Memory Problems, Alzheimer’s and Dementia

How Brain SPECT Imaging Can Help with Alzheimer’s, Dementia and Other Forms of Memory Problems

Identify vulnerability to dementia
Used as an early screening tool, early Rx
Help direct treatment
Follow up scans to see if treatment is helping
Evaluate amnesia
Help differentiate types of dementia — each with own pattern
- Alzheimer’s Disease
- Vascular Dementia
- Frontal Temporal Lobe Dementia
- HIV Dementia
- Dementia from depression
- Brain trauma
- Alcoholic or drug dementia

The incidence of Alzheimer’s disease is expected to triple by the year 2030 from 5 million to 15 million people. As the population ages, the incidence of dementia in the U.S. will become an even more common problem and take up an even larger percentage of the health care budget. With the advent of new medications that slow the course of some dementing processes, diagnostic tools that help in the early differential diagnosis of dementia are essential. The SPECT pattern for Alzheimer’s Disease is typically bilateral hypoperfusion in the parietal and temporal regions of the brain with frontal lobe hypoperfusion occurring later in the illness. Vascular dementia is characterized by multiple areas of decreased perfusion. HIV dementia is typically seen by decreased patchy uptake across the cortex. Frontal lobe dementias (as the name indicates) are often characterized by very poor frontal lobe perfusion. Psuedodementia (another condition, such as depression, that clinically appears like dementia) will not have a typical dementia pattern and may be more like a depression pattern.

Here is an example:

When Frank, a wealthy, well-educated man, entered his seventies, he began to grow forgetful. At first it was over small things, but as time went on the lapses of memory progressed to the point where he often forgot essential facts of his life: where he lived, his wife’s name and even his own name. His wife and children, not understanding the change in behavior, were aggravated with his absent-mindedness and often angry at him for it. Frank’s SPECT study showed a marked suppression across the entire brain, but especially in the frontal lobes, the parietal lobes and temporal lobes. This was a classic Alzheimer’s disease pattern. By showing the family these images and pointing out the physiological cause of Frank’s forgetfulness, in living images, I helped them understand that he was not trying to be annoying, but had a serious medical problem.

Consequently, instead of blaming him for his memory lapses, they began to show compassion towards him, and they developed strategies to deal more effectively with the problems of living with a person who has Alzheimer’s Disease. In addition, I placed Frank on new experimental treatments for Alzheimer’s Disease that seemed to slow the progression of the illness.