Striatal dopaminergic transmission and neocortical glucose utilization in Alzheimerʹs disease: a triple-tracer positron emission tomography study

The central dopaminergic neuron system is related to cognitive function and behavior. For Alzheimerʹs disease (AD), using PET and the ligands of dopa, D2 receptor antagonist, and deoxyglucose, we previously found that dopa uptake into the striatum (the Ki value) was correlated with the Mini-Mental State (MMS) score. AD patients exhibiting wandering had an increased level of D2 receptor (the k3/k4 value). The Ki value was correlated with glucose metabolism (CMRglc) of the frontal and temporal lobes, those of wanderers being lower than nonwanderers. We investigated the relationships between the Ki value and the k3/k4 value with reference to cognitive impairment and wandering. Using the three-tracer technique for the single subject, the Ki value, the k3/k4 value, and CMRglc in 12 AD patients were measured. For the wanderers, there was a reverse correlation between the Ki and the k3/k4 values. Multiple regression analysis showed that the score on the verbal fluency test was explained by the Ki value and CMRglc of the frontal and temporal lobes, while MMS score was related to more global areas.