Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dementia in Parkinson's disease is thought to be attributable not only to subcortical lesions but also to cortical alterations, especially frontal lobe dysfunction. To evaluate cortical function, the regional cerebral blood flow (rCBF) was estimated of 13 demented and 13 non-demented age matched patients with Parkinson's disease compared with that of 10 age matched controls using I-123 iodoamphetamine single photon emission tomography (IMP-SPECT). The rCBF of the nondemented Parkinson's patients showed no significant differences from that of the control subjects. In the demented patients, the bilateral frontal and parietal and left temporal regional blood flow was significantly less than in the controls. Four demented patients showed isolated frontal hypoperfusion, 8 showed fronto-parietal hypoperfusion, and 1 showed isolated parietal hypoperfusion. Frontal hypoperfusion was therefore present in 12 of the 13 demented patients, and this finding agrees with the frontal lobe dysfunction hypothesis. Parietal rCBF had a significant positive correlation with cortical functions such as calculation and language ability in the MMSE scores. The parietal and temporal reduction in rCBF probably reflects the presence of Alzheimer pathology, cortical Lewy body disease, or both.
 ...
PMID:SPECT findings in Parkinson's disease associated with dementia. 143 61

The increasing availability of single-photon emission computed tomography (SPECT) perfusion brain scans has led to the investigation of a variety of neuropsychiatric conditions including the movement disorders such as Huntington's and Parkinson's disease. In general, observers have noted that Huntington patients have bilaterally decreased uptake of technetium 99m HM-PAO and iodine 123 IMP in the basal ganglia regions involving the heads of the caudate nucleic and adjacent structure, which reflects decreased neuronal function. These functional changes precede the morphological changes due to caudate nucleus atrophy that are observed on computed tomography and magnetic resonance imaging. Cortical changes occur in severely diseased Huntington's patients but are more nonspecific. Prediction of individuals at risk for Huntington's disease using SPECT scans should be done with caution and in association with other clinical data. In contrast, in Parkinson's disease mild diffusely decreased perfusion is commonly noted throughout the cerebral structures, except for the cerebellum. In Parkinson's disease, there is less agreement among observers as to whether the basal ganglia are abnormal. Some observers report that there are no specific basal ganglia perfusion defects in excess of those changes seen elsewhere in the brain. Others report diminished basal ganglia uptake associated with L-dopa therapy in some Parkinson's patients, and in patients with hemi-parkinsonism there have been perfusion deficits reported in the contralateral basal ganglia. In some Parkinson patients, bilateral Alzheimer's-like posterior temporoparietal cortical perfusion defects have been observed in association with progressive dementia. Basal ganglia and cortical perfusion changes also have been reported in a few patients with a variety of other less common movement disorders.
 ...
PMID:The scintigraphic evaluation of Huntington's disease and other movement disorders using single photon emission computed tomography perfusion brain scans. 182 59

The 159 patients with Parkinson's disease with onset after the age of 50 (mean: 62.3 years) were studied with reference to diagnosis and treatment. The results were as follows: 1. Other than the characteristic features, the symptoms at onset were depression (6% of the patients), lumbago (4%), hemiplegia-like (4%) and dizziness (3%), causing misdiagnoses in some of the patients. Among 159 patients studied, the severity most frequent was Yahr stage 3 (63%) at first examination, indicating the necessity of earlier diagnosis. 2. Magnetic resonance imaging (MRI) of the substantia nigra and striatum was investigated using a 1.5 Tesla field and T2-weighted images, which gave no specific results concerning diagnosis and severity. However, it was useful in differential diagnosis between this disease and parkinsonism caused by multiple system atrophy and cerebrovascular diseases. 3. With 123I-IMP SPECT, decrease in blood flow in the frontal and temporal lobes correlated with the severity (Yahr stage) of the disease. Regarding cognitive functions the scores of Hasegawa's Dementia Scale and Mini-Mental State showed a highly significant correlation with the amount of blood flow in frontal and parietal lobes, suggesting that dementia might be caused by dysfunction of these lobes. 4. In 98 patients treated with levodopa mixed with dopa-economizers for more than a year, the maximum improvement was small in severely disabled patients of Yahr stage 5 and 4 because none improved to stage 3A or below (3A is an arbitrary criterion meaning mild involvement in stage 3 with 3P meaning more severe cases).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Diagnosis and treatment of Parkinson's disease in the elderly]. 187 Feb 74

This report discusses the clinical significance of bilateral parietal abnormalities on I-123 IMP SPECT imaging in 158 patients with cerebral disorders. This pattern was seen in 15 out of 21 patients with Alzheimer's disease; it was also seen in 4 out of 5 patients with Parkinson's disease with dementia, in 3 out of 17 patients with vascular dementia, in 1 out of 36 patients with cerebral infarction without dementia, in 1 out of 2 patients with hypoglycemia, and in 1 out of 2 patients with CO intoxication. Detection of bilateral parietal abnormalities is a useful finding in the diagnosis of Alzheimer's disease, but one should keep in mind that other cerebral disorders may also show a similar pattern with I-123 IMP SPECT imaging.
 ...
PMID:Differential diagnosis of bilateral parietal abnormalities in I-123 IMP SPECT imaging. 227 32

N-isopropyl-p[123I]iodoamphetamine (123I-IMP) SPECT and regional cerebral blood flow (rCBF) studies were performed in 20 patients with Parkinson's disease (PD) and 8 normal subjects. RCBF was measured by the arterial blood sampling method which used the microsphere model. We analyzed seven factors which might be related to the rCBF in PD, i.e., age, stage, duration of the disease, cerebral atrophy, severity of dementia, laterality of symptoms and motor disability score (MDS; the degree of akinesia, rigidity, tremor, gait disturbance, freezing and pulsion sign). Compared with normal subjects, global CBF (supratentorial mean rCBF) was reduced 21.8% in PD. In particular, rCBF in the basal ganglia and that of frontal cortex were reduced 25.3%, 24.8%, respectively. Distribution patterns of rCBF in PD were almost as same as those in normals except for cerebellum. The reduction of both rCBFs in the basal ganglia and parietal cortex significantly correlated with MDS (p less than 0.05, respectively). Especially, akinesia was closely correlated to the reduction of rCBF in the parietal cortex (p less than 0.02). Moreover, we observed a significant relationship between cerebral atrophy and reduction of rCBF in each region except for cerebellum. However, there was no significant correlation between the severity of dementia and reduction of rCBF, even in the frontal cortex or parietal cortex. These data show that the severity of dementia in PD may be connected with other factors except for rCBF. 123I-IMP SPECT study is a useful method for clinical evaluation of PD.
 ...
PMID:[Clinical evaluation of Parkinson's disease using 123I-IMP SPECT]. 261 27

Measurement of regional cerebral blood flow (rCBF) in 30 patients with Parkinson's disease using single-photon emission computed tomography and 123I-IMP demonstrated that hypoperfusion was relatively severer in the parietal cortex than other cortices before and after a 1-year follow-up period. The decline in the scores of the Mini-Mental State Examination was significantly correlated with the decrease in rCBF in the parietal cortex during the follow-up period. Our findings suggest that the parietal cortex is involved in the cognitive impairment in patients with Parkinson's disease.
 ...
PMID:Twelve-month follow-up study of regional cerebral blood flow in Parkinson's disease. 760 85

A 64-year-old right-handed man was admitted because of increasing clumsiness of the right hand and difficulty in walking since 8 months earlier. The WAIS revealed verbal IQ 124, performance IQ 104 and full scale IQ 115. Neurological examination revealed slight dysarthria and normal eye movements. The right upper extremity showed Gegenhalten, tremor, dystonic elbow flexion, marked grasp reflex, grasping and groping behavior. Voluntary movements were slow and clumsy on the right side. However, neither ideational nor ideomotor apraxia was observed. Tendon reflexes were slightly exaggerated on the right side. Plantar responses were normal. The patient had difficulty in initiating forward walking and turning movements. Once started, he walked dragging his right foot ahead of the left with short steps. A line on the floor was of no benefit. He could not stride across the line on the floor in front of him. Analysis of gait with floor reaction force revealed that the single step rhythm of his frozen gait was about 1.5 Hz, which contrasted with the high frequency seen in Parkinson's disease. MRI demonstrated atrophy of the frontal and parietal lobes on both sides. 123I-IMP single-photon emission CT demonstrated severe hypoperfusion of the left frontal and parietal lobes. Frozen or shuffling gait is a popular symptom as well as unsteady gait and tendency to fall in corticobasal degeneration. It may result from the frontal lobe dysfunction. Lack of improvement in freezing by the visual input contrasts with Parkinson's disease and may be related to dysfunction of the mesial part of the frontal lobe or the parietal lobe involved in corticobasal degeneration.
 ...
PMID:[Analysis of gait disturbance in a patient with corticobasal degeneration]. 778 Dec 31

