Monitoring of drug treatment and psychosocial intervention with SPECT in Alzheimer patients Implications for neurologically appropriate psychosocial interventions. An observational study. The Osaki-Tajiri Project

Abstract

We previously examined cerebral blood flow (CBF) with single-photon emission computed tomography (SPECT) in Alzheimer’s disease (AD) with reference to drug treatment (donepezil) and psychosocial intervention.Objective:The aim is to provide “brain-based” evidence for psychosocial interventions using SPECT.Methods:The participants were 27 consecutive outpatients with AD who received the drug and psychosocial intervention, and SPECT three times (baseline, pre-/post-intervention) at 6 month-intervals. The significance level of changes in CBF (Z score) and the extent of significantly changed areas, calculated with the eZIS system, were used as monitoring parameters. The participants were classified into three groups: improve (post-intervention CBF increased), worsening (progressive decline), and no change.Results:Six, 8, and 13 patients were classified as improve, worsening, and no change, respectively. All subjects in the improve group showed improvement in cognitive test scores for the MMSE and/or the CGI scores associated with the brain area with a CBF increase (right parietal lobe), suggesting appropriate psychosocial intervention (visuospatial intervention).Conclusion:These results suggest that monitoring of CBF with the eZIS system may be clinically applicable for monitoring of drug treatment and psychosocial intervention in AD patients.

Using eZIS of SPECT to evaluate the therapeutic effect of carotid endarterectomy

“…Some teams used it to distinguish Alzheimer’s from other types of dementia [23]. In addition, based on the monitoring of cerebral blood flow, some studies have found that eZIS can be used for clinical monitoring of Alzheimer’s drug treatment (such as Donepezil) and psychosocial intervention [24], and can also be used to study the correlation between the Alzheimer’s Disease Assessment Scale and the reduction of local cerebral blood flow [25]. With the development of statistical analysis in SPECT, eZIS has been applied to the diagnosis and evaluation of cerebral ischemia.…”

Two-layer analytical model for estimation of layer thickness and flow using Diffuse Correlation Spectroscopy

“…Here, k n is the wavenumber of the light at wavelength λ and D Bn is the Brownian diffusion coefficient for the n-th layer, a parameter that describes the scatterer dynamics inside each layer and thus can quantify the motion of RBC in thick/deep tissue [2,11]. The field autocorrelation at the surface, G 0 (r, τ), can be obtained by solving Eq (6) in the Fourier domain with respect to the transverse coordinate ρ as Ĝðq; z; tÞ ¼…”

“…On the other hand, abnormal blood flow in the vasculature were shown to be associated with critical pathologies such as cardiovascular diseases, stroke, head trauma, peripheral arterial disease, cancer, and other conditions where the impaired blood flow impacts surrounding tissue [1][2][3]. As a result, continuous monitoring of blood flow is crucial, and depending on the clinical need, physicians currently use a variety of non-invasive techniques to monitor microvascular blood flow such as Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Computed Tomography (CT), etc [4][5][6][7]. However, the currently available tools aren't suitable for continuous blood flow monitoring as they entail major disadvantages including discomfort to the patient, harm from the use of ionizing radiation and contrast agents, poor portability and high cost [8][9][10].…”

“…Like other diffuse optical methods such as Near Infrared Spectroscopy (NIRS) and Diffuse Optical Spectroscopy (DOS), DCS is non-invasive and can be made to have a high temporal resolution [2,17]. DCS is relatively low-cost, easily portable, and is more suitable for continuous bedside monitoring compared to other more well-known non-invasive vascular imaging techniques such as MRI and US [4][5][6][8][9][10]. Moreover, DCS is more sensitive to the blood flow in capillaries and small vessels, making it potentially a better indicator of tissue perfusion than methods which measure blood flow velocity in large vessels such as US [18].…”