Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
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FDG PET Findings according to Wandering Patterns of Patients with Drug-naïve Alzheimer's Disease

  • Received : 2018.08.08
  • Accepted : 2018.11.02
  • Published : 2018.09.30
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Abstract

Background and Purpose: To explore anatomic substrate of specific wandering patterns in patients with Alzheimer's disease (AD) by performing positron emission tomography with $^{18}F$ fluorodeoxyglucose positron emission tomography (FDG PET). Methods: Drug-naïve AD patients with wandering (n=80) and without wandering (n=262) were recruited. First, the specific pattern of wandering type was operationally classified according to specific wandering score and clinical assessment. Second, brain FDG PET was performed and fluorodeoxyglucose (FDG) uptake differences of specific brain regions according to wandering patterns were compared to those of non-wanderers. Results: In patients with pacing pattern, FDG PET showed significant lower FDG uptake in both middle cingulum and left putamen cluster compared to non-wanderers. The right precuneus and supplementary motor area in patients with random pattern and left calcarine sulcus, right calcarine sulcus, right middle cingulum, and right post central gyrus in patients with lapping pattern had significantly lower FDG uptake compared to non-wanderers. Conclusions: This study showed that wandering in patients with AD had three distinct patterns. These specific patterns showed significant lower FDG uptake in specific brain areas compared to non-wanderers.

