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Biomedical subjects

R Duara

Publications and source records attributed to R Duara.

At least 109 records · Page 6Linked to original sources
PubMed1987

Intercorrelations of regional cerebral glucose metabolic rates in Alzheimer's disease.

Patterns of cerebral metabolic correlations were compared between 21 Alzheimer's disease patients and 21 healthy age-matched controls in the resting state. Cerebral metabolic rates for glucose were determined by positron emission tomography using [18F]2-fluoro-2-deoxy-D-glucose. Partial correlation coefficients, controlling for whole brain glucose metabolism, were evaluated between pairs of regional glucose metabolic rates in 59 brain regions. Reliable correlation coefficients were obtained with the 'jackknife' and 'bootstrap' statistical procedures. Compared with healthy controls, the Alzheimer patients had significantly fewer reliable partial correlation coefficients between frontal and parietal lobe regions, and more reliable correlations between the cerebellum and temporal lobe. The number of reliable correlations between many bilaterally symmetric brain regions was reduced in the Alzheimer patients, as compared with controls. These results suggest that in the early stages of Alzheimer's disease there is a breakdown of the organized functional activity between the two cerebral hemispheres, and between parietal and frontal lobe structures.

Aged↗
PubMed1987

Behavioral activation and the variability of cerebral glucose metabolic measurements.

Variability in cerebral glucose metabolism was examined between and within subjects when paired studies were performed in the resting state or in a behaviorally activated state. Both normal and demented subjects were studied twice each, from 1 to 6 weeks apart, under near-identical conditions, using positron emission tomography (PET) and [18F]fluorodeoxyglucose. Resting state studies were repeated in nine normal and four demented subjects. A picture-viewing test, used for activation during PET, was used repeatedly in seven normal and five demented subjects. Within-subject variability, as assessed by the percent difference in metabolic rates in paired studies, was reduced by 60-70% for activation state compared to resting state studies in normals. It is concluded that PET studies of brain metabolism, which are designed to study the active brain, should indeed be performed in functionally activated states, as in addition to demonstrating metabolism during a defined functional state, activation studies show reduced variability of cerebral metabolic measures.

Aged↗
PubMed1987

Decline in cerebral glucose utilisation and cognitive function with aging in Down's syndrome.

The cerebral metabolic rate for glucose (CMRglc) was measured with positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose in 14 healthy subjects with Down's syndrome, 19 to 33 years old, and in six healthy Down's syndrome subjects over 35 years, two of whom were demented. Dementia was diagnosed from a history of mental deterioration, disorientation and hallucinations. All Down's syndrome subjects were trisomy 21 karyotype. CMRglc also was examined in 15 healthy men aged 20-35 years and in 20 healthy men aged 45-64 years. All subjects were at rest with eyes covered and ears plugged. Mean hemispheric CMRglc in the older Down's syndrome subjects was significantly less, by 23%, than in the young Down's syndrome group; statistically significant decreases in regional metabolism (rCMRglc) also were present in all lobar regions. Comparison of the younger control group with the older control group showed no difference in CMRglc or any rCMRglc (p greater than 0.05). Assessment of language, visuospatial ability, attention and memory showed significant reductions in test scores of the old as compared with the young Down's syndrome subjects. These results show that significant age differences in CMRglc and rCMRglc occur in Down's syndrome but not in healthy controls, and that, although only some older Down's syndrome subjects are demented, significant age reductions in neuropsychologic variables occur in all of them.

Adolescent↗
PubMed1987

Relation of measured brain glucose utilisation and cerebral atrophy in man.

The effect of cerebral atrophy on measured cerebral metabolic rates for glucose (CMRglc), as determined with positron emission tomography (PET), was examined in 49 healthy males aged 21-83 years. Global CMRglc and regional CMRglc for 34 grey matter regions parallel to and from 30 to 80 mm above the inferior orbital meatal (IOM) line were measured under resting conditions, using [18F]-fluorodeoxyglucose and an ECAT II positron emission tomograph. Using a GE 8800 CT/T scanner, slices parallel to and from 30 to 80 mm above the IOM line were analysed for CSF volume. Cerebral atrophy, indicated by increased CSF volume, was correlated significantly with global CMRglc, but accounted for no more than 13% of the variance in the CMRglc measurements. Methods for correcting for inter-subject variation in CSF volume were proposed. Global values for CMRglc, uncorrected or corrected for CSF volume, were found to be age invariant. These findings indicate that (a) cerebral atrophy has a small, but statistically significant effect on CMRglc as measured with PET; (b) CMRglc is age invariant in healthy males.

Adult↗
PubMed1987

Human task-specific somatosensory activation.

We used positron emission tomography to study normal patterns of local cortical metabolic activation induced by somatosensory stimuli. Palpation and sorting of mah-jongg tiles by textured design increased local glucose metabolic rate (lCMRgl), by 18% on average, in contralateral somatosensory cortex. A graphesthesia task gave a similar result. In contrast, vigorous vibrotactile stimulation of fingers, face, or knee did not produce a consistent focus of activation. Our results indicate that lCMRgl activation is best achieved by somatosensory tasks requiring an active perceptual effort.

Aged↗
PubMed1987

Two behavioral states studied in a single PET/FDG procedure: theory, method, and preliminary results.

We have developed a method that allows two sets of regional cerebral metabolic rates of glucose (rCMRglc) to be obtained in a single extended procedure using positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG). This is an adaptation of the deoxyglucose method, with the addition of a second injection of FDG immediately after completion of the first scan, then followed 30 min later by a second scan. A model has been developed to allow for correction of measured tracer concentration in the second scan by subtracting the predicted remnant from the first scan. The possible applications of this method in studying behavior-metabolism relationships are demonstrated. The preliminary results show 6%-12% changes in rCMRglc values for appropriate brain regions when the behavioral state is altered, but show 0%-5% change in rCMRglc values when the behavioral state is unchanged. The method can contribute significantly to the understanding of behavior-metabolism relationships by allowing the noninvasive study of two behavioral states in a single PET procedure.

Brain↗
PubMed1986

Brain morphometry in autistic men as measured by volumetric computed tomography.

Brains of 12 physically healthy men, aged 18 to 39 years, with clear childhood diagnoses of infantile autism, and those of 16 healthy age- and sex-matched normal controls, were examined with computed transverse axial tomography. No significant group differences were seen in volumes of cerebrospinal fluid, white matter, gray matter, the third ventricle, the lateral ventricles, the caudate nuclei, lenticular nuclei, or the thalami, or in the relative symmetry of these structures. These results suggest that the cerebral defect in autism is functional or microscopic, without major gross anatomic correlate.

Adolescent↗
PubMed1986

Neocortical metabolic abnormalities precede nonmemory cognitive defects in early Alzheimer's-type dementia.

Neuropsychological function and resting regional neocortical glucose metabolism, as measured by positron-emission tomography, were studied in 22 patients with mild and moderate Alzheimer's-type dementia. Metabolic reductions in the parietal association cortex and increased left-right metabolic asymmetry were observed in patients with mild and moderate degrees of dementia. Five patients with mild dementia had no impairment of neocortically mediated neuropsychological function, yet they demonstrated these same neocortical metabolic abnormalities. Asymmetry of neocortically mediated, neuropsychological functions correlated with metabolic asymmetries in patients with moderate but not mild dementia. These results suggest that physiological dysfunction in the that physiological dysfunction in the association neocortex is evident in early Alzheimer's-type dementia before the neuropsychological consequences of that dysfunction are demonstrable.

Aged↗
PubMed1986

Age differences in intercorrelations between regional cerebral metabolic rates for glucose.

Patterns of cerebral metabolic intercorrelations were compared in the resting state in 15 healthy young men (ages 20 to 32 years) and 15 healthy elderly men (ages 64 to 83 years). Controlling for whole-brain glucose metabolism, partial correlation coefficients were determined between pairs of regional cerebral metabolic rates for glucose determined by positron emission tomography using [18F]fluorodeoxyglucose and obtained in 59 brain regions. Compared with the young men, the elderly men had fewer statistically significant correlations, with the most notable reductions observed between the parietal lobe regions, and between the parietal and frontal lobe regions. These results suggest that cerebral functional interactions are reduced in healthy elderly men.

