Dementia-Alzheimer's type identified in three diagnostic modalities.

摘要

The problem. The purpose of this study was to compare results of three clinical diagnostic modalities for patients suspected of having Dementia Alzheimer's type (DAT). The study investigated for positive correlation, or rates of agreement, among neurology, nuclear medicine's single photon emission computerized tomography (SPECT) imaging, and neuropsychological assessments, in order to provide data on the need for multimodal diagnostic approaches in the clinical setting.; Method. Diagnostic impressions were completed without knowledge of the results of the other two modalities. A review was made of the diagnostic impressions of neurology, SPECT scans, and neuropsychological assessments, for all 20 subjects in the study. Their rates of agreement were observed for selected clinical issues, such as primary diagnosis, laterality with right- or left-hemisphere involvement, or bilateral-diffuse findings.; Results. Results of the study suggest moderate rates of agreement between SPECT scans and other modalities in the area of primary diagnosis. Levels of confidence were somewhat higher when all three modalities were used in the clinical setting. Lower rates of agreement were observed with regard to lateral versus bilateral findings. SPECT scans endorsed the highest number of lateral findings, but not as have been observed in earlier studies. Findings were classified as bilateral with greater involvement on one side or the other, rather than right or left hemisphere. This may be due to the rapidly increasing quality of neuroimaging in the past several years. Neurology and neuropsychological findings suggested right or left, by implication and inference, from selected test results. However, the rate of agreement with SPECT was not high. The unexpected finding was the significant degree of agreement endorsing frontal lobe involvement.