(133)Xe SPECT cerebral blood flow study in a healthy population: determination of T-scores.

UNLABELLED Dementia is becoming a major health problem as the population of the Northern Hemisphere ages. Early differential diagnosis between normal cognitive decline and dementia is particularly difficult. If psychometric evaluation can contribute to the diagnosis, quantitative cerebral functional imaging would play an important role. We therefore proposed, first, to constitute a normative dataset that could later be used to identify subjects at risk for neurodegenerative processes and, second, to describe the risk of abnormal global cerebral blood flow (gCBF) by defining categories based on the standardized cutoff scores of a young, healthy population (T-score). METHODS Of a total of 203 healthy volunteers, 187 were included in the protocol, which included evaluation of medical history, neurologic and neuropsychologic status, and body composition; analysis of blood; and measurement of gCBF by means of (133)Xe SPECT. RESULTS With ANOVA analysis using age and sex as between-subject factors and gCBF as a within-subject factor, a significantly higher gCBF was found in women than in men. In addition, a linear reduction as a function of age was observed for both sexes (-0.3%/y). T-score was determined for the 18- to 28-y-old age group, for whom gCBF was found to be 46.7 +/- 5.1 mL/min/100 g tissue in men and 49.0 +/- 5.0 mL/min/100 g tissue in women. The age-dependent decrease could thus be expressed in T-scores and, in the 29- to 38-y-old, 39- to 48-y-old, and >48-y-old age groups, averaged -0.63, -1.29, and -1.92, respectively, in men and -0.63, -0.83, and-2.40, respectively, in women. Cognitive performance, body composition, and blood analysis revealed the expected significant effects from sex and age. CONCLUSION The large-scale reference database of gCBF measurements constituted from a healthy, well-controlled population enabled age and sex stratification, which showed significant differences between the sexes and a significant decline as a function of age. T-scores were determined and warrant further studies on the prospective identification of early dementia by (133)Xe SPECT in elderly individuals.

[1]  A. Davies,et al.  The influence of age on trail making test performance. , 1968, Journal of clinical psychology.

[2]  E M Stokely,et al.  Normal Distribution of Regional Cerebral Blood Flow Measured by Dynamic Single-Photon Emission Tomography , 1986, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[3]  B. Reisberg,et al.  Computed Tomography and Positron Emission Transaxial Tomography Evaluations of Normal Aging and Alzheimer's Disease , 1983, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[4]  J. Hatazawa,et al.  Correlations between Regional Cerebral Blood Flow and Age‐related Brain Atrophy: A Quantitative Study with Computed Tomography and the Xenon‐133 Inhalation Method , 1983, Journal of the American Geriatrics Society.

[5]  Dastur Dk Cerebral Blood Flow and Metabolism in Normal Human Aging, Pathological Aging, and Senile Dementia: , 1985 .

[6]  J. Raven,et al.  Manual for Raven's progressive matrices and vocabulary scales , 1962 .

[7]  Laura Fratiglioni,et al.  Worldwide Prevalence and Incidence of Dementia , 1999, Drugs & aging.

[8]  Michael E. Phelps,et al.  Effects of Human Aging on Patterns of Local Cerebral Glucose Utilization Determined by the [18F] Fluorodeoxyglucose Method , 1982, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  J. Crawford Alzheimer's disease risk factors as related to cerebral blood flow: additional evidence. , 1998, Medical hypotheses.

[10]  I Kanno,et al.  Two Methods for Calculating Regional Cerebral Blood Flow from Emission Computed Tomography of Inert Gas Concentrations , 1979, Journal of computer assisted tomography.

[11]  O. Paulson,et al.  99mTc-d,l-HMPAO and SPECT of the Brain in Normal Aging , 1991, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[12]  R. L. Rogers,et al.  Cerebral blood flow changes in benign aging and cerebrovascular disease , 1984, Neurology.

[13]  R. Keefover,et al.  Aging and cognition. , 1998, Neurologic clinics.

[14]  Karl J. Friston,et al.  Decreases in Regional Cerebral Blood Flow with Normal Aging , 1991, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  Richard S. J. Frackowiak,et al.  Cerebral blood flow, blood volume and oxygen utilization. Normal values and effect of age. , 1990, Brain : a journal of neurology.

[16]  D Comar,et al.  Regional Cerebral Blood Flow and Oxygen Consumption in Human Aging , 1984, Stroke.

[17]  S. Bentin,et al.  Reduction in Regional Cerebral Blood Flow During Normal Aging in Man , 1980, Stroke.

[18]  F Shishido,et al.  Age-related decline of cerebral oxygen metabolism in normal population detected with positron emission tomography. , 1992, Neurological research.

[19]  R. Rizzoli,et al.  Assessment of whole-body composition with dual-energy x-ray absorptiometry. , 1992, Radiology.

[20]  S H Ferris,et al.  Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. , 1997, JAMA.

[21]  J. Perlmutter,et al.  Vibration-Induced Regional Cerebral Blood Flow Responses in Normal Aging , 1992, Journal of Cerebral Blood Flow and Metabolism.

[22]  M D Ginsberg,et al.  Sensitivity of Cerebral Glucose Metabolism to Age, Gender, Brain Volume, Brain Atrophy, and Cerebrovascular Risk Factors , 1988, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[23]  J. Mazziotta,et al.  Positron emission tomography study of human brain functional development , 1987, Annals of neurology.

[24]  O B Paulson,et al.  Regional Cerebral Blood Flow Assessed by 133Xe Inhalation and Emission Tomography: Normal Values , 1985, Journal of computer assisted tomography.

[25]  K. Meguro,et al.  Stability of cerebral blood flow and oxygen metabolism during normal aging. , 1990, Gerontology.

[26]  B S Polla,et al.  Cellular basis of ECD brain retention. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[27]  S M Davis,et al.  Cerebral blood flow and cerebrovascular CO2 reactivity in stroke‐age normal controls , 1983, Neurology.

[28]  N. Lassen,et al.  Regional Cerebral Blood Flow in Stroke by 133Xenon Inhalation and Emission Tomography , 1981, Stroke.

[29]  D Commenges,et al.  Are sex and educational level independent predictors of dementia and Alzheimer’s disease? Incidence data from the PAQUID project , 1999, Journal of neurology, neurosurgery, and psychiatry.

[30]  D. Rüfenacht,et al.  Discrepancies between HMPAO and ECD SPECT imaging in brain tumors. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[31]  F. Sakai,et al.  Effects of advancing age on regional cerebral blood flow. Studies in normal subjects and subjects with risk factors for atherothrombotic stroke. , 1979, Archives of neurology.

[32]  F Fazekas,et al.  Cerebellar glucose consumption in normal and pathologic states using fluorine-FDG and PET. , 1987, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[33]  B S Polla,et al.  Oxido-reductive state: the major determinant for cellular retention of technetium-99m-HMPAO. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[34]  R. Frackowiak,et al.  Quantitative Measurement of Regional Cerebral Blood Flow and Oxygen Metabolism in Man Using 15O and Positron Emission Tomography: Theory, Procedure, and Normal Values , 1980, Journal of computer assisted tomography.

[35]  M. Devous 19 – SPECT Functional Brain Imaging , 2002 .

[36]  K. Boone,et al.  Cerebral blood flow changes in normal aging: Spect measurements , 1995 .