Published online Jun 22, 2017. doi: 10.5498/wjp.v7.i2.121
Peer-review started: February 12, 2017
First decision: March 28, 2017
Revised: April 10, 2017
Accepted: May 3, 2017
Article in press: May 5, 2017
Published online: June 22, 2017
To evaluate usefulness of single photon emission computed tomography (SPECT) with three-dimensional stereotactic surface projection (3D-SSP) in distinguishing between Alzheimer’s disease (AD) and depression.
We studied 43 patients who presented with both depressive symptoms and memory disturbance. Each subject was evaluated using the following: (1) the Minimal Mental State Examination; (2) the Hamilton Rating Scale for Depression; (3) Clinical Global Impression-Severity scale (CGI-S); and (4) SPECT imaging with 3D-SSP.
The MMSE scores correlated significantly with the maximum Z-scores of AD-associated regions. CGI-S scores correlated significantly with the maximum Z-scores of depression-associated regions. Factor analysis identified three significant factors. Of these, Factor 1 could be interpreted as favouring a tendency for AD, Factor 2 as favouring a tendency for pseudo-dementia, and Factor 3 as favouring a depressive tendency.
We investigated whether these patients could be categorized as types: Type A (true AD), Type B (pseudo-dementia), Type C (occult AD), and Type D (true depression). The factor scores in factor analysis supported the validity of this classification. Our results suggest that SPECT with 3D-SSP is highly useful for distinguishing between depression and depressed mood in the early stage of AD.
Core tip: The present study aimed to evaluate whether statistical analysis of single photon emission computed tomography images by three-dimensional stereotactic surface projection (3D-SSP) is useful for distinguishing between Alzheimer’s disease (AD) and depression. The Minimal Mental State Examination, the Hamilton Rating Scale for Depression, and Clinical Global Impression-Severity scale findings correlated significantly with the Z-scores of AD-associated and depression-associated regions as determined using 3D-SSP analysis. Furthermore, factor analysis identified three significant factors: Factor 1, a tendency for AD; Factor 2, a tendency for pseudo-dementia; and Factor 3, a depressive tendency.