Predominant left hemisphere metabolic dysfunction in dementia.

Thirty-one patients with probable Alzheimer's disease and 11 patients with memory disorders, attributable to multiple cerebral infarctions, were studied using 18-F-fluorodeoxyglucose-positron emission tomography scans. Asymmetry in cerebral glucose metabolism within these diagnostic groups was assessed by comparison with the metabolic rates obtained in age-equivalent healthy control subjects. A significantly greater number of individuals in both patient groups exhibited predominant left rather than right hemisphere hypometabolism. In addition, for patients with Alzheimer's disease, the degree of asymmetry was not related to either the severity or duration of dementia. These findings could be explained by greater susceptibility of the left hemisphere to degenerative or ischemic brain disease, by a specific sampling effect, or most likely, by greater metabolic deficits resulting from left rather than right hemisphere impairment.

[1]  B. Seltzer,et al.  A comparison of clinical features in early- and late-onset primary degenerative dementia. One entity or two? , 1983, Archives of neurology.

[2]  A. C. Eycleshymer,et al.  A cross-section anatomy , 1970 .

[3]  N. Foster,et al.  Alzheimer's disease , 1983, Neurology.

[4]  T. Tewson,et al.  Synthesis of no-carrier-added fluorine- 18 2-fluoro-2-deoxy-D-glucose. , 1983, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[5]  R A Margolin,et al.  Cerebral glucose utilization, as measured with positron emission tomography in 21 resting healthy men between the ages of 21 and 83 years. , 1983, Brain : a journal of neurology.

[6]  F. Sakai,et al.  Noninvasive regional cerebral blood flow measurements in dementia. , 1980, Archives of neurology.

[7]  J. Semmes.  Hemispheric specialization: A possible clue to mechanism☆ , 1968 .

[8]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[9]  M. Gibson.  SPSS X introductory statistics guide , 1983 .

[10]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[11]  M N Rossor,et al.  A post-mortem study of the cholinergic and GABA systems in senile dementia. , 1982, Brain : a journal of neurology.

[12]  Luigi Mansi,et al.  Cortical abnormalities in Alzheimer's disease , 1984, Annals of neurology.

[13]  I. Feinberg,et al.  RELATION OF EEG TO CEREBRAL BLOOD FLOW AND METABOLISM IN OLD AGE. , 1963, Electroencephalography and clinical neurophysiology.

[14]  Percival Bailey.  La cécité psychique. , 1963 .

[15]  D. Neary,et al.  Neuropsychological syndromes in presenile dementia due to cerebral atrophy. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[16]  R A Koeppe,et al.  Alternative Approach to Single-Scan Estimation of Cerebral Glucose Metabolic Rate Using Glucose Analogs, with Particular Application to Ischemia , 1984, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[17]  M D Devous,et al.  SPECT Study of Regional Cerebral Blood Flow in Alzheimer Disease , 1986, Journal of computer assisted tomography.

[18]  J. Haxby,et al.  Positron emission tomography in Alzheimer's disease , 1986, Neurology.

[19]  J. Haxby,et al.  Relations between Neuropsychological and Cerebral Metabolic Asymmetries in Early Alzheimer's Disease , 1985, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[20]  E. Busse,et al.  Studies in the processes of aging: electroencephalographic findings in 400 elderly subjects. , 1955, Electroencephalography and clinical neurophysiology.

[21]  J. Wade,et al.  The clinical diagnosis of Alzheimer's disease. , 1987, Archives of neurology.

[22]  H. Gastaut,et al.  Electroencephalographic study of the signs of chronic vascular insufficiency of the Sylvian region in aged people. , 1960, Electroencephalography and clinical neurophysiology.

[23]  P T Fox,et al.  Regional Asymmetries of Cerebral Blood Flow, Blood Volume, and Oxygen Utilization and Extraction in Normal Subjects , 1987, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[24]  N. Foster,et al.  Wechsler Adult Intelligence Scale performance. Cortical localization by fluorodeoxyglucose F 18-positron emission tomography. , 1984, Archives of neurology.

[25]  W D Obrist,et al.  Differences in the distribution of gray and white matter in human cerebral hemispheres. , 1980, Science.

[26]  Luigi Mansi,et al.  Regional cortical dysfunction in Alzheimer's disease as determined by positron emission tomography , 1984, Annals of neurology.

[27]  M. Roth,et al.  The Association Between Quantitative Measures of Dementia and of Senile Change in the Cerebral Grey Matter of Elderly Subjects , 1968, British Journal of Psychiatry.

[28]  E. Renzi,et al.  The Relationship Between Visuo-Spatial Impairment and Constructional Apraxia , 1967 .

[29]  N. Geschwind,et al.  Cerebral lateralization. Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. , 1985, Archives of neurology.

[30]  Robert P. Friedland,et al.  Alzheimer's disease: Anterior-posterior and lateral hemispheric alterations in cortical glucose utilization , 1985, Neuroscience Letters.

[31]  A. Kertesz,et al.  Right-hemisphere deficits, lesion size and location , 1981 .

[32]  R. Finn,et al.  Multimillicurie preparation of 2-[18F]-fluoro-2-deoxy-D-glucose via nucleophilic displacement with fluorine-18 labelled fluoride. 1. Purification and quality control procedures , 1985 .

[33]  J. Haxby,et al.  Neocortical metabolic abnormalities precede nonmemory cognitive defects in early Alzheimer's-type dementia. , 1986, Archives of neurology.

[34]  J. Fleiss.  The design and analysis of clinical experiments , 1987 .

[35]  P. Sharp,et al.  Application of iodine-123-labeled isopropylamphetamine imaging to the study of dementia. , 1986, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[36]  A. Albanese,et al.  Choline acetyltxansferase (CUT) activity Wers in right and left human temporal lobes , 1981, Neurology.

[37]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.