Advance prediction of Mild Cognitive Impairment (MCI) using 99mTc-ECD SPECT brain blood flow imaging

Abstract

Aim: Mild Cognitive Impairment (MCI) is considered as a precursor state of Alzheimer disease (AD). SPECT brain blood flow imaging was investigated in MCI and it's relevance to the prognosis of MCI was evaluated in an attempt define the characteristics of brain blood flow imaging of MCI (amnestic MCI; aMCI) converting to AD. Methods: Ninety-two patients over 60 years old with amnesia were studied. 99mTc-ECD SPECT brain blood flow examinations of the subject under drug-free conditions were conducted and imaging was analyzed according to the first clinical diagnosis. Patients given a diagnosis of MCI on the first clinical diagnosis, were examined again after 2 years and the SPECT imaging before 2 years previously was classified and analyzed. Results: Of them, there were 35 MCI patients, converting of 13 AD patients (37.1%; aMCI), 10 MCI patients (28.6%; nonconverter), 4 depression patients (11.4%; Depression type MCI (dMCI)), 1 Geriatric psychosis patient, but 7 patients dropped out. In the aMCI group, relative hypoperfusion was recognized in the posterior cingulate and the precuneus. In the dMCI group, relative hypoperfusion was recognized in the dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate. In the non-converter group, relative hypoperfusion was recognized in the basal forebrain. Conclusions: The hypoperfusion of the precuneus in aMCI, and the hypoperfusion of the right frontal lobe (DLPFC, dorsalanterior cingulate) in dMCI were characteristic brain blood-flow abnormalities. We believe 99mTc-ECD SPECT brain blood flow imaging to be useful in the diagnosis of aMCI and in the early detection of depression.