Predictive utility of neuropsychological measures and single photon emission computed tomography (SPECT) in the classification of cerebral perfusion deficits in dementia of the Alzheimer type (DAT)
The general purpose of this study was to investigate the relationship between neuropsychological tests scores and perfusion deficits, based upon measures of regional cerebral blood flow (rCBF) taken from the single photon emission computed tomography (SPECT) scans of patients suffering from dementia of the Alzheimer type (DAT). The study was designed to determine if DAT patients categorized as having left hemisphere, right hemisphere, diffuse, or an absence of perfusion deficits, as measured by SPECT, would be accurately grouped into their respective categories, and if they would exhibit the corresponding neuropsychological deficiencies usually associated with lateral hemispheric asymmetries.Selected subjects were 80 right handed, DAT patients from the North Broward Medical Center - Memory Disorder Center, in Pompono Beach, Florida, who had been administered a neuropsychological test battery, and a SPECT scan.Through several ANOVA's that were calculated for each of the neuropsychological variables, it was concluded that DAT patients who suffered from perfusion deficits exhibited significantly lower levels of neuropsychological functioning than DAT patients without perfusion deficits.These analyses revealed significantly lower levels of neuropsychological performance in the perfusion deficit group on the combination of left hemisphere WAIS-R subtests (Information, Similarities & Vocabulary), WMS - Logical Story (p < .01), WRAT-R Reading, WRAT-R Mathematics, WMS Paired Associates, and the Rey Complex Figure (p < .05).A separate step-wise discriminant function analysis indicated that a combination of the neuropsychological variables could not accurately classify the DAT patients into their respective right hemisphere, left hemisphere, diffuse, or absence of perfusion deficit groups. The discriminant function classified only 32.5% of the grouped cases accurately. Of the original thirteen neuropsychological variables, only Paired Associates immediate recall of the WMS entered the discriminant analysis equation. This accounted for only 23% of the total variability that could be explained by differences between the perfusion deficit groups. In several post hoc ANOVA's using the Bonferroni method of multiple comparisons, it was revealed that the absence of perfusion deficit group scored significantly higher than the other groups on the majority of the left hemisphere neuropsychological measures. However, none of the right hemisphere neuropsychological measures attained significance.