ABSTRACT
INTRODUCTION: Changes in regional cerebral blood flow (rCBF) have been reported in idiopathic Parkinson's disease (PD). Nonetheless, their typical pattern still remains controversial regarding some features, such as basal ganglia involvement and the main cortical regions affected. Functional neuroimaging makes it possible to identify the brain dysfunctions of the neural circuits underlying the disease. Voxel-based analysis methods make it possible to increase the reliability of the results. OBJECTIVE: To assess the rCBF changes in patients with PD and their relation with disease duration. MATERIALS AND METHODS: Thirty PD adult patients without dementia underwent evaluation with (99m)Tc-ECD SPECT. SPM5 was used for statistical comparison with 25 normal controls of similar ages. The disease course duration in years was added as a covariate. Additionally, patients with a 6-year evolution or less and those with more than 6 years were compared separately with normal controls. RESULTS: Significant hypoperfusion was detected in bilateral premotor and posterior parietal cortex and increase of perfusion was present in the cerebellum. These changes correlated with the years of evolution of the illness. Patients with longer evolution also presented thalamic, subthalamic and basal ganglia hypoperfusion. CONCLUSIONS: We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease.
Subject(s)
Cerebrovascular Circulation , Parkinson Disease/physiopathology , Adult , Aged , Cerebellum/blood supply , Cerebellum/diagnostic imaging , Cerebral Cortex/blood supply , Cerebral Cortex/diagnostic imaging , Confounding Factors, Epidemiologic , Female , Humans , Male , Middle Aged , Parkinson Disease/diagnostic imaging , Prospective Studies , Time Factors , Tomography, Emission-Computed, Single-PhotonABSTRACT
Introducción: En la enfermedad de Parkinson idiopática (EP) se han observado alteraciones del flujo sanguíneo cerebral regional (FSCr) cuyo patrón característico aún presenta aspectos controvertidos, como la existencia de alteraciones gangliobasales y las áreas corticales más afectadas. La neuroimagen funcional permite observar las disfunciones de circuitos neuronales existentes en estos pacientes. Los métodos de análisis estadístico basado en vóxeles permiten incrementar la validez de los resultados. Objetivo: Investigar los cambios de la perfusión cerebral existentes en pacientes con EP y su relación con la duración de los síntomas. Materiales y métodos: Treinta pacientes adultos con EP sin demencia fueron estudiados mediante SPECT cerebral con 99mTc-ECD. Se utilizó SPM5 para su comparación estadística con un grupo control de 25 sujetos sanos de edades similares. Se introdujo, como covariable en dicha comparación, el tiempo de evolución en años y se analizaron por separado los pacientes con 6 años o menos de evolución y aquellos con más de 6 años. Resultados: Se detectó hipoperfusión significativa en la corteza premotora y parietal posterior bilateral y aumento del flujo en el cerebelo. Estas alteraciones se correlacionaron con los años de evolución de la enfermedad. Los pacientes con evolución más prolongada presentaron además hipoperfusión talámica, subtalámica y gangliobasal. Conclusiones: Describimos alteraciones del FSCr en la EP que se relacionan con los circuitos implicados en el control del movimiento. Las mismas son más evidentes en los pacientes con evolución más prolongada de la enfermedad(AU)
Introduction: Changes in regional cerebral blood flow (rCBF) have been reported in idiopathic Parkinson's disease (PD). Nonetheless, their typical pattern still remains controversial regarding some features, such as basal ganglia involvement and the main cortical regions affected. Functional neuroimaging makes it possible to identify the brain dysfunctions of the neural circuits underlying the disease. Voxel-based analysis methods make it possible to increase the reliability of the results. Objective: To assess the rCBF changes in patients with PD and their relation with disease duration. Materials and methods: Thirty PD adult patients without dementia underwent evaluation with 99mTc-ECD SPECT. SPM5 was used for statistical comparison with 25 normal controls of similar ages. The disease course duration in years was added as a covariate. Additionally, patients with a 6-year evolution or less and those with more than 6 years were compared separately with normal controls. Results: Significant hypoperfusion was detected in bilateral premotor and posterior parietal cortex and increase of perfusion was present in the cerebellum. These changes correlated with the years of evolution of the illness. Patients with longer evolution also presented thalamic, subthalamic and basal ganglia hypoperfusion. Conclusions: We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease(AU)