Adult↗
PubMed1986

Relations among age, visual memory, and resting cerebral metabolism in 40 healthy men.

Visual memory, as measured by the Benton Visual Retention Test (BVRT), and resting regional cerebral metabolic rates for glucose (rCMRglc), as measured by positron emission tomography (PET) and [18-F]fluorodeoxyglucose, were examined in 40 very healthy men, aged 21 to 83 years. Age-related differences in visual memory were found but were significantly smaller than differences reported in the general population. This discrepancy is attributable to our rigorous health screening. The age-related differences found in this sample are estimates of the lower limit of population differences unconfounded by disease. Age-related differences on undistracted delayed visual memory were greater than differences on immediate visual memory, suggesting age-related differences in spontaneous elaborative visual information processing. No relation between visual memory and resting rCMRglc was found, supporting the hypothesis that mental abilities are unrelated to resting brain metabolism unless both functions are influenced by disease.

Adult↗
PubMed1986

Effects of fasting on ketone body concentrations in healthy men of different ages.

This work was performed to assess age effects on fasting-induced hyperketonemia and to determine if measurement of cerebral glucose utilization by positron emission tomography after 6 to 8 hr of fasting is associated with hyperketonemia that could influence cerebral glucose metabolism. Acetoacetate and 3-hydroxybutyrate were assayed in venous blood from healthy men of various ages, subjected to an 18-hr fast. At 18 hr of fasting but not at 14 hr or earlier, 3-hydroxybutyrate concentrations were correlated significantly with age; concentrations of acetoacetate and 3-hydroxybutyrate were significantly higher than at earlier times in the fast, p less than or equal to .05, with elevations of 82% and 214% over baseline, respectively. Acetoacetate and 3-hydroxybutyrate concentrations were higher on the day when cerebral glucose utilization was determined than after a comparable fast at another time. The observed level of hyperketonemia, however, would not substantially influence cerebral glucose metabolism. The findings indicate that aging is associated with increased susceptibility to fasting-induced hyperketonemia.

3-Hydroxybutyric Acid↗
PubMed1986

Positron emission tomography in Alzheimer's disease.

Twenty-one patients with a clinical diagnosis of dementia of the Alzheimer's type (DAT) and 29 healthy, age-matched controls were studied using positron emission tomography (PET) and [18F]2-fluoro-2-deoxy-D-glucose to measure regional cerebral glucose consumption in the resting state. Reductions in ratio measures of relative metabolism in some parietal, temporal, and frontal regions were found in mild, moderate, and severe DAT groups. A significant increase in right/left metabolic asymmetry, particularly in parietal regions, also was seen in mild and moderate groups. Only in the severely demented patients was the absolute cerebral metabolic rate reduced significantly from control values. Fourteen patients had repeated PET studies, but only those patients with moderate to severe dementia showed a decline in IQ over 6 to 15 months. There were no significant changes in metabolic measures over time. PET is useful in quantifying regional cerebral dysfunction in DAT, even in the early stages of the disease.

Aged↗
PubMed1985

Brain metabolism in autism. Resting cerebral glucose utilization rates as measured with positron emission tomography.

The cerebral metabolic rate for glucose was studied in ten men (mean age = 26 years) with well-documented histories of infantile autism and in 15 age-matched normal male controls using positron emission tomography and (F-18) 2-fluoro-2-deoxy-D-glucose. Positron emission tomography was completed during rest, with reduced visual and auditory stimulation. While the autistic group as a whole showed significantly elevated glucose utilization in widespread regions of the brain, there was considerable overlap between the two groups. No brain region showed a reduced metabolic rate in the autistic group. Significantly more autistic, as compared with control, subjects showed extreme relative metabolic rates (ratios of regional metabolic rates to whole brain rates and asymmetries) in one or more brain regions.

Adolescent↗
PubMed1985

Clinical history, brain metabolism, and neuropsychological function in Alzheimer's disease.

