Clinical application of stable xenon CT-CBF studies without denitrogenation

P300 and cerebral blood flow before and after TRH in olivopontocerebellar atrophy

Ten cases of olivopontocerebellar atrophy (OPCA) (mean age 56 +/- 9 years) and 8 healthy controls (mean age 58 +/- 9 years) were studied. The P300 was measured with a Synax 1100 evoked potential recorder and the regional cerebral blood flow was measured using the stable xenon computed tomography method. The P300 latency was significantly longer in the OPCA group than in the healthy control group. The P300 latency after the intravenous infusion of thyrotropin releasing hormone (TRH) in the OPCA group was significantly shorter than that before the intravenous infusion of TRH. The blood flows in all the measured areas (the cerebellar cortex, the cerebellar white matter, the brainstem, the thalamus, the basal ganglia, the frontal lobe cortex and the frontal lobe white matter) were significantly lower in the OPCA group than in the healthy control group. The blood flows in the cerebellar cortex and in the frontal lobe cortex after the intravenous infusion of TRH were significantly higher than those before the intravenous infusion of TRH. The prolongation of P300 latency in the OPCA group suggests that subclinical disturbance in recognition function is present in OPCA and may be related to the blood flow decrease outside the cerebellum.

Regional cerebral blood flow in lacunar infarction

Ten cases of lacunar infarction, 10 cases of nonlacunar cerebral thrombosis, and 8 healthy controls who did not have risk factors of cerebrovascular diseases were studied. Subcortical cystic infarctions with a diameter of less than 1.5 cm were classified as lacunar infarction and the other cerebral thrombosis were classified as nonlacunar cerebral thrombosis. Cerebral blood flow examination by Xenon computed tomography (CT) method was performed within 14 days after the onset of stroke. Stable Xenon was inhaled for 3 minutes and CT scan was taken once before the inhalation, 3 times during the inhalation, and 5 times in the washout phase. Regional blood flows in the infarcted area, around the infarcted area, and in the cerebral cortex and the cerebral white matter where the influence of the infarction was considered to be little were measured before and after intravenous injection of 17 mg/kg acetazolamide. In the lacunar infarction, the blood flow in the cerebral cortex where the influence of the infarction was considered to be little was decreased and the cerebrovascular dilatory reserve capacity in the cerebral cortex and the cerebral white matter was decreased. Arteriolosclerosis is considered to be the basic cause of lacunar infarction.

Central motor conduction time in patients with periventricular lucencies

Central motor conduction time and regional cerebral blood flow were measured before and 20 min after intravenous injection of 17 mg/kg acetazolamide in 10 patients with periventricular lucencies (PVL) and 10 age-matched healthy controls. Central motor conduction time was measured using a magnetic stimulator and regional cerebral blood flow was measured by stable xenon computed tomography method. The central motor conduction time was significantly longer in the patients with PVL than in the healthy controls and was shortened significantly by the intravenous injection of acetazolamide in the patients with PVL. The blood flow not only in the periventricular white matter but also in the cerebral cortex and the cerebral white matter was significantly lower in the patients with PVL than in the healthy controls. The intravenous injection of acetazolamide increased significantly the regional cerebral blood flow except in the PVL areas. The prolongation of the central motor conduction time may be at least partly related with decreased blood flow in the cerebral cortex and cerebral white matter.

Effects of intravenous L-dopa on P300 and regional cerebral blood flow in parkinsonism

The P300 and regional cerebral blood flow were measured before and after intravenous injection of L-dopa in 10 patients with idiopathic Parkinson's disease and 10 patients with vascular parkinsonism. The P300 was measured with an evoked potential recorder using an oddball paradigm and the regional cerebral blood flow was measured using the stable xenon computed tomography method. The P300 latency was significantly longer and the regional cerebral blood flow in the cerebral cortex and basal ganglia was significantly lower in the Parkinson's disease group and the vascular parkinsonism group than in the age-matched healthy control group. The intravenous injection of L-dopa improved these abnormalities significantly in the Parkinson's disease group but did not improve these abnormalities in the vascular parkinsonism group. Cognitive function is considered to be impaired in Parkinson's disease and vascular parkinsonism and L-dopa is considered to improve it in Parkinson's disease.