REGIONAL CEREBRAL GLUCOSE-METABOLISM AND POSTMORTEM PATHOLOGY IN ALZHEIMERS-DISEASE

In four patients with an antemortem diagnosis of probable Alzheimer's disease (AD) regional cerebral glucose metabolism (rCMRGl) was studied prospectively by positron emission tomography (PET) and compared with postmortem semiquantitative neuropathology. The interval between the last PET study and autopsy was 1.3+/-0.8 years. In comparison with age -matched controls, the AD patients showed predominant temporoparietal hypometabolism spreading to other cortical and subcortical regions dur ing serial PET scans. All patients had neuropathological findings typi cal for AD. There was a significant relationship between rCMRGl and de nsity of senile plaques (SP) in one patient (tau(b) = -0.86, P < 0.05) . SP were distributed quite homogeneously in all regions examined. Neu rofibrillary tangles (NFT) were concentrated focally in the hippocampu s-amygdala-entorhinal complex. In the context of widespread developing cortical hypometabolism, the predilection of NFT for involvement in l imbic areas suggests a disruption of projection neurons as the pathoge netic process of cortical dysfunction.