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References

  1. Synder LH, Rupprecht P, Pyrek J, Brekhus S, Moss T. Wandering. Gerontologist 1978;18:272-280. https://doi.org/10.1093/geront/18.3.272
  2. Dawson P, Reid DW. Behavioral dimensions of patients at risk of wandering. Gerontologist 1987;27:104-107. https://doi.org/10.1093/geront/27.1.104
  3. Algase DL, Kupferschmid B, Beel-Bates CA, Beattie ER. Estimates of stability of daily wandering behavior among cognitively impaired long-term care residents. Nurs Res 1997;46:172-178. https://doi.org/10.1097/00006199-199705000-00008
  4. Carr D, Muschert GW, Kinney J, Robbins E, Petonito G, Manning L, et al. Silver alerts and the problem of missing adults with dementia. Gerontologist 2010;50:149-157. https://doi.org/10.1093/geront/gnp102
  5. Monsour N, Robb SS. Wandering behavior in old age: a psychosocial study. Soc Work 1982;27:411-416.
  6. Martino-Saltzman D, Blasch BB, Morris RD, McNeal LW. Travel behavior of nursing home residents perceived as wanderers and nonwanderers. Gerontologist 1991;31:666-672. https://doi.org/10.1093/geront/31.5.666
  7. Cumming J, Cumming E, Titus J, Schmelzle E, MacDonald J. The episodic nature of behavioural disturbances among residents of facilities for the aged. Can J Public Health 1982;73:319-322.
  8. Gurwitz JH, Sanchez-Cross MT, Eckler MA, Matulis J. The epidemiology of adverse and unexpected events in the long-term care setting. J Am Geriatr Soc 1994;42:33-38. https://doi.org/10.1111/j.1532-5415.1994.tb06070.x
  9. Hussian RA. Stimulus control in the modification of problematic behavior in elderly institutionalized patients. Int J Behav Geriatr 1982;1:33-42.
  10. Liu L, Gauthier L, Gauthier S. Spatial disorientation in persons with early senile dementia of the Alzheimer type. Am J Occup Ther 1991;45:67-74. https://doi.org/10.5014/ajot.45.1.67
  11. Yang YS, Hwang I, Kwak YT. Neuropsychological characteristics of wandering in patients with drug-naive Alzheimer's disease. Dement Neurocognitive Disord 2014;13:74-78. https://doi.org/10.12779/dnd.2014.13.3.74
  12. Hope T, Tilling KM, Gedling K, Keene JM, Cooper SD, Fairburn CG. The structure of wandering in dementia. Int J Geriatr Psychiatry 1994;9:149-155. https://doi.org/10.1002/gps.930090209
  13. Klein DA, Steinberg M, Galik E, Steele C, Sheppard JM, Warren A, et al. Wandering behaviour in community-residing persons with dementia. Int J Geriatr Psychiatry 1999;14:272-279. https://doi.org/10.1002/(SICI)1099-1166(199904)14:4<272::AID-GPS896>3.0.CO;2-P
  14. Sink KM, Covinsky KE, Newcomer R, Yaffe K. Ethnic differences in the prevalence and pattern of dementia-related behaviors. J Am Geriatr Soc 2004;52:1277-1283. https://doi.org/10.1111/j.1532-5415.2004.52356.x
  15. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939-944. https://doi.org/10.1212/WNL.34.7.939
  16. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination(K-MMSE) in dementia patients. J Korean Neurol Assoc 1997;15:300-308.
  17. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566-572. https://doi.org/10.1192/bjp.140.6.566
  18. Mahoney FI, Barthel DW. Functional evaluation: Barthel index. Md State Med J 1965;14:61-65.
  19. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res 2004;57:297-305. https://doi.org/10.1016/j.jpsychores.2004.01.004
  20. Song JA. Relationship of premorbid personality and behavioral responses to stress to wandering behavior of residents with dementia in long term care facilities [dissertation]. Ann Arbor (MI): University of Michigan; 2003.
  21. Algase DL, Beattie ER, Bogue EL, Yao L. The Algase Wandering Scale: initial psychometrics of a new caregiver reporting tool. Am J Alzheimers Dis Other Demen 2001;16:141-152. https://doi.org/10.1177/153331750101600301
  22. Phillips VL, Diwan S. The incremental effect of dementia-related problem behaviors on the time to nursing home placement in poor, frail, demented older people. J Am Geriatr Soc 2003;51:188-193. https://doi.org/10.1046/j.1532-5415.2003.51057.x
  23. Tetewsky SJ, Duffy CJ. Visual loss and getting lost in Alzheimer's disease. Neurology 1999;52:958-965. https://doi.org/10.1212/WNL.52.5.958
  24. McShane R, Gedling K, Keene J, Fairburn C, Jacoby R, Hope T. Getting lost in dementia: a longitudinal study of a behavioral symptom. Int Psychogeriatr 1998;10:253-260. https://doi.org/10.1017/S1041610298005365
  25. Rowe MA, Bennett V. A look at deaths occurring in persons with dementia lost in the community. Am J Alzheimers Dis Other Demen 2003;18:343-348. https://doi.org/10.1177/153331750301800612
  26. Kavcic V, Duffy CJ. Attentional dynamics and visual perception: mechanisms of spatial disorientation in Alzheimer's disease. Brain 2003;126:1173-1181. https://doi.org/10.1093/brain/awg105
  27. Benton AL. Disorders of spatial orientation. In: Vinken PJ, Bruyn GW, editors. Handbook of Clinical Neurology. New York (NY): Wiley, 1969;212-228.
  28. Chiu YC, Algase D, Whall A, Liang J, Liu HC, Lin KN, et al. Getting lost: directed attention and executive functions in early Alzheimer's disease patients. Dement Geriatr Cogn Disord 2004;17:174-180. https://doi.org/10.1159/000076353
  29. Passini R, Rainville C, Marchand N, Joanette Y. Wayfinding in dementia of the Alzheimer type: planning abilities. J Clin Exp Neuropsychol 1995;17:820-832. https://doi.org/10.1080/01688639508402431
  30. Rolland Y, Payoux P, Lauwers-Cances V, Voisin T, Esquerre JP, Vellas B. A SPECT study of wandering behavior in Alzheimer's disease. Int J Geriatr Psychiatry 2005;20:816-820. https://doi.org/10.1002/gps.1362
  31. Meguro K, Yamaguchi S, Yamazaki H, Itoh M, Yamaguchi T, Matsui H, et al. Cortical glucose metabolism in psychiatric wandering patients with vascular dementia. Psychiatry Res 1996;67:71-80. https://doi.org/10.1016/0925-4927(96)02549-8
  32. Lai CK, Arthur DG. Wandering behaviour in people with dementia. J Adv Nurs 2003;44:173-182. https://doi.org/10.1046/j.1365-2648.2003.02781.x
  33. Griffiths PD, Perry RH, Crossman AR. A detailed anatomical analysis of neurotransmitter receptors in the putamen and caudate in Parkinson's disease and Alzheimer's disease. Neurosci Lett 1994;169:68-72. https://doi.org/10.1016/0304-3940(94)90358-1
  34. Koenraadt KL, Roelofsen EG, Duysens J, Keijsers NL. Cortical control of normal gait and precision stepping: an fNIRS study. Neuroimage 2014;85:415-422. https://doi.org/10.1016/j.neuroimage.2013.04.070
  35. Sahyoun C, Floyer-Lea A, Johansen-Berg H, Matthews PM. Towards an understanding of gait control: brain activation during the anticipation, preparation and execution of foot movements. Neuroimage 2004;21:568-575. https://doi.org/10.1016/j.neuroimage.2003.09.065
  36. Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates. Brain 2006;129:564-583. https://doi.org/10.1093/brain/awl004
  37. Selemon LD, Goldman-Rakic PS. Common cortical and subcortical targets of the dorsolateral prefrontal and posterior parietal cortices in the rhesus monkey: evidence for a distributed neural network subserving spatially guided behavior. J Neurosci 1988;8:4049-4068. https://doi.org/10.1523/JNEUROSCI.08-11-04049.1988
  38. Nagahama Y, Okada T, Katsumi Y, Hayashi T, Yamauchi H, Sawamoto N, et al. Transient neural activity in the medial superior frontal gyrus and precuneus time locked with attention shift between object features. Neuroimage 1999;10:193-199. https://doi.org/10.1006/nimg.1999.0451
  39. Sarlegna FR, Mutha PK. The influence of visual target information on the online control of movements. Vision Res 2015;110:144-154. https://doi.org/10.1016/j.visres.2014.07.001
  40. Prosperini L, Leonardi L, De Carli P, Mannocchi ML, Pozzilli C. Visuo-proprioceptive training reduces risk of falls in patients with multiple sclerosis. Mult Scler 2010;16:491-499. https://doi.org/10.1177/1352458509359923