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Predominant Left Hemisphere Metabolic Dysfunction in Dementia
David A. Loewenstein, PhD;
Warren W. Barker, MA;
Jen-Yueh Chang, MS;
Anthony Apicella, MS;
Fumihito Yoshii, MD;
Paresh Kothari, PhD;
Bonnie Levin, PhD;
Ranjan Duara, MD
Arch Neurol. 1989;46(2):146-152.
Abstract
• Thirty-one patients with probable Alzheimer's disease and 11 patients with memory disorders, attributable to multiple cerebral infarctions, were studied using 18-F-fluorodeoxyglucose-positron emission tomography scans. Asymmetry in cerebral glucose metabolism within these diagnostic groups was assessed by comparison with the metabolic rates obtained in age-equivalent healthy control subjects. A significantly greater number of individuals in both patient groups exhibited predominant left rather than right hemisphere hypometabolism. In addition, for patients with Alzheimer's disease, the degree of asymmetry was not related to either the severity or duration of dementia. These findings could be explained by greater susceptibility of the left hemisphere to degenerative or ischemic brain disease, by a specific sampling effect, or most likely, by greater metabolic deficits resulting from left rather than right hemisphere impairment.
Author Affiliations
From the Wien Center for Alzheimer's Disease and Memory Disorders (Drs Loewenstein and Duara) and the Baumritter Institute of Nuclear Medicine (Drs Yoshii, Kothari, and Duara, and Messrs Barker, Chang, and Apicella), Mount Sinai Medical Center, Miami Beach; and the Departments of Radiology (Drs Kothari and Duara), Neurology (Drs Levin and Duara), and Psychiatry (Dr Loewenstein), and the Center on Aging (Dr Loewenstein), University of Miami School of Medicine.
Footnotes
Accepted for publication July 27, 1988.
Presented as an abstract at the 13th International Symposium on Cerebral Blood Flow and Metabolism: "Brain 87," Montreal, June 24, 1987.
Reprint requests to Division of Nuclear Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140 (Dr Duara).
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