title: Preserved acetazolamide reactivity in lacunar patients with severe white-matter lesions: 15O-labeled gas and H2O positron emission tomography studies.
abstract: Limited evidence exists on the relationships between severity of white-matter lesions (WMLs) and cerebral hemodynamics in patients without major cerebral artery disease. To examine changes of cerebral blood flow (CBF), oxygen metabolism, and vascular reserve capacity associated with severity of WML in patients with lacunar stroke, we used a positron emission tomography (PET). Eighteen lacunar patients were divided into two groups according to the severity of WMLs, assessed by Fazekas classification; grades 0 to 1 as mild WML group and grades 2 to 3 as severe WML group. Rapid dual autoradiography was performed with (15)O-labeled gas-PET followed by (15)O-labeled water-PET with acetazolamide (ACZ) challenge. Compared with the mild WML group, the severe WML group showed lower CBF (20.6±4.4 versus 29.9±8.2 mL/100 g per minute, P=0.008), higher oxygen extraction fraction (OEF) (55.2±7.4 versus 46.7±5.3%, P=0.013), and lower cerebral metabolic rate of oxygen (CMRO(2)) (1.95±0.41 versus 2.44±0.42 mL/100 g per minute, P=0.025) in the centrum semiovale. There were no significant differences in the ACZ reactivity between the two groups (48.6±22.6% versus 42.5±17.2%, P=0.524). Lacunar patients with severe WMLs exhibited reduced CBF and CMRO(2), and increased OEF in the centrum semiovale. The ACZ reactivity was preserved in both patients with severe and mild WMLs in each site of the brain.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nezu
authors.forename: Chiaki
authors.initials: C
authors.lastname: Yokota
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Uehara
authors.forename: Miho
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Fukushima
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Iida
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
mesh_terms: D000368:Aged; D002531:Cerebellum / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000494:pharmacology; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D011859:Radiography; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging* / Q000378:metabolism*
chemical_list: C061328:N-acetylglycinamide; D005998:Glycine