Age and gender effects on normal regional cerebral blood flow studied using two different voxel-based statistical analyses

Fully automated analysis programs have been applied more and more to aid for the reading of regional cerebral blood flow SPECT study. They are increasingly based on the comparison of the patient study with a normal database. In this study, we evaluate the ability of Three-Dimensional Stereotactic Surface Projection (3 D-S.S.P.) to isolate effects of age and gender in a previously studied normal population. The results were also compared with those obtained using Statistical Parametric Mapping (S.P.M.99). Methods Eighty-nine 99mTc-E.C.D.-SPECT studies performed in carefully screened healthy volunteers (46 females, 43 males; age 20 - 81 years) were analysed using 3 D-S.S.P.. A multivariate analysis based on the general linear model was performed with regions as intra-subject factor, gender as inter-subject factor and age as co-variate. Results Both age and gender had a significant interaction effect with regional tracer uptake. An age-related decline (p < 0.001) was found in the anterior cingulate gyrus, left frontal association cortex and left insula. Bilateral occipital association and left primary visual cortical uptake showed a significant relative increase with age (p < 0.001). Concerning the gender effect, women showed higher uptake (p < 0.01) in the parietal and right sensorimotor cortices. An age by gender interaction (p < 0.01) was only found in the left medial frontal cortex. The results were consistent with those obtained with S.P.M.99. Conclusion 3 D-S.S.P. analysis of normal r.C.B.F. variability is consistent with the literature and other automated voxel-based techniques, which highlight the effects of both age and gender. (authors)