Neural basis of three dimensions of agitated behaviors in patients with Alzheimer disease

Figures & data

Table 1 Factor analysis of the ABID frequency scores among 32 AD patients

Item number	Agitated behavioral characteristics	Factor 1	Factor 2	Factor 3
2	Physically threatening or aggressive toward others	0.953*	0.126	0.054
5	Destroying property	0.917*	0.114	0.012
11	Restlessness, fidgetiness, and inability to sit still	0.899*	0.157	0.056
3	Harmful to self	0.837*	0.012	0.153
7	Trying to leave (or leaving) home inappropriately	0.819*	0.219	0.215
10	Inappropriate sexual behavior	0.710*	0.074	0.052
8	Arguing, irritability, or complaining	−0.099	0.894*	0.213
1	Verbally threatening or aggressive toward others	0.042	0.843*	0.276
4	Inappropriate screaming or crying out	−0.085	0.766*	0.426
13	Easily agitated or upset	0.389	0.748*	0.092
12	Worrying, anxiety, and/or fearfulness	0.374	0.707*	−0.050
9	Socially inappropriate behavior	0.149	0.691*	0.318
6	Refusing to accept appropriate help	0.422	0.553*	0.123
16	Seeing, hearing, or sensing distressing people or things that are not really present	0.048	0.114	0.850*
15	Incorrect, distressing beliefs	0.173	0.291	0.684*
14	Waking and getting up at night (other than trip to the bathroom)	0.137	0.318	0.552*

Note:

* Factor loadings of 0.5 or more.

Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease.

Table 2 The clinical and demographic data of AD patients

Demographic variables	AD patients (n=32)
Age, years	73.3±8.1
Education, years	9.8±0.7
Sex (males/females)	10/22
Dementia history
Duration of illness, years	3.9±1.2
MMSE	18.2±2.9
CDR (0.5/1/2)	2/20/10
ABID questionnaire
Frequency ratings	33.8±11.3
Mean factor score (ABID: frequency ratings)
Factor 1 (physically agitated behavior)	0.2025±0.9967
Factor 2 (verbally agitated behavior)	0.3608±0.9177
Factor 3 (psychosis symptoms)	0.2586± 1.2560

Note: Data are presented as the mean ± SD.

Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CDR, Clinical Dementia Rating; MMSE, Mini-Mental State Examination; SD, standard deviation.

Figure 1 Results of SPM analysis in relation to physically agitated behavior.

Notes: The figure shows areas with significant negative correlations between the rCBF values and the factor scores of the frequency rating of the ABID in relation to physically agitated behavior, for all AD patients (n=32) (P_FDR-CORR 0.05). The Talairach coordinates are given in Table 3.
Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CORR, correction; FDR, false discovery rate; rCBF, regional cerebral blood flow; SPM, statistical parametric mapping.

Table 3 Significant negative correlations between rCBF values and the factor scores of the frequency rating of the ABID in relation to physically agitated behavior, for all AD patients

Cluster	Region	Brodmann’s area	Talairach coordinates			Voxels in cluster	Z-value
			x	y	z
1	Rt superior temporal gyrus	22	63	−7	−1	373	3.61
2	Rt inferior frontal gyrus	47	16	10	−21	132	3.68
3	Rt inferior frontal gyrus	47	27	9	−15	132	3.45

Notes: N=32. P_FDR-CORR 0.05 (results of a voxel-wise SPM analysis).

Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CORR, correction; FDR, false discovery rate; rCBF, regional cerebral blood flow; Rt, right; SPM, statistical parametric mapping.

Figure 2 Results of SPM analysis in relation to verbally agitated behavior.

Notes: The figure shows areas with significant negative correlations between the rCBF values and the factor scores of the frequency rating of the ABID in relation to verbally agitated behavior, for all AD patients (n=32) (P_FDR-CORR 0.05).
Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CORR, correction; FDR, false discovery rate; rCBF, regional cerebral blood flow; SPM, statistical parametric mapping.

Table 4 Significant negative correlations between rCBF values and the factor scores of the frequency rating of the ABID in relation to verbally agitated behavior, for all AD patients

Cluster	Region	Brodmann’s area	Talairach coordinates			Voxels in cluster	Z-value
			x	y	z
1	Lt inferior frontal gyrus	46	−53	34	14	500	4.71
2	Lt insula	13	−35	13	−2	388	3.88
3	Lt inferior frontal gyrus	44	−49	10	16	388	3.50

Notes: N=32. P_FDR-CORR 0.05 (results of a voxel-wise SPM analysis).

Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CORR, correction; FDR, false discovery rate; Lt, left; rCBF, regional cerebral blood flow; SPM, statistical parametric mapping.

Figure 3 Results of SPM analysis in relation to psychosis symptoms.

Notes: The figure shows areas with significant negative correlations between the rCBF values and the factor scores of the frequency rating of the ABID in relation to psychosis symptoms, for all AD patients (n=32) (P_FDR-CORR 0.05).
Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; FDR, false discovery rate; rCBF, regional cerebral blood flow; SPM, statistical parametric mapping.

Table 5 Significant negative correlations between rCBF values and the factor scores of the frequency rating of the ABID in relation to psychosis symptoms, for all AD patients

Cluster	Region	Brodmann’s area	Talairach coordinates			Voxels in cluster	Z-value
			x	y	z
1	Rt angular gyrus	39	38	−65	20	505	5.21
2	Rt occipital lobe	19	30	−77	35	505	5.16

Notes: N=32. P_FDR-CORR 0.05 (results of a voxel-wise SPM analysis).

Abbreviations: ABID, Agitated Behavior in Dementia Scale; AD, Alzheimer disease; CORR, correction; FDR, false discovery rate; rCBF, regional cerebral blood flow; Rt, right; SPM, statistical parametric mapping.