Hayashi H, Odano I, Nishihara M, Higuchi S, Sakai K, Ishikawa A
Kaku Igaku. 1989 Nov;26(11):1405-15.
N-isopropyl-p[123I]iodoamphetamine (123I-IMP) SPECT and regional cerebral blood flow (rCBF) studies were performed in 20 patients with Parkinson's disease (PD) and 8 normal subjects. RCBF was measured by the arterial blood sampling method which used the microsphere model. We analyzed seven factors which might be related to the rCBF in PD, i.e., age, stage, duration of the disease, cerebral atrophy, severity of dementia, laterality of symptoms and motor disability score (MDS; the degree of akinesia, rigidity, tremor, gait disturbance, freezing and pulsion sign). Compared with normal subjects, global CBF (supratentorial mean rCBF) was reduced 21.8% in PD. In particular, rCBF in the basal ganglia and that of frontal cortex were reduced 25.3%, 24.8%, respectively. Distribution patterns of rCBF in PD were almost as same as those in normals except for cerebellum. The reduction of both rCBFs in the basal ganglia and parietal cortex significantly correlated with MDS (p less than 0.05, respectively). Especially, akinesia was closely correlated to the reduction of rCBF in the parietal cortex (p less than 0.02). Moreover, we observed a significant relationship between cerebral atrophy and reduction of rCBF in each region except for cerebellum. However, there was no significant correlation between the severity of dementia and reduction of rCBF, even in the frontal cortex or parietal cortex. These data show that the severity of dementia in PD may be connected with other factors except for rCBF. 123I-IMP SPECT study is a useful method for clinical evaluation of PD.
对20例帕金森病(PD)患者和8名正常受试者进行了N-异丙基-p[123I]碘安非他明(123I-IMP)单光子发射计算机断层扫描(SPECT)及局部脑血流量(rCBF)研究。采用微球模型的动脉血采样法测量rCBF。我们分析了7个可能与PD患者rCBF相关的因素,即年龄、分期、病程、脑萎缩、痴呆严重程度、症状偏侧性和运动障碍评分(MDS;运动不能、强直、震颤、步态障碍、冻结和冲动征的程度)。与正常受试者相比,PD患者的全脑血流量(幕上平均rCBF)降低了21.8%。特别是,基底节和额叶皮质的rCBF分别降低了25.3%和24.8%。除小脑外,PD患者rCBF的分布模式与正常人几乎相同。基底节和顶叶皮质rCBF的降低均与MDS显著相关(p均小于0.05)。特别是,运动不能与顶叶皮质rCBF的降低密切相关(p小于0.02)。此外,我们观察到除小脑外,各区域脑萎缩与rCBF降低之间存在显著关系。然而,即使在额叶皮质或顶叶皮质,痴呆严重程度与rCBF降低之间也没有显著相关性。这些数据表明,PD患者痴呆的严重程度可能与rCBF以外的其他因素有关。123I-IMP SPECT研究是临床评估PD的一种有用方法。