By checking changes in cerebral blood flow, the path to a more accurate diagnosis of mixed dementia has been opened.
Severance Hospital Neurology Professor Byeong-Seok Yeh, Lecturer Seok-Woo Kang, Yonsei University School of Medicine Brain Research Institute Professor Se-Woon Jeon’s research team developed a technique for diagnosing ‘mixed dementia’ in which Alzheimer’s disease (senile dementia) and Lewy body disease occur simultaneously according to an increase in cerebral blood flow.
The findings were published in the latest issue of Alzheimer’s Disease and Dementia, a journal of the American Alzheimer’s Association.
There are more than 50 diseases that cause dementia, including Alzheimer’s disease, Lewy body disease, and cerebrovascular disease. When two or more causative diseases occur together, it is called mixed dementia. Alzheimer’s disease and Lewy body disease often occur simultaneously.
People with mixed dementia show a faster rate of decline in cognitive and physical functions than those with isolated dementia. About 50% of all dementia patients suffer from mixed dementia, but most are only diagnosed with Alzheimer’s disease, not mixed dementia. This is because there is no test that can confirm protein deposition that causes Lewy body disease.
In Alzheimer’s disease, amyloid-beta protein builds up in the brain and deteriorates the function of parts responsible for memory, such as the temporal lobe. In Lewy body disease, alpha-synuclein protein builds up in the brain and attacks nerve cells, reducing dopamine secretion and causing hallucinations and fluctuations in cognitive function.
The research team performed a positron emission tomography (PET) scan on 99 patients with dementia registered at Severance Hospital to examine the effects of amyloid-beta protein deposition and alpha-synuclein protein-induced dopamine secretion decrease on cerebral blood flow increase and decrease and dementia symptoms. investigated
As a result, it was confirmed that the two proteins affect blood flow in different brain regions. Amyloid-beta protein deposition decreased medial temporal lobe blood flow, and alpha-synuclein protein-induced dopamine dysfunction increased hippocampal blood flow.
These blood flow changes caused specific symptoms. Decreased blood flow to the medial temporal lobe caused overall cognitive decline, including memory loss, while increased blood flow to the hippocampus caused concentration, fluctuations in cognitive function with decreased visuospatial function, and visual hallucinations.
The research team believes that the difference in blood flow caused by proteins that cause each disease can serve as a criterion for confirming the onset of mixed dementia.
Professor Byung-Seok Yea said, “It is very difficult to accurately diagnose patients with mixed dementia due to the variety of symptoms.” We hope to improve the prognosis by proceeding.”
Daeik Kwon Medical Reporter dkwon@hankookilbo.com
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2023-08-31 12:05:31
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