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Neuroanatomical Abnormalities Before the Onset of Various Types of Delusions in a Patient With Alzheimer Disease
Shutaro Nakaaki, M.D., Ph.D.; Junko Sato, Ph.D.; Katsuyoshi Torii, M.D., Ph.D.; Takatsune Kawaguchi, M.D., Ph.D.; Akiko Kawaguchi, M.D., Ph.D.; Jin Narumoto, M.D., Ph.D.; Masaru Mimura, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:E65-E66. doi:10.1176/appi.neuropsych.12090213
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Dept. of Neuropsychiatry Keio University School of Medicine Tokyo, Japan (SN, MM)
Dept. of Psychiatry and Cognitive-Behavioral Medicine Nagoya City University Graduate School of Medical Sciences Nagoya, Japan (SN, JS, KT, TK, AK)
Dept. of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya, Japan
Dept. of Psychiatry Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto, Japan (JN)

Correspondence: Dr. Shutaro Nakaaki; e-mail: hzi05510@nifty.com

Copyright © 2013 American Psychiatric Association

Extract

To the Editor: Structural brain abnormalities associated with delusions in Alzheimer Disease (AD) are poorly understood. Also, whether the neural substrate underlying the delusions develops before the onset of the delusions is unclear. Here, we report on an AD patient who developed various types of delusions and who exhibited magnetic resonance imaging (MRI) findings atypical of AD before the onset of the delusions.

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FIGURE 1. Results Obtained Using the Voxel-Based Specific Regional Analysis System for Alzheimer Disease (VSRAD) [A]: in the Presently-Reported Patient Before the Onset of Delusions; and [B] in a Patient With AD Who Did Not Develop Delusions

[A]: Axial VSRAD (current patient; age 78 years) shows several areas with atrophy, including bilateral insular cortices, the anterior cingulate cortex, the right orbitofrontal cortex, bilateral inferior frontal cortices, and bilateral hippocampal regions; [B]: control case (78-year-old patient with AD who did not develop delusions) mainly shows atrophy in bilateral hippocampal regions.

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References

McKhann  G;  Drachman  D;  Folstein  M  et al:  Clinical Diagnosis of Alzheimer’s Disease: Report of the NINCDS-ADRDA Work Group Under the Auspices of the Dept. of Health and Human Services Task Force on Alzheimer’s Disease.  Neurology 1984; 34:939–944
[CrossRef] | [PubMed]
 
Hirata  Y;  Matsuda  H;  Nemoto  K  et al.  Voxel-based morphometry to discriminate early Alzheimer’s disease from controls.  Neurosci Lett 2005; 382:269–274
[CrossRef] | [PubMed]
 
Bruen  PD;  McGeown  WJ;  Shanks  MF  et al:  Neuroanatomical correlates of neuropsychiatric symptoms in Alzheimer’s disease.  Brain 2008; 131:2455–2463
[CrossRef] | [PubMed]
 
Matsuoka  T;  Narumoto  J;  Shibata  K  et al:  Insular hypoperfusion correlates with the severity of delusions in individuals with Alzheimer’s disease.  Dement Geriatr Cogn Disord 2010; 29:287–293
[CrossRef] | [PubMed]
 
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