Utility of late N-isopropyl-p-(iodine-123)-iodoamphetamine brain distribution in predicting outcome following cerebral infarction

BACKGROUND AND PURPOSE

The purpose of this study was to determine utility of late N-isopropyl-p-(iodine-123)-iodoamphetamine distribution in predicting neurological and language outcome.

METHODS

We prospectively studied 29 patients with unilateral hemispheric ischemic cerebral infarction using the neuroimaging method of single-photon emission computed tomography and the above tracer. Four different imaging measures reflecting late tracer distribution or redistribution and three measures indicative of the patients' overall neurological or language outcome at 3 months were used in the data analysis. All patients had neuroimaging within 30 days of infarction, and 14 patients were imaged within 10 days of infarction. Data analysis was performed for all patients combined and then separately on the groups imaged within 10 days of and more than 10 days after infarction.

RESULTS

The volume of the late image defect significantly correlated with one measure of neurological outcome in the whole group and in those imaged more than 10 days after cerebral infarction. However, these results are difficult to explain based on the present understanding of the physiology of late N-isopropyl-p-(iodine-123)-iodoamphetamine distribution.

CONCLUSIONS

We feel that the pattern of late N-isopropyl-p-(iodine-123)-iodoamphetamine distribution is probably not useful as an independent predictor of neurological and language outcome.

Essential voice tremor: treatment with propranolol

We studied chronic oral propranolol therapy and placebo in seven patients with essential voice tremor. Mean scores for voice tremor and voice quality did not differ for placebo or propranolol. Hand tremor amplitude decreased significantly with propranolol. Voice tremor seems to be more resistant to propranolol therapy than hand tremor.