Dement Neurocogn Disord.  2017 Mar;16(1):26-31. 10.12779/dnd.2017.16.1.26.

Cerebral Perfusion Changes after Acetyl-L-Carnitine Treatment in Early Alzheimer's Disease Using Single Photon Emission Computed Tomography

Affiliations
  • 1Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
  • 2Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea. siuy@catholic.ac.kr
  • 3Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
Although acetyl-L-carnitine (ALC) treatment may have beneficial effects on Alzheimer's disease (AD), its underlying neural correlates remain unclear. The purpose of this study was to investigate cerebral perfusion changes after ALC treatment in AD patients using technetium-99m hexamethylpropylene amine oxime single photon emission computed tomography (SPECT).
METHODS
A total of 18 patients with early AD were prospectively recruited and treated with ALC at 1.5 g/day for 1.4±0.3 years. At baseline and follow-up, brain SPECT, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), and Neuropsychiatric Inventory (NPI) were used to assess participants. After ALC administration, changes in brain perfusion, severity of dementia, cognitive performance, and neuropsychiatric disturbances were examined.
RESULTS
After ALC administration, changes in scores of MMSE, CDR, GDS, and NPI were not statistically significant (p>0.05). Voxel-wise whole-brain image analysis revealed that perfusion was significantly (p<0.001) increased in the right precuneus whereas perfusion was reduced in the left inferior temporal gyrus (p<0.001), the right middle frontal gyrus (p<0.001), and the right insular cortex (p=0.001) at follow-up.
CONCLUSIONS
Although previous studies have suggested that AD patients generally demonstrate progressive deterioration in brain perfusion and clinical symptoms, this study reveals that the perfusion of the precuneus is increased in AD patients after ALC administration and their cognitive and neuropsychiatric symptoms are not aggravated. Further studies are warranted to determine the potential association between perfusion increase in the precuneus and clinical symptoms after ALC treatment in AD patients.

Keyword

Alzheimer's disease; acetyl-L-carnitine; single photon emission computed tomography; brain perfusion; cognitive function

MeSH Terms

Acetylcarnitine*
Alzheimer Disease*
Brain
Cerebral Cortex
Cognition
Dementia
Follow-Up Studies
Humans
Parietal Lobe
Perfusion*
Prospective Studies
Temporal Lobe
Tomography, Emission-Computed, Single-Photon*
Acetylcarnitine

Figure

  • Fig. 1 Changes in regional cerebral blood flow at follow-up. At each voxel, increase or decrease in brain perfusion is indicated by red-yellow or blue-green color, respectively. Images are shown in neurological convention. Color bars represent voxel-level t-values.


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