factor to consider, not only in the diagnosis, but also in the treatment and prognosis of patients with AD. Geriatr Gerontol Int 2013; 13: 555-562. [ABSTRACT FROM AUTHOR]

Aim: It remains unknown whether antiplatelet agents have a preventive effect on cognitive decline in patients with Alzheimer's disease (AD). We investigated the effects of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, on cognition and regional cerebral blood flow (rCBF) in elderly patients with AD and cerebrovascular disease (CVD). Methods: A total of 20 patients with AD and CVD were randomly assigned to a cilostazol group ( n = 11, 100 mg daily) or control group ( n = 9, aspirin 100 mg or clopidogrel 50 mg-75 mg daily) for 6 months. Results: The cilostazol group did not show any statistically significant changes in cognitive function test scores, whereas the control group showed statistically significant cognitive decline on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (Japanese version), Revised Wechsler Memory Scale (logical memory-I) and Trail Making Test-A. Analysis of covariance of treatment effect revealed that the cilostazol group showed increased rCBF in the right anterior cingulate lobe compared with baseline, whereas the control group showed decreased rCBF in the left middle temporal gyrus compared with baseline. Conclusion: These findings suggest that cilostazol might have a preventive effect on cognitive decline in patients with AD and CVD. Geriatr Gerontol Int 2013; 13: 90-97. [ABSTRACT FROM AUTHOR]

Objectives: Japanese style, superficial acupuncture (SA) has been clinically evaluated for its therapeutic benefit, yet the neurophysiologic responses associated with SA remain unclear. This study was performed to measure changes in regional cerebral blood flow (rCBF) following SA at LI-4 and LI-11 in healthy volunteers using single photon emission computed tomography (SPECT). Changes in SPECT activity following Japanese style SA were compared to previous reports of SPECT changes following electroacupuncture (EA) at the same acupoints. Design and setting: Ten (10) healthy volunteers were enrolled for this study. A few days after the baseline brain SPECT, SA was performed at LI-4 and LI-11 for 15 minutes and a second brain perfusion image was acquired for each subject. We used SPM2 to analyze the changes in rCBF after SA through a paired t test. In addition, the differences of rCBF changes between SA and EA were compared using a two-sample t test. Results: Cerebral blood perfusion significantly increased after SA in the left superior frontal gyrus, left middle cingulum, left insular, right medial orbital frontal gyrus, and right middle cingulum (paired t test, uncorrected p < 0.005), while no regions showed a significant decrease. The results comparing poststimulation images between SA and EA demonstrated that the perfusion in the right lingual, both thalamus, left middle temporal gyrus, left insula, and both cerebellum were significantly increased in SA compared with EA (false discovery rate [FDR] corrected p < 0.05). Conclusions: There were specific increase patterns of rCBF following SA at LI-4 and LI-11, which were similar to those following EA. However, there were significant differences in the decrease pattern of rCBF between SA and EA, which might be due to the difference of the strength of acupuncture stimulation between the two methods. These results may contribute to developing a better strategy to a select stimulation method in acupuncture therapy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the necessity of morphological images (MI) in reading somatostatin receptor scintigraphy (SRS) in patients with suspected neuroendocrine gastroenteropancreatic (GEP) tumors.Material and Methods: A Japanese multicenter clinical trial of SRS was conducted in 40 patients with suspected GEP tumors. Three experienced radiologists interpreted the images in three separate sessions in a blinded manner (1: SRS images alone, 2: MI alone, 3: SRS and MI analyzed simultaneously), and the reading results of each session were compared. In addition, the diagnostic abilities of SRS, MI and SRS alone and simultaneous SRS and MI readings were compared for patients where final diagnosis was obtained.Results: SRS detected more suspected lesions (positive or inconclusive uptake) than morphological images did (51 vs 27 lesions), but included many physiological uptakes detected as positive or inconclusive uptakes. Combined reading of SRS and morphological images helped to correctly recognize these physiological uptakes, and also helped in determining the anatomical localization of the abnormal uptakes. Combined reading of SRS and morphological images gave the highest diagnostic impact.Conclusion: The sensitivity of SRS with regard to GEP is high. However the specificity is very low. Morphologic imaging is necessary for the exclusion of physiological uptake and correct anatomic location of an abnormal tracer uptake. The combined reading of SRS and morphologic imaging studies gives the highest diagnostic impact. [ABSTRACT FROM AUTHOR]