Brain imaging is performed using radiopharmaceuticals by single photon emission computed tomography (SPECT) and positron emission tomography (PET). SPECT and PET radiopharmaceuticals are classified according to blood-brain-barrier permeability, cerebral perfusion and metabolism receptor-binding, and antigen-antibody binding. The blood-brain-barrier (BBB) SPECT agents, such as 99mTcO4-, [99mTc]DTPA, 201TI and [67Ga]citrate are excluded by normal brain cells, but enter into tumor cells because of altered BBB. These agents were used in the earlier period for the detection of brain tumors. SPECT perfusion agents such as [123I]IMP, [99mTc]HMPAO, [99mTc]ECD are lipophilic agents and therefore, diffuse into the normal brain. These tracers have been successfully used to detect various cerebrovascular diseases such as stroke, Parkinson disease, Huntington's disease, epilepsy, dementia, and psychiatric disorders. Xenon-133 and radiolabeled microspheres have been used for the measurement of cerebral blood flow (CBF). Important receptor-binding SPECT radiopharmaceuticals include [123I]QNE, [123I]IBZM, and [123I]iomazenil. These tracers bind to specific receptors in the brain, thus displaying their distribution in various receptor-related cerebral diseases. Radioiodinated monoclonal antibodies were used for the detection of brain tumors. PET radiopharmaceuticals for brain imaging are commonly labeled with positron-emitters such as 11C, 13N, 15O, and 18F, although other radionuclides such as 82Rb, 62Cu and 68Ga also were used. The brain uptake of [13N]glutamate, [68Ga]EDTA and [82Rb]RbCl depends on the BBB permeability, but these are rarely used for brain imaging. Several cerebral perfusion agents have been introduced, of which [15O]water, [13N]ammonia, and [15O]butanol have been used more frequently. Regional CBF has been quantitated by using these tracers in normal and different cerebral disease states. Other perfusion agents include [15O]O2, [11C]CO, [11C]CO2, [18F]fluoromethane, [15O]O2, [11C]butanol, and [62Cu]PTSM. Among the PET cerebral metabolic agents, [18F]fluorodeoxyglucose (FDG) is most commonly used to detect metabolic abnormalities in the brain. Various brain tumors have been graded by [18F]FDG PET. This technique was used to detect epileptic foci by showing increased uptake in the foci during the ictal period and decreased uptake in the interictal period. Differentiation between recurrent tumors and radiation necrosis and the detection of Alzheimer's disease have been made successfully by [18F]FDG PET. Other PET metabolic agents such as [11C]deoxyglucose, and [11C]methylmethionine have drawn attention in the detection of brain tumors. [18F]fluorodopa is a cerebral neurotransmitter agent, which has been found very useful in the detection of Parkinson disease that shows reduced uptake of the tracer in the striatum of the brain.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Radiopharmaceuticals for brain imaging. 781 3

We reconstructed three-dimensional (3D) surface images from data from single-photon emission computed tomography (SPECT) with N-isopropyl-p[123I]-iodoamphetamine (123I-IMP) in 29 patients with Parkinson's disease, 16 patients with Alzheimer's disease and 11 normal control subjects. In patients with nondementing Parkinson's disease, perfusion defects were frequently found in the parietal cortical region at a threshold value of 65%. In demented Parkinson's disease patients, perfusion defects were frequently noted at threshold of 45-65%, and were more marked in the bilateral temporal and parietal cortices. In Alzheimer's disease, perfusion defects were similar to those found in dementing Parkinson's disease. These results suggest that dementia in Parkinson's disease is related to the perfusion reduction of the temporoparietal cortex, and may support the view that Parkinson's disease and Alzheimer's disease overlap in some patients. A 3D display of an 123I-IMP brain tomogram may be useful for detecting cortical lesions in patients with dementia or cognitive impairment.
 ...
PMID:Brain perfusion imaging in Parkinson's disease and Alzheimer's disease demonstrated by three-dimensional surface display with 123I-iodoamphetamine. 813 97

N-isopropyl-p[123I]iodoamphetamine (123I-IMP) SPECT and quantitative regional cerebral blood flow (rCBF) studies were performed in 111 patients with cerebral disorders. Continuous arterial blood sampling method based on the microsphere model was used as a quantitative rCBF measurement. We evaluated rCBF in patients with dementia and also in patients with poor activities of daily living (ADL). Patients with dementia showed significant reduction of mean CBF in contrast to patients without dementia. Significant decrease of rCBF in the bilateral frontal cortex, parietal cortex and basal ganglia and the right temporal cortex were found in demented patients. Although patients with vascular dementia showed decreased rCBF in bilateral basal ganglia, demented patients with Parkinson's disease showed no significant reduction of rCBF in any regions. Patients with poor ADL showed decreased rCBF in all brain regions. And particularly frontal and basal ganglionic defects were most pronounced. Patients with poor ADL resulted from cerebral infarction showed significant decrease of rCBF in bilateral basal ganglia. However, there was no significant correlation in Parkinson's disease between ADL and rCBF. The rCBF measurement with 123I-IMP is useful for clinical evaluation of demented patients and patients with poor ADL.
 ...
PMID:[Quantitative regional cerebral blood flow study with 123I-IMP in patients with dementia and in patients with poor activities of daily living]. 827 96


1 2 Next >>