Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1992 Oct;55(10):960–963. doi: 10.1136/jnnp.55.10.960

SPECT findings in Parkinson's disease associated with dementia.

H Sawada 1, F Udaka 1, M Kameyama 1, N Seriu 1, K Nishinaka 1, K Shindou 1, M Kodama 1, N Nishitani 1, K Okumiya 1
PMCID: PMC1015200  PMID: 1431961

Abstract

Dementia in Parkinson's disease is thought to be attributable not only to subcortical lesions but also to cortical alterations, especially frontal lobe dysfunction. To evaluate cortical function, the regional cerebral blood flow (rCBF) was estimated of 13 demented and 13 non-demented age matched patients with Parkinson's disease compared with that of 10 age matched controls using I-123 iodoamphetamine single photon emission tomography (IMP-SPECT). The rCBF of the nondemented Parkinson's patients showed no significant differences from that of the control subjects. In the demented patients, the bilateral frontal and parietal and left temporal regional blood flow was significantly less than in the controls. Four demented patients showed isolated frontal hypoperfusion, 8 showed fronto-parietal hypoperfusion, and 1 showed isolated parietal hypoperfusion. Frontal hypoperfusion was therefore present in 12 of the 13 demented patients, and this finding agrees with the frontal lobe dysfunction hypothesis. Parietal rCBF had a significant positive correlation with cortical functions such as calculation and language ability in the MMSE scores. The parietal and temporal reduction in rCBF probably reflects the presence of Alzheimer pathology, cortical Lewy body disease, or both.

Full text

PDF
961

Images in this article

961Image
on p.961
962Image
on p.962

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Byrne E. J., Lennox G., Lowe J., Godwin-Austen R. B. Diffuse Lewy body disease: clinical features in 15 cases. J Neurol Neurosurg Psychiatry. 1989 Jun;52(6):709–717. doi: 10.1136/jnnp.52.6.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Crystal H. A., Dickson D. W., Lizardi J. E., Davies P., Wolfson L. I. Antemortem diagnosis of diffuse Lewy body disease. Neurology. 1990 Oct;40(10):1523–1528. doi: 10.1212/wnl.40.10.1523. [DOI] [PubMed] [Google Scholar]
  3. Ebmeier K. P., Calder S. A., Crawford J. R., Stewart L., Besson J. A., Mutch W. J. Clinical features predicting dementia in idiopathic Parkinson's disease: a follow-up study. Neurology. 1990 Aug;40(8):1222–1224. doi: 10.1212/wnl.40.8.1222. [DOI] [PubMed] [Google Scholar]
  4. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  5. Gaspar P., Gray F. Dementia in idiopathic Parkinson's disease. A neuropathological study of 32 cases. Acta Neuropathol. 1984;64(1):43–52. doi: 10.1007/BF00695605. [DOI] [PubMed] [Google Scholar]
  6. Henriksen L., Boas J. Regional cerebral blood flow in hemiparkinsonian patients. Emission computerized tomography of inhaled 133Xenon before and after levodopa. Acta Neurol Scand. 1985 Apr;71(4):257–266. doi: 10.1111/j.1600-0404.1985.tb03198.x. [DOI] [PubMed] [Google Scholar]
  7. Hornykiewicz O., Kish S. J. Biochemical pathophysiology of Parkinson's disease. Adv Neurol. 1987;45:19–34. [PubMed] [Google Scholar]
  8. Javoy-Agid F., Taquet H., Ploska A., Cherif-Zahar C., Ruberg M., Agid Y. Distribution of catecholamines in the ventral mesencephalon of human brain, with special reference to Parkinson's disease. J Neurochem. 1981 Jun;36(6):2101–2105. doi: 10.1111/j.1471-4159.1981.tb10843.x. [DOI] [PubMed] [Google Scholar]
  9. Johnson K. A., Mueller S. T., Walshe T. M., English R. J., Holman B. L. Cerebral perfusion imaging in Alzheimer's disease. Use of single photon emission computed tomography and iofetamine hydrochloride I 123. Arch Neurol. 1987 Feb;44(2):165–168. doi: 10.1001/archneur.1987.00520140035014. [DOI] [PubMed] [Google Scholar]
  10. Kuhl D. E., Metter E. J., Riege W. H. Patterns of local cerebral glucose utilization determined in Parkinson's disease by the [18F]fluorodeoxyglucose method. Ann Neurol. 1984 May;15(5):419–424. doi: 10.1002/ana.410150504. [DOI] [PubMed] [Google Scholar]
  11. Le Moal M., Galey D., Cardo B. Behavioral effects of local injection of 6-hydroxydopamine in the medial ventral tegmentum in the rat. Possible role of the mesolimbic dopamingergic system. Brain Res. 1975 Apr 25;88(1):190–194. doi: 10.1016/0006-8993(75)90972-5. [DOI] [PubMed] [Google Scholar]
  12. Mayeux R., Stern Y., Rosenstein R., Marder K., Hauser A., Cote L., Fahn S. An estimate of the prevalence of dementia in idiopathic Parkinson's disease. Arch Neurol. 1988 Mar;45(3):260–262. doi: 10.1001/archneur.1988.00520270034017. [DOI] [PubMed] [Google Scholar]
  13. Multicentre randomised clinical trial of chorion villus sampling and amniocentesis. First report. Canadian Collaborative CVS-Amniocentesis Clinical Trial Group. Lancet. 1989 Jan 7;1(8628):1–6. [PubMed] [Google Scholar]
  14. Perlmutter J. S., Raichle M. E. Regional blood flow in hemiparkinsonism. Neurology. 1985 Aug;35(8):1127–1134. doi: 10.1212/wnl.35.8.1127. [DOI] [PubMed] [Google Scholar]
  15. Rinne J. O., Rummukainen J., Paljärvi L., Rinne U. K. Dementia in Parkinson's disease is related to neuronal loss in the medial substantia nigra. Ann Neurol. 1989 Jul;26(1):47–50. doi: 10.1002/ana.410260107. [DOI] [PubMed] [Google Scholar]
  16. Taylor A. E., Saint-Cyr J. A., Lang A. E. Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain. 1986 Oct;109(Pt 5):845–883. doi: 10.1093/brain/109.5.845. [DOI] [PubMed] [Google Scholar]
  17. Whitehouse P. J., Hedreen J. C., White C. L., 3rd, Price D. L. Basal forebrain neurons in the dementia of Parkinson disease. Ann Neurol. 1983 Mar;13(3):243–248. doi: 10.1002/ana.410130304. [DOI] [PubMed] [Google Scholar]
  18. Wolfson L. I., Leenders K. L., Brown L. L., Jones T. Alterations of regional cerebral blood flow and oxygen metabolism in Parkinson's disease. Neurology. 1985 Oct;35(10):1399–1405. doi: 10.1212/wnl.35.10.1399. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES