Statistical maps of cerebral blood flow deficits in Alzheimer's disease

Images of cerebral blood flow or metabolism are useful as adjunct to the differential diagnosis of cortical dementia. The aim of this study was to create statistical objective voxel maps of significant differences in regional cerebral blood flow between patients with Alzheimer's disease and age-matched healthy volunteers. Maps of significantly reduced cerebral blood flow were created based on a spatially normalized distribution of cerebral blood flow, measured with O-15-water and positron emission tomography in 16 Alzheimer's patients, compared to 16 healthy age-matched volunteers. After spatial normalization of voxel counts, the t-statistic of the cerebral blood flow deficit was determined from the local voxel-SDs. In the patients, significant reduction (P < 0.05) of the flow distribution was present in regions near the hippocampus, extending rostrally to the temporo-parietal region in both hemispheres, including the medial parietal cortex plus smaller frontal areas. The maximum reduction occurred in the left tapetum/hippocampus (53%, P = 0.061). In conclusion, statistical maps of cerebral blood flow deficits objectively reveal the location of deficits, identifying areas that are difficult to identify by subjective visual inspection of conventional sections of cerebral blood flow maps. This is particularly well illustrated by the pronounced flow reduction of the medial parietal cortices.