BACKGROUND: A consensus on the brain dysfunction(s) underlying the delusions of Alzheimer's Dementia (AD) remains to be achieved. The aim of the present study was to test the hypothesis that content-based categorization of delusional ideas manifests as dysfunction of category-specific brain regions. METHODS: Fifty-nine consecutive first-visit AD outpatients underwent Single Photon Emission Computed Tomography (SPECT), Mini-Mental State Examination, and Behavioral Pathology in Alzheimer's Disease Frequency-Weighted Severity scale (BEHAVE-AD-FW) to assess cerebral blood flow (CBF), cognitive function, and delusion, respectively. SPECT images were analyzed by SPM5. RESULTS: CBF decreased at the temporal poles and right inferior temporal gyrus in "delusion of theft," at the temporal poles in "suspiciousness/paranoia," at the right parahippocampal gyrus and insula in "abandonment," and at the right amygdala in "Residence is not home." CONCLUSIONS: Our findings offer a perspective on the discrete categories of the pathological thoughts of AD patients that have previously been lumped together as "delusions." Dysfunction of the temporal poles may be associated with a socioemotional deterioration that may include pathological suspiciousness. Delusion of theft may be a manifestation of socioemotional deterioration and poor insight. Emotional factors may be essential for delusions of abandonment and "not home."
BACKGROUND: A consensus on the brain dysfunction(s) underlying the delusions of Alzheimer's Dementia (AD) remains to be achieved. The aim of the present study was to test the hypothesis that content-based categorization of delusional ideas manifests as dysfunction of category-specific brain regions. METHODS: Fifty-nine consecutive first-visit AD outpatients underwent Single Photon Emission Computed Tomography (SPECT), Mini-Mental State Examination, and Behavioral Pathology in Alzheimer's Disease Frequency-Weighted Severity scale (BEHAVE-AD-FW) to assess cerebral blood flow (CBF), cognitive function, and delusion, respectively. SPECT images were analyzed by SPM5. RESULTS: CBF decreased at the temporal poles and right inferior temporal gyrus in "delusion of theft," at the temporal poles in "suspiciousness/paranoia," at the right parahippocampal gyrus and insula in "abandonment," and at the right amygdala in "Residence is not home." CONCLUSIONS: Our findings offer a perspective on the discrete categories of the pathological thoughts of ADpatients that have previously been lumped together as "delusions." Dysfunction of the temporal poles may be associated with a socioemotional deterioration that may include pathological suspiciousness. Delusion of theft may be a manifestation of socioemotional deterioration and poor insight. Emotional factors may be essential for delusions of abandonment and "not home."
Authors: Corinne E Fischer; Windsor Kwan-Chun Ting; Colleen P Millikin; Zahinoor Ismail; Tom A Schweizer Journal: Int J Geriatr Psychiatry Date: 2015-03-27 Impact factor: 3.485
Authors: Zahinoor Ismail; Byron Creese; Dag Aarsland; Helen C Kales; Constantine G Lyketsos; Robert A Sweet; Clive Ballard Journal: Nat Rev Neurol Date: 2022-01-04 Impact factor: 44.711
Authors: Georges Naasan; Suzanne M Shdo; Estrella Morenas Rodriguez; Salvatore Spina; Lea Grinberg; Lucia Lopez; Anna Karydas; William W Seeley; Bruce L Miller; Katherine P Rankin Journal: Brain Date: 2021-04-12 Impact factor: 15.255