Objective: To test usefulness of arterial spin labeling (ASL) perfusion MRI for diagnoses of Parkinson’s disease (PD) with dementia.

Background: Dopamine transporter (DAT) images may be helpful to ascertain existence of defect of DAT in the striatum, but not to give information concerning to cerebral blood flow (CBF) that is needed to diagnose PD with dementia.

Methods: Fifty-five PD patients (20 Male/25 Female, Age 70.2±5.7 (mean±SD) years, disease duration7.55±3.3) who met a Japanese PD diagnosis criteria and 35 age and sex normal controls were scanned by using a pseudo-continuous arterial spin labeling (PCASL) method with a 1.5 Tesla MRI unit (Achieva A-series; Philips Medical Systems, Best, The Netherlands). Regional CBF was compared in the frontal, the parietoposterial, and the posterior cortex using region-of-interest analysis. In addition, evaluation of DAT images were conducted by a single photon emission computed tomography (SPECT) device (Bright View, Philips, Amsterdam, Netherlands) using 123I-N-w-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-FP-CIT). Clinical signs were evaluated by Hoehn-Yahr stage, unified Parkinson’s disease rating scale (UPDRS), minimental state examination (MMSE), frontal assessment battery (FAB) and the Montreal cognitive assessment (MOCA).

Results: PD patients showed reduced DAT uptakes in the striatum that confirm diagnoses of PD. PD patients had UPDRS with 33.9±5.2 MMSE with 24.0±3.9, FAB with 13.5±3.7, MOCA with 21.7±5.7. PD patients showed four regional CBF patterns. The first group had normal regional CBF patterns comparing with those of normal controls. The second group had reduced frontal cortex regional CBF patterns comparing with those of normal controls. The third group had reduced parietoposterial cortex regional CBF patterns comparing with those of normal controls. The fourth group had reduced posterial cortex regional CBF patterns comparing with those of normal controls. Result of cognitive examinations were demonstrated in the Figure 1.

Conclusions: This is a study to detect four patterns of hypoperfusion in the cortex in PD patients with dementia using ASL perfusion MRI. Because ASL perfusion MRI is completely noninvasive and can, therefore, safely be used for repeated assessments, this method can compensate for monitoring of PD patients with dementia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/arterial-spin-labeling-perfusion-mri-compensate-for-other-diagnostic-tools-in-evaluation-of-parkinsons-disease-with-dementia/