Data concerning 7 patients with a diagnosis of presumptive Alzheimer's disease (mean age, 65.6 years) are presented in detail in relation to the patients' regional cerebral metabolic rates for glucose. Rates were measured by positron emission tomography with fluorine 18-labeled fluoro-2-deoxy-D-glucose under conditions of reduced visual and auditory stimulation. A relationship was found between severity of dementia and brain metabolism. In patients with mild to moderate Alzheimer's disease, memory and intellectual deficits were evident without major reductions in absolute metabolic rates, while ratios of regional to whole brain metabolism revealed reductions in regions of the parietal lobes. In the late, severe form of the disease, brain metabolic rates were consistently and significantly reduced. The findings suggest that memory and intellectual deficits are reflected in reductions of brain metabolism in some brain regions in mild to moderate forms of Alzheimer's disease and that, in the late, severe form of the disease, reductions occur consistently throughout the brain.

Aged↗
PubMed1985

Relations between neuropsychological and cerebral metabolic asymmetries in early Alzheimer's disease.

Regional CMRglc (rCMRglc) values were determined with positron emission tomography (PET) in 10 patients with mild to moderate clinically diagnosed Alzheimer's disease (AD) and in 26 healthy controls. rCMRglc in frontal, parietal, and temporal association cortices were significantly more laterally asymmetrical in AD patients than in controls (p less than 0.05). Furthermore, lateral asymmetry of rCMRglc in AD patients but not in the control subjects correlated significantly with asymmetry of language and visuospatial functions such that lower left than right rCMRglc was associated with relatively greater impairment of language and vice versa. The results demonstrate that discrepancies between language and visuospatial deficits in patients with early AD are related to asymmetrical reductions in cerebral cortical glucose metabolism.

Aged↗
PubMed1985

Brain metabolism as measured with positron emission tomography: serial assessment in a patient with familial Alzheimer's disease.

This paper presents, for the first time, repeated assessments of cerebral metabolism and neuropsychological competence in early Alzheimer's disease. Regional cerebral metabolic rates for glucose were measured with positron emission tomography and 18F-fluoro-2-deoxy-D-glucose on three occasions at 8-month intervals, in a 57-year-old man with Alzheimer's disease of 2 1/2 years' duration and with a family history of neuropathologically confirmed Alzheimer's disease. Data were compared with mean cerebral metabolic rates from 12 healthy men. No differences in regional cerebral metabolic rates for glucose were found on the initial patient scan, whereas metabolism on the second and third scans was reduced significantly in the parietal lobes and bilaterally in some parietal lobe regions. Memory loss was demonstrable at the first scan, but then and at later scans, other aspects of cognitive performance remained within normal limits (Wechsler Adult Intelligence Scale, Boston Naming Test, Two-dimensional Block Construction). The results show that memory loss can precede a measurable reduction of cerebral metabolism in early Alzheimer's disease, but that later reductions in parietal lobe metabolism may not be accompanied by additional measurable neuropsychological deficits.

Aged↗
PubMed1984

Human brain glucose utilization and cognitive function in relation to age.

Brain oxidative metabolism was examined with positron emission tomography and [18F]2-deoxy-D-glucose in 40 healthy men aged 21 to 83 years, under conditions of reduced visual and auditory stimulation. The mean cerebral metabolic rate for glucose (CMRglc) equaled 4.6 to 4.7 mg X 100 gm-1 X min-1 and did not correlate significantly with age (p greater than 0.05). Regional cerebral metabolic rates for glucose (rCMRglc) and Q ratios (rCMRglc/CMRglc), which had lower coefficients of variation than did rCMRglc, also did not correlate with age. Hyperfrontality of cerebral metabolism was absent at all ages. Age decrements were demonstrated in the error score on the Benton Revised Visual Retention Test and in the Performance Subtest scaled score of the Wechsler Adult Intelligence Scale (WAIS) but not in the Verbal Subtest scaled score of the WAIS. The cognitive test scores did not correlate with brain metabolic rates. The results indicate that brain oxidative metabolism, when measured under resting conditions with reduced sensory input, is not reduced in relation to age in healthy men. Furthermore, no significant relations between intelligence and resting cerebral metabolism are evident.

Adult↗