Heterogeneous factors in dementia with Parkinson's disease: IMP-SPECT study.
BACKGROUND
Nature of the dementing process in Parkinson's disease, and particularly its relationship with Alzheimer's disease, diffuse Lewy body disease or frontal dementia remains controversial.


OBJECTIVE
We hypothesize that origins of dementia in Parkinson's disease are heterogeneous, so we compared cortical regional cerebral blood flow (rCBF) between Parkinson's disease patients with and without dementia.


METHODS
Forty consecutive patients with Hoehn-Yahr stage III or IV Parkinson's disease were used (13 patients had dementia (PDD group), and 27 patients had no dementia (PDND group)).


RESULTS
There were significant rCBF reductions in the left parietal association cortex and left frontal association cortex in PDD. Multiple logistic regression analysis demonstrated that only rCBF of the left frontal association cortex was significant. PDD patients were divided into three groups according to rCBF patterns: frontal hypoperfusion group, Alzheimer's disease-like group, and diffuse Lewy body disease-like group.


CONCLUSIONS
Controversial study results involving PDD patients may be mainly due to heterogeneity in dementing processes in Parkinson's disease.
Matsui
Hideaki
H
Departments of Neurology, Sumitomo Hospital, 5-3-20 Nakanoshima, Kita-ku, Osaka, 530-0005, Japan. hide0729@kuhp.kyoto-u.ac.jp
Nishinaka
Kazuto
K
Oda
Masaya
M
Hara
Narihiro
N
Komatsu
Kenichi
K
Kubori
Tamotsu
T
Udaka
Fukashi
F
D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003704:Dementia / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007291:Inosine Monophosphate; D008297:Male; D008609:Mental Status Schedule; D010300:Parkinson Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon
D007291:Inosine Monophosphate