A functional neuroimaging study of appetite loss in Alzheimer's disease.

Autor: Ismail Z; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Herrmann N, Rothenburg LS, Cotter A, Leibovitch FS, Rafi-Tari S, Black SE, Lanctôt KL
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2008 Aug 15; Vol. 271 (1-2), pp. 97-103. Date of Electronic Publication: 2008 May 20.
DOI: 10.1016/j.jns.2008.03.023
Abstrakt: Background: Alzheimer's Disease (AD) is frequently associated with changes in appetite. This study investigated the relationship between regional cerebral perfusion and appetite loss in AD.
Methods: 64 patients with possible or probable AD were characterized as being with (n=22) or without (n=44) appetite loss based on the Neuropsychiatric Inventory (NPI) Appetite subscale. 99mTc-ECD SPECT scans were coregistered to a standardized template in Talairach space generating mean ratios of uptake referenced to the cerebellum. Regions of interest (ROIs) included anterior cingulate cortex (ACC), middle mesial temporal cortex (MTC-m), inferior mesial temporal cortex (MTC-i), insula (INS), orbitofrontal cortex (OFC) and thalamus-hypothalamus (THAL).
Results: Backward stepwise logistic regression analysis of these ROIs showed hypoperfusion in the L-ACC (p=0.015) and L-OFC (p=0.015), relative sparing of perfusion in the R-ACC (p=0.010), R-OFC (p=0.010) and L-MTC-m (p=0.006), and greater anxiety (p=0.005) independently predicted loss of appetite (chi(2)=22.24, p=0.001, Nagelkerke R(2)=0.41).
Conclusions: Hypoperfusion in the left anterior cingulate and left orbitofrontal cortices, and relative sparing of perfusion in the right anterior cingulate, right orbitofrontal and left middle mesial temporal cortices emerged as predictors of appetite loss in this sample of patients. These findings are consistent with impairments in the extrinsic motivational pathways of eating and impaired reward value of food as components of appetite loss in AD.
Databáze: MEDLINE
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