BACKGROUND: Alzheimer's Disease (AD) is frequently associated with changes in appetite. This study investigated the relationship between regional cerebral perfusion and appetite loss in AD. METHODS: 64 patients with possible or probable AD were characterized as being with (n=22) or without (n=44) appetite loss based on the Neuropsychiatric Inventory (NPI) Appetite subscale. 99mTc-ECD SPECT scans were coregistered to a standardized template in Talairach space generating mean ratios of uptake referenced to the cerebellum. Regions of interest (ROIs) included anterior cingulate cortex (ACC), middle mesial temporal cortex (MTC-m), inferior mesial temporal cortex (MTC-i), insula (INS), orbitofrontal cortex (OFC) and thalamus-hypothalamus (THAL). RESULTS: Backward stepwise logistic regression analysis of these ROIs showed hypoperfusion in the L-ACC (p=0.015) and L-OFC (p=0.015), relative sparing of perfusion in the R-ACC (p=0.010), R-OFC (p=0.010) and L-MTC-m (p=0.006), and greater anxiety (p=0.005) independently predicted loss of appetite (chi(2)=22.24, p=0.001, Nagelkerke R(2)=0.41). CONCLUSIONS: Hypoperfusion in the left anterior cingulate and left orbitofrontal cortices, and relative sparing of perfusion in the right anterior cingulate, right orbitofrontal and left middle mesial temporal cortices emerged as predictors of appetite loss in this sample of patients. These findings are consistent with impairments in the extrinsic motivational pathways of eating and impaired reward value of food as components of appetite loss in AD.
BACKGROUND:Alzheimer's Disease (AD) is frequently associated with changes in appetite. This study investigated the relationship between regional cerebral perfusion and appetite loss in AD. METHODS: 64 patients with possible or probable AD were characterized as being with (n=22) or without (n=44) appetite loss based on the Neuropsychiatric Inventory (NPI) Appetite subscale. 99mTc-ECD SPECT scans were coregistered to a standardized template in Talairach space generating mean ratios of uptake referenced to the cerebellum. Regions of interest (ROIs) included anterior cingulate cortex (ACC), middle mesial temporal cortex (MTC-m), inferior mesial temporal cortex (MTC-i), insula (INS), orbitofrontal cortex (OFC) and thalamus-hypothalamus (THAL). RESULTS: Backward stepwise logistic regression analysis of these ROIs showed hypoperfusion in the L-ACC (p=0.015) and L-OFC (p=0.015), relative sparing of perfusion in the R-ACC (p=0.010), R-OFC (p=0.010) and L-MTC-m (p=0.006), and greater anxiety (p=0.005) independently predicted loss of appetite (chi(2)=22.24, p=0.001, Nagelkerke R(2)=0.41). CONCLUSIONS: Hypoperfusion in the left anterior cingulate and left orbitofrontal cortices, and relative sparing of perfusion in the right anterior cingulate, right orbitofrontal and left middle mesial temporal cortices emerged as predictors of appetite loss in this sample of patients. These findings are consistent with impairments in the extrinsic motivational pathways of eating and impaired reward value of food as components of appetite loss in AD.
Authors: Zahinoor Ismail; Eric E Smith; Yonas Geda; David Sultzer; Henry Brodaty; Gwenn Smith; Luis Agüera-Ortiz; Rob Sweet; David Miller; Constantine G Lyketsos Journal: Alzheimers Dement Date: 2015-06-18 Impact factor: 21.566
Authors: Tommaso Ballarini; Leonardo Iaccarino; Giuseppe Magnani; Nagehan Ayakta; Bruce L Miller; William J Jagust; Maria Luisa Gorno-Tempini; Gil D Rabinovici; Daniela Perani Journal: Hum Brain Mapp Date: 2016-07-13 Impact factor: 5.038
Authors: Alexandra E Thompson; Camilla N Clark; Christopher J Hardy; Phillip D Fletcher; John Greene; Jonathan D Rohrer; Jason D Warren Journal: Neurocase Date: 2016-03-10 Impact factor: 0.881
Authors: Camilla N Clark; Hannah L Golden; Oliver McCallion; Jennifer M Nicholas; Miriam H Cohen; Catherine F Slattery; Ross W Paterson; Phillip D Fletcher; Catherine J Mummery; Jonathan D Rohrer; Sebastian J Crutch; Jason D Warren Journal: Soc Cogn Affect Neurosci Date: 2018-02-01 Impact factor: 3.436