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NEUROLOGY 1998;51:1009-1013
© 1998 American Academy of Neurology

Brain perfusion imaging predicts survival in Alzheimer's disease

William J. Jagust, MD, Mary N. Haan, DrPH, Bruce R. Reed, PhD and Jamie L. Eberling, PhD

From The Center for Functional Imaging (Drs. Jagust, Reed, and Eberling), Lawrence Berkeley National Laboratory, and the Departments of Neurology (Drs. Jagust and Reed) and Epidemiology and Preventive Medicine (Dr. Haan), University of California, Davis.

Address correspondence and reprint requests to Dr. William J. Jagust, Center for Functional Imaging, 55-121, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720.

Background: The variability of disease course in patients diagnosed with AD makes prediction of survival difficult, despite the identification of numerous predictors to date. This study evaluated the predictive utility of measurements of regional cerebral blood flow (rCBF) obtained with SPECT in a group of AD patients.

Methods: Fifty AD patients were studied with SPECT and followed longitudinally. SPECT measures of relative rCBF were calculated by measuring radioactivity densities in dorsolateral frontal, orbitofrontal, temporal, and parietal cortex normalized to occipital cortical radioactivity density. Subjects were classified into three tertiles of rCBF ratios for each region. These rCBF ratios were used as predictors of survival in life-table and proportional hazard models to predict survival.

Results: Right parietal rCBF was a significant predictor of survival in the life-table analysis, with subjects in the lowest tertile having shortest survivals. No other brain region was a significant predictor of survival. In a proportional hazards model when a variety of other potential predictors were accounted for, right parietal rCBF ratio remained a significant predictor.

Conclusions: These results demonstrate that brain perfusion in the right parietal lobe is a significant predictor of survival in patients with AD even when other predictors are taken into consideration. This suggests that SPECT perfusion imaging may provide additional useful information on disease prognosis in AD.

Supported by NIH grants AG07793 and AG10129.

Received February 2, 1998. Accepted in final form May 29, 1998.






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