Liu R S, Lin K N, Wang S J, Shan D E, Fuh J L, Yeh S H, Liu H C
Department of Nuclear Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Nucl Med Commun. 1992 Oct;13(10):744-8.
99Tcm-hexamethylpropyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) of brain was performed in 43 unselected patients with Parkinson's disease to evaluate whether low cerebral perfusion on SPECT correlated with cognitive impairment in the patients. All patients received neurological, Mini-Mental State Examination and a neuropsychological assessment. Eighteen (41.9%) of the 43 patients were demented. Thirty patients (69.8%) had abnormal SPECT: 17 had perfusion defects in cortical regions, eight in basal ganglia and five in both regions. Of the 22 patients with abnormal cortical perfusion, 15 (68.2%) were demented; only three (14.3%) of the 21 patients without cortical defect were demented (P < 0.01). Twelve of the 15 demented patients had low perfusion in the parietal region alone or in parietal and occipital regions. The cortical perfusion defects, present in 22 (51.2%) Parkinson's patients, are highly correlated with cognitive impairment. The pattern of SPECT abnormality in most demented patients with Parkinson's disease is similar to that seen in Alzheimer's disease, suggesting that the underlying pathophysiology for dementia in patients with Parkinson's disease may be similar to that in Alzheimer's disease.
对43例未经挑选的帕金森病患者进行了99锝-六甲基丙烯胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT），以评估SPECT上的低脑灌注是否与患者的认知障碍相关。所有患者均接受了神经学检查、简易精神状态检查和神经心理学评估。43例患者中有18例（41.9%）患有痴呆。30例患者（69.8%）SPECT异常：17例皮质区域有灌注缺损，8例基底节有灌注缺损，5例两个区域均有灌注缺损。在22例皮质灌注异常的患者中，15例（68.2%）患有痴呆；在21例无皮质缺损的患者中，只有3例（14.3%）患有痴呆（P<0.01）。15例痴呆患者中有12例仅顶叶区域或顶叶和枕叶区域灌注低。22例（51.2%）帕金森病患者存在的皮质灌注缺损与认知障碍高度相关。大多数帕金森病痴呆患者的SPECT异常模式与阿尔茨海默病相似，提示帕金森病患者痴呆的潜在病理生理学可能与阿尔茨海默病相似。
