title: Brain SPECT analysis by 3D-SSP and clinical features of Parkinson's disease.
abstract: OBJECTIVE
  The aim of the present study is to investigate the association of symptoms in Parkinson's disease (PD) with cerebral perfusion on single photon emission computed tomography (SPECT). The clinical features of PD were compared with SPECT images of the brain obtained by three-dimensional stereotactic surface projection (3D-SSP) analysis.
  
  
  METHODS
  Thirty-eight patients who had PD without dementia (17 men and 21 women with a mean age of 68.6 +/- 4.7 years) were enrolled in this study. Their symptoms were rated using the unified Parkinson's disease rating scale (UPDRS). Within a week, all patients were examined by SPECT with 1-123, and reconstructed images were analyzed with 3D-SSP using an image-analysis software, iSSP ver. 3.5. Data on brain surface perfusion extracted by 3D-SSP analysis were compared between the PD patients and the normal control group. The same comparisons were made for subgroups of PD patients with severe symptoms, such as tremor, gait disturbance, bradykinesia, and the UPDRS motor score.
  
  
  RESULTS
  Cerebral perfusion was decreased at the anterior cingulate cortex and occipital lobe of the PD patients compared with the normal controls. In the subgroups with severe gait disturbance and severe bradykinesia, additional hypoperfusion was seen at the lateral frontal association and lateral temporal association and the medial frontal gyrus, and by the pixel-by-pixel comparison, perfusion was significantly decreased (p < 0.05) at the medial frontal gyrus and anterior cingulate cortex compared with the normal control group.
  
  
  CONCLUSIONS
  In PD patients, severe gait disturbance and bradykinesia may be correlated with hypoperfusion of the medial aspect of the frontal lobe. This suggests that functional disturbance of the supplementary motor area and other parts of the frontal lobe are involved in the development of gait disturbance and bradykinesia in PD.
authors.affiliation: Neurology, Asahikawa Red Cross Hospital, Asahikawa 070-8530, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Mito
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yoshida
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yabe
authors.forename: Kenichi
authors.initials: K
authors.lastname: Makino
authors.forename: Kunio
authors.initials: K
authors.lastname: Tashiro
authors.forename: Seiji
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Hidenao
authors.initials: H
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging; D006801:Humans; D018476:Hypokinesia / Q000000981:diagnostic imaging; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*