18 F-Fluorodeoxyglucose Positron Emission Tomography Cortical Metabolic Activity Associated with Distinct Agitation Behaviors in Alzheimer Disease

Weissberger, Gali H.; Melrose, Rebecca J.; Narvaez, Theresa A.; Harwood, Dylan G.; Mandelkern, M.; Sultzer, David L.

doi:10.1016/j.jagp.2017.01.017

Cited by 53 publications

(23 citation statements)

References 41 publications

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“…In an EOAD cohort with mean disease duration of 3.18 years and MMSE 20.7, hypermetabolism in the left insula, superior frontal gyrus, temporal pole and precentral gyrus, the ACC, and the right inferior frontal gyrus were found in 19 subjects with the hyperactivity subsyndrome (Ballarini et al, 2016). This contrasts with a recent study in 88 mild to moderate late-onset AD (LOAD) (mean age 78 years, disease duration 3.2 years, MMSE 19.3), which instead found hypometabolism in the right temporal and bilateral middle and posterior cingulate regions in subjects with agitation (Weissberger et al, 2017).…”

Section: Metabolic Dysfunction and Npscontrasting

confidence: 91%

Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia

Chiew

Rosa‐Neto

et al. 2019

Front. Pharmacol.

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Neuropsychiatric symptoms (NPS) including behavioral and psychiatric symptoms are common in the dementia stages of Alzheimer's disease (AD) and are associated with poorer outcomes in cognition, functional states, quality of life, and accelerated progression to severe dementia or death. NPS are also increasingly observed in the mild cognitive impairment stage of AD and may predict incipient dementia. As such, there is an emerging conceptual framework, which support NPS as early non-cognitive symptoms of dementia. [18F]fluorodeoxyglucosepositron emission tomography is a technique that is sensitive in detecting resting metabolism associated with NPS in neuropsychiatric conditions, and there is a growing body of literature evaluating the role of NPS as early indicators of brain metabolic dysfunctions in AD. In this mini-review, we examine the frequency and associations of NPS with metabolic dysfunction in the AD continuum, including preclinical, prodromal, and dementia stages of AD. We will also present the validated neurobehavioral syndrome, mild behavioral impairment describes the later life emergence of sustained NPS as an at-risk state for incident cognitive decline and dementia, and an early presentation of neurodegenerative diseases in some. Lastly, we will discuss future directions in the field so as to better understand the neurobiological basis of NPS in the early stages of the AD continuum, and their role in predicting AD pathophysiological progression and incident dementia.

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Section: Metabolic Dysfunction and Npscontrasting

confidence: 91%

Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia

Chiew

Rosa‐Neto

et al. 2019

Front. Pharmacol.

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“…On the other hand, when irritability is grouped with affective symptoms (depression) or psychosis, no clear evidence for specific neurobiological substrates emerges (Tascone and Bottino, 2013). Recently, however, an FDG-PET study in AD demonstrated that irritability had common metabolic changes to agitation (right temporal, right frontal, bilateral middle, and posterior cingulate gyri) but differed in specific regions (right insular, precentral, and postcentral gyri) (Weissberger et al , 2017), reflecting neurodegeneration in regions associated with core AD pathology (Rosenberg, 2017). It is noteworthy that to date, most of the work on the neurobiology of irritability comes from the dementia literature with little data addressing emergent irritability in the predementia stages in spite of its prevalence.…”

Section: Irritabilitymentioning

confidence: 99%

Affective and emotional dysregulation as pre-dementia risk markers: exploring the mild behavioral impairment symptoms of depression, anxiety, irritability, and euphoria

Ismail

Gatchel

Bateman

et al. 2017

Int. Psychogeriatr.

160

109

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Affective symptoms are of prognostic utility, but interventions to prevent dementia syndromes are limited. Trials need to assess interventions targeting known dementia pathology, toward novel pathology, as well as using psychiatric medications. Research focusing explicitly on later life onset symptomatology will improve our understanding of the neurobiology of NPS and neurodegeneration, enrich the study sample, and inform observational and clinical trial design for prevention and treatment strategies.

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“…Brain imaging studies of agitation have shown greater hypometabolism with FDG-PET in frontal lobes compared to nonagitated patients. 88 Autopsy studies have shown a greater burden of neurofibrillary tangles but not of amyloid plaques in those with agitation during life. 86 Hallucinations characterized on the NPI have been correlated with occipital lobe dysfunction, 89 and disinhibition as assessed on the NPI reflects orbitofrontal dysfunction.…”

Section: Commentmentioning

confidence: 99%

The Neuropsychiatric Inventory: Development and Applications

Cummings

2020

J Geriatr Psychiatry Neurol

107

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Reasons for the Study: The Neuropsychiatric Inventory (NPI) has been used for studies of neuropsychiatric symptoms in neurodegenerative disorders for the past 25 years. This article reviews the history of the development and application of the NPI. Main Findings: The NPI consists of 10 (or 12) items that are assayed with questions, subquestions, and ratings of frequency and severity. The NPI has been shown to be valid and reliable. The NPI has been translated into approximately 40 languages; it has 4 of versions designed for different clinical applications. The NPI studies show contrasting profiles of behavioral symptoms in different neurologic disorders. The NPI has been used in approximately 350 clinical trials. In economic studies, the NPI captures the cost of behavioral symptoms in dementias. Principle Conclusions: The NPI is a useful instrument for capturing behavioral changes in Alzheimer disease and other neurodegenerative disorders.

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18 F-Fluorodeoxyglucose Positron Emission Tomography Cortical Metabolic Activity Associated with Distinct Agitation Behaviors in Alzheimer Disease

Cited by 53 publications

References 41 publications

Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia

Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia

Affective and emotional dysregulation as pre-dementia risk markers: exploring the mild behavioral impairment symptoms of depression, anxiety, irritability, and euphoria

The Neuropsychiatric Inventory: Development and Applications

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