ムラヤマ ノリオ    Murayama Norio
   村山 憲男
   所属
人間社会学部 心理学科
 
生活機構研究科 心理学専攻
 
生活心理研究所 所属教員
 
生活機構研究科 生活機構学専攻
   職種
准教授
言語種別 英語
発行・発表の年月 2010/09
形態種別 学術雑誌
査読 査読あり
標題 Diffuse occipital hypometabolism on 18F-FDG PET scans in patients with idiopathic REM sleep behavior disorder: prodromal dementia with Lewy bodies?
執筆形態 共著
掲載誌名 Psychogeriatrics
掲載区分国外
巻・号・頁 10,pp.144-152
著者・共著者 Hiroshige FUJISHIRO, Eizo ISEKI, Norio MURAYAMA, Ryoko YAMAMOTO, Shinji HIGASHI, Koji KASANUKI, Masaru SUZUKI, Heii ARAI, Kiyoshi SATO
概要 Background: Previous longitudinal studies have revealed that specific patterns on [(18) F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans in patients with amnesic mild cognitive impairment can predict Alzheimer's disease (AD). However, the significance of particular patterns on [(18) F]-FDG PET scans in prodromal patients with dementia with Lewy bodies (DLB) remains unclear.
Methods: Based on the prevailing evidence that rapid eye movement (REM) sleep behavior disorder (RBD) often precedes the onset of DLB, [(18) F]-FDG PET scans of nine non-demented patients reporting recurrent nocturnal dream-enactment behavior in our memory clinic were compared with the normative database using three-dimensional stereotactic surface projection (3D-SSP) images. All patients underwent clinical and neuropsychological examinations as well as cardiac [(123) I]-metaiodobenzylguanidine ([(123) I]-MIBG) scintigraphy.
Results: Four patients were found to have diffuse areas of reduced cerebral metabolic rate of glucose (CMRglc), predominantly in the occipital lobe, which is the preferentially affected region in DLB patients. In contrast, five patients showed no such occipital hypometabolism; instead, these five patients showed hypometabolism in the left anterior cingulate gyrus (Broadmann area (BA) 24), right frontal lobe (BA 32) and right anterior temporal lobe (BA 38), which are the preferentially affected regions in Parkinson's disease rather than DLB. The extent of the reduction in CMRglc in the left occipital lobe was correlated with scores on the Bender Gestalt Test, which reflects visuospatial ability, but not with global cognitive measures. All patients showed reduced cardiac [(123) I]-MIBG levels, consistent with underlying Lewy body disease.
Conclusion: These variations in [(18) F]-FDG PET scans raise the possibility that the specific pattern of CMRglc reduction may predict developing DLB in patients with idiopathic RBD. Further follow-up studies are needed, particularly on patients with diffuse occipital hypometabolism.