Association Between Brain Functional Failure and Dementia Severity in Alzheimer’s Disease: Resting Versus Stimulation PET Study

OBJECTIVE: This study tested the hypothesis that regional cerebral glucose metabolism during neuronal activation is a more sensitive index of neuronal dysfunction and clinical severity in Alzheimer’s disease than is glucose metabolism at rest. METHOD: The subjects were 15 Alzheimer’s disease patients with a wide range of Mattis Dementia Rating Scale scores (23–128). By using positron emission tomography, absolute glucose metabolism was measured in the parietal, occipital (visual areas), and temporal (auditory areas) cortical regions during rest (eyes/ears covered) and audiovisual stimulation. RESULTS: In the parietal cortex, glucose metabolism correlated with dementia severity in both conditions. In contrast, in the relatively preserved visual and auditory cortical regions, glucose metabolism predicted dementia severity during stimulation but not at rest. CONCLUSIONS: These findings suggest that regional cerebral glucose metabolism during stimulation is a more sensitive index of the functional/metabolic failure of neuronal systems than is metabolism at rest. (Am J Psychiatry 1999; 156:470–473)