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Abstract:
Purpose: This study was designed to validate a simple scoring
system that can be used routinely in the assessment of cerebral
dysfunction in patients with AD. Methods: 64 Alzheimer$E2Aos
patients (AD) underwent Positron Emission Tomography (PET) after
the administration of 8mCi of fluorodeoxyglucose (FDG). Metabolism
in various brain structures were scored by a blinded reviewer on
the following scale: 4=normal; 3=mildly decreased; 2=moderately
decreased; 1=severely decreased; and 0=no activity. Two scores were
calculated: one for the frontal, temporal, and parietal cortices
(areas affected by AD, Score I) and the other for the visual and
sensorimotor cortices, thalami and basal ganglia (areas not
affected by AD, Score II). The qualitative MISRS was calculated
using the formula: 200 x (Score I - Score II)/(Score I + Score II).
Regions of interest were placed on the same regions to obtain a
quantitative MISRS. MISRS values were compared to results from the
Mini-Mental Status Exam (MMSE), the Dementia Severity Rating Score
(the DSRS), and the level of tau protein in the cerebrospinal
fluid. Results: The qualitative and quantitative MISRS correlated
significantly with each other (R=0.73, p<0.0001). Both MISRS
values correlated significantly with the MMSE and DSRS (p<0.01)
suggesting that the worse the metabolism, the worse the clinical
findings. The MISRS did not correlate significantly with tau
protein. Conclusion: The MISRS can be used to assess severity of
AD, initial staging, and follow up..
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