Reversible Alcohol-related Dementia: A Five-year Follow-up Study Using FDG-PET and Neuropsychological Tests

Asada, Tomohiko; Takaya, Satoshi; Takayama, Yoshihiro; Hashikawa, Kazuo; Fukuyama, Hidenao

doi:10.2169/internalmedicine.49.2662

Cited by 16 publications

(5 citation statements)

References 23 publications

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“…Recovery can accompany prolonged sobriety (1, 3). Studies using positron emission tomography (PET) with fluorodeoxyglucose (FDG) have yielded analogous results to those with SPECT, where sober alcoholics showed deficits in regional glucose metabolism early in abstinence and at least partial recovery with sustained abstinence (12–14). Even with sustained abstinence, low glucose metabolism persisted in frontal cortex (15, 16) and limbic sites (17) in uncomplicated alcoholism, extending to the anterior vermis in cases of alcoholic cerebellar degeneration with ataxia (18).…”

Section: Introductionmentioning

confidence: 98%

A Selective Insular Perfusion Deficit Contributes to Compromised Salience Network Connectivity in Recovering Alcoholic Men

Sullivan

Müller‐Oehring

Pitel

et al. 2013

Biological Psychiatry

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Background Alcoholism can disrupt neural synchrony between nodes of intrinsic functional networks that are maximally active when resting relative to engaging in a task, the default mode network (DMN) pattern. Untested, however, are whether the DMN in alcoholics can rebound normally from the relatively depressed task-state to the active resting-state and whether local perfusion deficits could disrupt network synchrony when switching from conditions of rest to task to rest, thereby indicating a physiological mechanism of neural network adaptation capability. Methods Whole-brain, 3D pulsed-continuous arterial spin labeling (PCASL) provided measurements of regional cerebral blood flow (rCBF) in 12 alcoholics and 12 controls under three conditions: pre-task rest, spatial working-memory task, post-task rest. Results With practice, alcoholics and controls achieved similar task accuracy and reaction times. Both groups exhibited a high-low-high pattern of perfusion levels in DMN regions during the rest-task-rest runs and the opposite pattern in posterior and cerebellar regions known to be associated with spatial working memory. Alcoholics showed selective differences from controls in the rest-task-rest CBF pattern in the anterior precuneus and CBF level in the insula, a hub of the salience network. Connectivity analysis identified activation synchrony from an insula seed to salience nodes (parietal, medial frontal, anterior cingulate cortices) in controls only. Conclusions We propose that attenuated insular CBF is a mechanism underlying compromised connectivity among salience network nodes. This local perfusion deficit in alcoholics has the potential to impair ability to switch from cognitive states of interoceptive cravings to cognitive control for curbing internal urges.

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Section: Introductionmentioning

confidence: 98%

A Selective Insular Perfusion Deficit Contributes to Compromised Salience Network Connectivity in Recovering Alcoholic Men

Sullivan

Müller‐Oehring

Pitel

et al. 2013

Biological Psychiatry

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“…It is a result of degeneration of the neuronal cells (Troshin, 2009). Symptoms may include brain damage, dementia or amnesia, anxiety, depression, limb weakness, blurred vision (Asada et al, 2010). Neurotoxicity occurs upon the exposure to natural or synthetic toxic substances, called neurotoxins, characterized by their abilities to alter the normal activity of the nervous system causing damage to neurons such as: aluminum, mercury, copper, arsenic, lead and manganese (Pohl et al, 2011; Belyaeva et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Anti‐amnestic properties of Ginkgo biloba extract on impaired memory function induced by aluminum in rats

