{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T05:23:53Z","timestamp":1788067433873,"version":"build-2784847793"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Single-photon emission computed tomography (SPECT) is widely used in dementia clinics to evaluate regional cerebral blood flow (rCBF). Posterior cingulate cortex (PCC) hypoperfusion is a supportive, though not definitive, marker for Alzheimer\u2019s disease (AD). Magnetic resonance imaging (MRI)-defined sinus inflammation has been associated with systemic inflammation and altered brain connectivity; therefore, we aimed to determine whether MRI-defined chronic rhinosinusitis (CRS) is associated with differences in PCC perfusion patterns on SPECT among patients with cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 54 patients with cognitive impairment who had undergone brain MRI and SPECT. CRS was defined using MRI-based modified Lund\u2013Mackay scores. SPECT findings were analyzed using the easy Z-score Imaging System (eZIS), focusing on PCC severity, extent, and ratio. Comparisons were performed between patients with and without CRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten patients (18.5%) had CRS. The frequency of AD was higher in patients with CRS than in patients without CRS (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028). Compared with patients without CRS (n\u202f=\u202f44), those with CRS showed significantly greater PCC hypoperfusion: eZIS severity (1.7\u202f\u00b1\u202f0.5 vs. 1.2\u202f\u00b1\u202f0.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.026), extent (26.1\u202f\u00b1\u202f13.4% vs. 15.1\u202f\u00b1\u202f14.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.196), and ratio (5.0\u202f\u00b1\u202f2.8 vs. 2.0\u202f\u00b1\u202f1.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.013). No differences were observed in the cingulate island sign score (CIScore;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.215). Moreover, in the subgroup of patients clinically diagnosed with AD, those with CRS showed significantly greater PCC hypoperfusion than those without CRS (1.8\u202f\u00b1\u202f0.3 vs. 1.4\u202f\u00b1\u202f0.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023). PCC hypoperfusion in CRS overlapped with canonical AD patterns but was not observed in non-AD dementias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our exploratory findings suggest that MRI-defined CRS may be associated with differences in SPECT-derived PCC perfusion patterns in patients with cognitive impairment. Awareness of CRS as a common incidental MRI finding may help neurologists interpret SPECT results more cautiously in memory clinic settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1777862","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T05:36:57Z","timestamp":1776145017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Chronic rhinosinusitis and posterior cingulate hypoperfusion on SPECT in dementia diagnosis"],"prefix":"10.3389","volume":"17","author":[{"given":"Masato","family":"Kanazawa","sequence":"first","affiliation":[{"name":"Department of Neurology, Niigata Neurosurgical Hospital","place":["Niigata, Japan"]},{"name":"Faculty of Rehabilitation, Niigata University of Health and Welfare","place":["Niigata, Japan"]},{"name":"Department of Neurology, Brain Research Institute, Niigata University","place":["Niigata, Japan"]},{"name":"Department of Functional Neurology and Neurosurgery, Brain Research Institute, Niigata University","place":["Niigata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brain Research Institute, Niigata University","place":["Niigata, Japan"]},{"name":"Department of Functional Neurology and Neurosurgery, Brain Research Institute, Niigata University","place":["Niigata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Neurology, Niigata Rehabilitation Hospital","place":["Niigata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Niigata Neurosurgical Hospital","place":["Niigata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref1","first-page":"731","article-title":"Automated discrimination between very early Alzheimer disease and controls using an easy Z-score imaging system for multicenter brain perfusion single-photon emission tomography","volume":"28","author":"Matsuda","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1097\/MNM.0b013e32835587f8","article-title":"Significant correlation between cerebral hypoperfusion and neuropsychological assessment scores of patients with mild cognitive impairment","volume":"33","author":"Yoon","year":"2012","journal-title":"Nucl Med Commun"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/brain\/awt162","article-title":"The role of the posterior cingulate cortex in cognition and 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