Longitudinal change in 99mTcHMPAO cerebral perfusion SPECT in Parkinson's disease over one year

Background: Brain perfusion deficits have been reported previously in subjects with Parkinson's disease in comparison with healthy controls. Objective: To carry out a longitudinal study of perfusion in patients with Parkinson's disease and controls to find areas showing a reduction in perfusion over one year. Methods: Two HMPAO cerebral perfusion scans were acquired one year apart in 30 subjects with Parkinson's disease ( mean (SD) age, 76 ( 5) years) and 34 healthy comparison subjects ( 76 ( 7) years). Scans were normalised to the mean intensity in the cerebellum. Results: Using SPM99 within groups to investigate regions that showed a decrease in perfusion between scans, it was found that in Parkinson's disease subjects but not controls there was a significant cluster in the frontal lobe ( Brodmann area 10) where perfusion decreased over the year. Conclusions: The progressive frontal perfusion deficits in Parkinson's disease are consistent with results from previous structural and neuropsychological studies suggesting frontal lobe involvement and executive dysfunction even in early Parkinson's disease.