Abd‐Elhady

Elsheikh

Khalifa

2013

Intl J of Devlp Neuroscience

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Aluminum is the most widely used non-ferrous metal. However, recently it is reported to be a neurotoxic agent that could induce biochemical defects in brain by affecting levels of neurotransmitters and generating reactive oxygen species resulting in oxidative stress. This study aimed at evaluating neuroprotective effect of Ginkgo biloba extract(2) (GBE) (200 mg/kg for 28 days) in antagonizing aluminum-induced neurotoxicity through investigating certain parameters such as serum aluminum level, brain aluminum content, brain regional distribution of aluminum, brain oxidative stress biomarkers' content, and brain acetylcholinesterase(3) (AChE) activity. Passive avoidance paradigm was used to assess memory retrieval of rats. Rats' activities were studied using open field test. Results showed that administration of aluminum (10 mg/kg for 28 days) impaired rats' memory retrieval associated with marked elevation of aluminum brain content, serum aluminum level and AChE activity. In addition, aluminum treatment induced significant elevation in its brain content in all tested regions. GBE treatment attenuated neurotoxic effects of aluminum as evidenced by improving rats' performance in passive avoidance and lowering brain AChE activity. Moreover, marked elevation in brain content of oxidized glutathione(4) (GSSG) and malonedialdehyde(5) (MDA) as well as depletion of reduced glutathione(6) (GSH) demonstrated following aluminum administration were reversed reaching normal levels after GBE treatment. Open field test, demonstrated no changes in latency period, number of ambulation, rearing, and grooming following aluminum or other treatments. Therefore, GBE may be a promising therapy ameliorating neurotoxicity of aluminum as an environmental toxic agent.

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“…One of these cases was described by Asada, who reported a middle-aged man with alcohol-related dementia with memory impairment and depression, showing glucose hypometabolism in the right diencephalon, bilateral basal forebrain, temporal poles, supplementary motor areas, and dorsal brainstem. Together with the cessation of alcohol abuse, the patient’s clinical deficits and hypometabolism improved [ 35 ]. Interestingly, Kemppainen described a case of reversible diffuse brain hypometabolism in a patient with systemic lupus erythematosus and cognitive impairment, which improved after immunosuppressive treatment [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Depressive Pseudodementia with Reversible AD-like Brain Hypometabolism: A Case Report and a Review of the Literature

Pozzi

Licciardo

Musarra

et al. 2022

JPM

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Recent European guidelines recommend using brain FDG-PET to differentiate between Alzheimer’s disease (AD) and depressive pseudodementia (DP), with specific hypometabolism patterns across the former group, and typically normal or frontal hypometabolism in the latter. We report the case of a 74 years-old man with DP (MMSE 16/30), whose FDG-PET visual rating and semiquantitative analysis closely mimicked the typical AD pattern, showing severe hypometabolism in bilateral precuneus, parietal and temporal lobes, and sparing frontal areas, suggesting the diagnosis of moderate AD. Shortly after starting antidepressant polytherapy, he underwent formal NPS testing, which revealed moderate impairment of episodic memory and mild impairment on executive and visuospatial tests, judged consistent with neurodegenerative dementia and concomitant depression. Over the following two years, he improved dramatically: repeated NPS assessment did not show significant deficits, and FDG-PET showed restoration of cerebral metabolism. The confirmation of PET findings via semiquantitative analysis, and their reversion to normality with antidepressant treatment, proved the non-neurodegenerative origin of the initial AD-like FDG-PET abnormalities. We review similar cases and provide a comprehensive analysis of their implications, concluding that reversible FDG-PET widespread hypometabolism might represent a biomarker of pseudodementia. Therefore, we suggest caution when interpreting FDG-PET scans of depressed patients with cognitive impairment.

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Reversible Alcohol-related Dementia: A Five-year Follow-up Study Using FDG-PET and Neuropsychological Tests

Abstract: Objective As the pathophysiology of alcohol-related dementia (ARD)

Cited by 16 publications

References 23 publications

A Selective Insular Perfusion Deficit Contributes to Compromised Salience Network Connectivity in Recovering Alcoholic Men

A Selective Insular Perfusion Deficit Contributes to Compromised Salience Network Connectivity in Recovering Alcoholic Men

Anti‐amnestic properties of Ginkgo biloba extract on impaired memory function induced by aluminum in rats

Depressive Pseudodementia with Reversible AD-like Brain Hypometabolism: A Case Report and a Review of the Literature

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