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Am J Psychiatry 1995; 152:1470-1475
Copyright © 1995 by American Psychiatric Association
SPECT findings on psychosis in Alzheimer's disease
KJ Kotrla, RC Chacko, RG Harper, S Jhingran and R Doody
Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA.
OBJECTIVE: This study examined whether psychosis in Alzheimer's disease is
associated with cerebral perfusion patterns appreciable by single photon
emission computed tomography (SPECT) scans. METHOD: All cooperative
outpatients enrolled in an Alzheimer's disease research center with the
diagnosis of probable Alzheimer's disease and a Clinical Dementia Rating of
mild or moderate were interviewed with their primary caregivers. Current
and past psychiatric functioning was assessed by using the Hamilton
Depression Rating Scale, the Structured Clinical Interview for DSM-III-R,
and the Behavioral Pathology in Alzheimer's Disease Rating Scale. Patients
without premorbid psychosis received SPECT scans, and the scans of the
patients with delusions or hallucinations (N = 30) were compared to the
scans of patients without these symptoms (N = 16). RESULTS: The patients
with delusions (N = 29) had hypoperfusion of the left frontal lobe in
relation to the right frontal lobe. The patients with hallucinations (N =
10) had hypoperfusion in the parietal lobe. CONCLUSIONS: Psychotic patients
with Alzheimer's disease had a pattern of cerebral blood flow deficits
significantly different from that of nonpsychotic patients. This suggests
that patterns of cerebral dysfunction may be expressed symptomatically as
psychosis.
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