Global cerebral hypoperfusion in preclinical stage of idiopathic normal pressure hydrocephalus.
In patients with idiopathic normal pressure hydrocephalus (iNPH), ventriculomegaly and narrowed subarachnoid spaces at the high convexity appear in magnetic resonance (MR) images before the occurrence of objective symptoms. In addition, quantitative regional cerebral blood flow (rCBF) has been reported to be reduced in iNPH patients with objective symptoms. To determine whether reduced rCBF is responsible for the appearance of symptoms, we compared rCBF in patients with suspected iNPH with no objective triad symptoms (NOS), iNPH patients with apparent objective triad symptoms (AOS) and normal control subjects (NC). Regional CBF was quantified in 35 Regions-of-interest (ROIs) by 123I-IMP single photon emission computed tomography (SPECT) using the autoradiography (ARG) method. Multiple comparisons showed that, in all brain regions examined except for in the frontal white matter, rCBF in the NOS group was significantly lower than that in the NC group, but in all brain regions, not significantly different from that of the AOS group. These results suggest that factors other than rCBF in the resting state are responsible for the occurrence of objective symptoms of iNPH.
Takaya
Masahiko
M
Department of Psychiatry, Osaka University Graduate School of Medicine, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Kazui
Hiroaki
H
Tokunaga
Hiromasa
H
Yoshida
Tetsuhiko
T
Kito
Yumiko
Y
Wada
Tamiki
T
Nomura
Keiko
K
Shimosegawa
Eku
E
Hatazawa
Jun
J
Takeda
Masatoshi
M
D000368:Aged; D000369:Aged, 80 and over; D001345:Autoradiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000523:psychology; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020367:Iofetamine; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D020367:Iofetamine