Alzheimer's disease in adults with Down's syndrome: the relationship between regional cerebral blood flow equivalents and dementia

Twenty adult patients suffering from Down's syndrome (DS) were recruited from hospitals and the community, together with 14 age‐ and sex‐matched controls of normal intelligence. Dementia was diagnosed in patients using a structured psychiatric and physical examination as well as a carer interview and case notes. All patients and controls were imaged using single photon emission computerized tomography with 99mTc‐exametazime. Four patients were clinically demented and all of them showed regional cerebral blood flow (rCBF) changes commonly found in patients with Alzheimer's disease, namely bilateral temporo‐parietal deficits. These changes were also observed in about half of the patients without clinical evidence of dementia, but in none of the healthy controls. Across the group of patients, temporo‐parietal rCBF deficits were associated with evidence of deterioration, but not with advancing age.

[1]  J. Risberg Regional cerebral blood flow measurements by 133Xe-inhalation: Methodology and applications in neuropsychology and psychiatry , 1980, Brain and Language.

[2]  C Oliver,et al.  Down's Syndrome and Alzheimer's disease: a review , 1986, Psychological Medicine.

[3]  F. Schmitt,et al.  Assessing Utility of Single Photon Emission Computed Tomography (SPECT) Scan in Alzheimer Disease: Correlation with Cognitive Severity , 1990, Alzheimer disease and associated disorders.

[4]  G. A. Roeher,et al.  Canadian Association for the Mentally Retarded. , 1971, Canadian journal of public health = Revue canadienne de sante publique.

[5]  Klaus P. Ebmeier,et al.  Differential diagnosis in dementia using the cerebral blood flow agent 99mTc HM-PAO: a SPECT study. , 1987, Journal of computer assisted tomography.

[6]  H. Wiśniewski,et al.  Occurrence of neuropathological changes and dementia of Alzheimer's disease in Down's syndrome , 1985, Annals of neurology.

[7]  I. Mena,et al.  Temporal-parietal hypoperfusion with single-photon emission computerized tomography in conditions other than alzheimer’s disease , 1990 .

[8]  E. Wertman,et al.  Regional cerebral blood flow in down's syndrome , 1987, Annals of neurology.

[9]  R. S. Williams,et al.  A prospective study of Alzheimer disease in Down syndrome. , 1989, Archives of neurology.

[10]  J. Raven Guide to using the Coloured Progressive Matrices. , 1958 .

[11]  J. Haxby,et al.  Regional Cerebral Glucose Metabolism is Normal in Young Adults with down Syndrome , 1990, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[12]  D. Clair,et al.  PREMATURE SENILITY IN DOWN'S SYNDROME , 1985, The Lancet.

[13]  D Wyper,et al.  Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease. , 1990, Journal of neurology, neurosurgery, and psychiatry.

[14]  J. Haxby,et al.  Decline in cerebral glucose utilisation and cognitive function with aging in Down's syndrome. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[15]  M. Abou-Saleh,et al.  The Use and Applications of Single-Photon Emission Computerised Tomography in Dementia , 1990, British Journal of Psychiatry.

[16]  P. Francis,et al.  Effect of Central Cholinergic Stimulation on Regional Cerebral Blood Flow in Alzheimer's Disease , 1991, British Journal of Psychiatry.

[17]  G. Goodwin,et al.  The pattern of function-related regional cerebral blood flow investigated by single photon emission tomography with 99mTc-HMPAO in patients with presenile Alzheimer's disease and Korsakoff's psychosis , 1989, Psychological Medicine.

[18]  P F Sharp,et al.  Multimodal Imaging in Alzheimer's Disease , 1990, British Journal of Psychiatry.

[19]  A. Brun,et al.  A Longitudinal Study of Dementia of Alzheimer Type in Down's Syndrome , 1991 .

[20]  M. Franceschi,et al.  Prevalence of dementia in adult patients with trisomy 21. , 2005, American journal of medical genetics. Supplement.

[21]  H. Wiśniewski,et al.  Down's Syndrome and the Dementia of Alzheimer Disease , 1990 .

[22]  Lloyd M. Dunn Expanded manual for the Peabody picture vocabulary test , 1965 .

[23]  D. Neary,et al.  Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[24]  N. Schupf,et al.  Premature regression of adults with Down syndrome. , 1987, American journal of mental deficiency.

[25]  B. J. Shepstone,et al.  Effect of central cholinergic stimulation on regional cerebral blood flow in Alzheimer disease , 1990, The Lancet.

[26]  C. Grady,et al.  Topographical Comparison of Lesions in Trisomy 21 and Alzheimer’s Disease: A Study with PET, Anatomical and Neuropathological Investigations , 1990 .

[27]  R. Levy,et al.  The investigation of Alzheimer's disease with single photon emission tomography. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[28]  R. Ihl,et al.  Stage-dependent reductions of regional cerebral blood flow measured by HMPAO-SPECT in dementia of Alzheimer type , 1989, Psychiatry Research.