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[Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease].

Cerebral atrophy and regional cerebral blood flow (rCBF) of patients with Parkinson's disease were studied. The study included 25 Parkinson's disease patients and 25 normal control subjects. Patients with symptomatic Parkinsonism, stroke, hypertension and cerebral arteriosclerosis were excluded from this study. The rCBF was measured with the intra-arterial Xe-133 injection method via 8 channel detection. The rCBF was calculated by an initial slope analysis. As to the cerebral atrophy, the ventricle size and cortical atrophy were studied by images of the brain CT scan. The results obtained were as follows :1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan , but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease . 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways.