Abnormal brain glucose metabolism in the delusional misidentification syndromes: A positron emission tomography study in Alzheimer disease

Marc J. Mentis, Edward A. Weinstein, Barry Horwitz, Andrew R. McIntosh, Pietro Pietrini, Gene E. Alexander, Maura Furey, Declan G.M. Murphy

Research output: Contribution to journalArticle

106 Scopus citations

Abstract

Brain lesions have been reported with increasing frequency in the delusional misidentification syndromes (DMS). This is the first controlled study to describe DMS regional cerebral metabolic rates of glucose (rCMRglc). We compared rCMRglc (using positron emission tomography) and neuropsychological data in 9 patients with DMS and Alzheimer dementia (AD), 15 AD patients without DMS, and 17 healthy controls. The DMS group differed from the AD group without DMS in having significant hypometabolism in paralimbic (orbitofrontal and cingulate areas bilaterally) and left medial temporal areas, and significant bilateral normalized hypermetabolism in sensory association cortices (superior temporal and inferior parietal) without right left asymmetry. Compared to healthy controls, both AD groups had significant dorsolateral frontal hypometabolism bilaterally. No specific DMS neuropsychological profile was identified. Dysfunctional connections among multimodal association areas, paralimbic structures, and dorsolateral frontal cortex are proposed as the predisposing neural deficit underlying DMS, causing cognitive-perceptual-affective dissonance, which under specific conditions results in "positive" delusion formation.

Original languageEnglish (US)
Pages (from-to)438-441,443-449
JournalBiological Psychiatry
Volume38
Issue number7
DOIs
StatePublished - Oct 1 1995
Externally publishedYes

Keywords

  • Glucose brain metabolism
  • delusion
  • dementia
  • frontal lobe
  • limbic system
  • paralimbic system

ASJC Scopus subject areas

  • Biological Psychiatry

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