Kawamura J, Meyer J S, Terayama Y, Weathers S
From the Cerebral Blood Flow Laboratory, Veterans Affairs Medical Center, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, U.S.A.; Neuroradiology Service, Veterans Affairs Medical Center, USA.
From the Cerebral Blood Flow Laboratory, Veterans Affairs Medical Center, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, U.S.A.; Department of Radiology, Baylor College of Medicine, Houston, TX, U.S.A.; Neuroradiology Service, Veterans Affairs Medical Center, USA.
J Stroke Cerebrovasc Dis. 1991;1(4):196-202. doi: 10.1016/S1052-3057(10)80017-5. Epub 2010 May 26.
Longitudinal measurements of local cerebral blood flow (LCBF) were performed in 13 patients with multi-infarct dementia (MID) utilizing the xenon-enhanced computed tomography-CBF method. Subjects were divided into two groups: a group consisting of five patients with MID who deteriorated (aged 60.6 ± 5.3 years) and whose CCSE scores decreased and a stable group comprised of eight patients (aged 64.5 ± 4.5 years) whose CCSE scores did not change. Mean intervals between first and second LCBF measurements were 663 ± 182 days for the deteriorated group and 795 ± 495 days for the stable group. In the deteriorated group, LCBF values for frontal cortex, thalamus, and frontal white matter had declined further at the second measurement. In the stable group, LCBF values were not uniformly stable, but there were no overall mean decreases. The annual rate of decline among patients who deteriorated for frontal cortex, thalamus, and frontal white matter exceeded annual declines measured in elderly normal volunteers. Results suggest that progressive cerebral hypoperfusion contributes to cognitive declines in mild MID, but, if cerebral perfusion of frontal lobes and basal ganglia can become stabilized, further cognitive deterioration can be prevented.
利用氙增强计算机断层扫描脑血流量（CBF）方法，对13例多发梗死性痴呆（MID）患者进行了局部脑血流量（LCBF）的纵向测量。研究对象被分为两组：一组由5例病情恶化的MID患者组成（年龄60.6±5.3岁），其认知能力筛查量表（CCSE）评分下降；另一组为稳定组，由8例患者组成（年龄64.5±4.5岁），其CCSE评分未发生变化。病情恶化组首次和第二次LCBF测量的平均间隔时间为663±182天，稳定组为795±495天。在病情恶化组中，第二次测量时额叶皮质、丘脑和额叶白质的LCBF值进一步下降。在稳定组中，LCBF值并非全部稳定，但总体平均没有下降。病情恶化患者额叶皮质、丘脑和额叶白质的年下降率超过了老年正常志愿者的年下降率。结果表明，进行性脑灌注不足会导致轻度MID患者的认知功能下降，但如果额叶和基底神经节的脑灌注能够稳定下来，则可以预防进一步的认知功能恶化。
