Journal of the Neurological Sciences
Volume 288, Issue 1 , Pages 88-91, 15 January 2010

Hypoperfusion of the motor cortex associated with parkinsonism in dementia with Lewy bodies

  • Ryuichi Takahashi

      Affiliations

    • Department of Neurology, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan
    • Corresponding Author InformationCorresponding author. Kohjidai 5-7-1, Nishi-ku, Kobe, Hyogo 651-2273, Japan. Tel.: +81 078 997 2200; fax: +81 078 993 3728.
    • ,
  • Kazunari Ishii

      Affiliations

    • Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan
    • Department of Radiology, Kinki University School of Medicine, Osakasayama, Osaka, Japan
    • ,
  • Kenichi Shimada

      Affiliations

    • Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan
    • ,
  • Shingo Ohkawa

      Affiliations

    • Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan
    • ,
  • Yo Nishimura

      Affiliations

    • Department of Neurology, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan

Received 3 August 2009; received in revised form 24 September 2009; accepted 29 September 2009. published online 26 October 2009.

Abstract 

Objective

This study aimed to investigate the impact of parkinsonism on regional cerebral blood flow (rCBF) in dementia with Lewy bodies (DLB).

Method

Forty-four probable DLB patients, comprising 13 patients without parkinsonism and 31 patients with parkinsonism, and 16 normal controls were selected for this study. We evaluated the rCBF in each group by means of N-isopropyl-p-[123I] iodoamphetamine (IMP) and single photon emission computed tomography (SPECT). The rCBF in the different groups was compared using voxel-by-voxel Statistical Parametrical Mapping (SPM).

Result

Patients with DLB showed low rCBF in the frontal, temporal, and occipital cortex with relative sparing of the paracentral region. DLB patients with parkinsonism (DLB-P) had lower rCBF in the primary motor cortex (M1) and left supplementary motor area (SMA) than DLB patients without parkinsonism (DLB-nonP). DLB-nonP patients showed decreased rCBF in the left temporo-occipital region.

Conclusion

This study suggests that two distinct clinical entities are involved in DLB. In addition, CBF changes in the M1 and SMA are seen in the early stages of Parkinson's disease. This result would help in diagnosing DLB in the context of Lewy body (LB) disease.

Keywords: Dementia with Lewy bodies, Single photon emission computed tomography, Parkinsonism, Visual hallucination, Dementia, Primary motor cortex, Supplementary motor area

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PII: S0022-510X(09)00893-4

doi:10.1016/j.jns.2009.09.033

Journal of the Neurological Sciences
Volume 288, Issue 1 , Pages 88-91, 15 January 2010

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