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Cerebral perfusion as a diagnostic marker of early Alzheimer's disease

From the Departments of Psychiatry, Neurology, and Radiology, College of Physicians and Surgeons, Columbia University, and Brain Imaging Division, Department of Biological Psychiatry, New York State Psychiatric Institute, New York, NY.

Clinical diagnosis of Alzheimer's disease (AD) is not fully satisfactory, and laboratory markers of this disease are not yet established. We report substantial regional Cerebral Blood Flow (rCBF) abnormalities in patients with documented early stages of the disease, when differential diagnosis is most critical. Thirty-six patients with carefully documented clinical diagnosis of early AD (mean disease duration, 3.25 ± 1.80 years) and 12 elderly healthy controls participated in rCBF studies using the ¹³³Xe inhalation method. Whole-brain perfusion was significantly (p < 0.001) lower in the AD group, and a characteristic perfusion deficit was consistently found in temporoparietal cortex of the AD patients. Discriminant analyses demonstrated over 90% correct classification of the two groups. Two subgroups of patients with mildest disease manifestations were equally well discriminated. The similarity of these findings to those in late stages, which have been validated neuro-pathologically, offers indirect confirmation of validity and specificity. These results suggest that rCBF procedures may provide an accurate and sensitive laboratory marker for early AD.

Address correspondence and reprint requests to Dr. Prohovnik, Department of Biological Psychiatry, Psychiatric Institute, 722 West 168th Street, New York, NY 10032.

Supported in part by NIH grants AG 05433 and MH 35636, and grants from the Jean and Louis Dreyfus Foundation and the Charles S. Robertson Memorial Gift for research in Alzheimer's disease.

Received September 3, 1987. Accepted for publication in final form October 28, 1987.

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