We investigated the regional cerebral blood flow (rCBF) in 8 patients with Parkinson disease (PD) with cognitive impairment (age; 64-82 years, Mini-Mental State Examination score = MMSE score; 22-6 points, Yahr stage; III-V), with the standard transaxial images and the Z-score images using the three-dimensional stereotactic surface projections (3D-SSP) of 123I-IMP SPECT. A contrast database was created by averaging extracted database sets of the contrast group (numbers; 14 cases, age; 64-82 years, MMSE score; > or = 29 points). The regions of the perfusion reduction shown on the standard transaxial images were similarly demonstrated on the Z-score images in 6 of the 8 patients, and only the Z-score images demonstrated definite regions of perfusion reduction in remaining 2 patients. Both the standard transaxial and Z-score images demonstrated the perfusion reduction in the temporo-parietal regions in all of the patients, and the Z-score images but not the standard transaxial ones detected the reduction in the posterior cingulate gyrus and precuneus in 3 patients. 3D-SSP images of 123I-IMP SPECT are thus more sensitive in detecting rCBF of the medial aspect of the parietal cortex than the standard transaxial images, and can be used as a diagnostic tool to objectively evaluate the cognitive function of PD patients.
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