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Reduced regional cerebral blood flow in Huntington's disease studied by SPECT
S G Hasselbalch1, G Oberg, S A Sørensen
1Department of Neurology, Rigshospitalet, University State Hospital, Copenhagen, Denmark.
Insights
Regional cerebral blood flow is reduced in both brain areas and cognitive functions in Huntington
Area of Science:
- Neurology
- Neuroimaging
- Neuropsychology
Background:
- Huntington's disease (HD) is a progressive neurodegenerative disorder.
- Understanding regional cerebral blood flow (rCBF) changes is crucial for diagnosing and managing HD.
Purpose of the Study:
- To investigate rCBF in patients with Huntington's disease.
- To explore the relationship between rCBF and cognitive deficits in HD.
Main Methods:
- High-resolution single photon emission computed tomography (SPECT) using Tc-99m-HMPAO.
- Studied 18 patients with HD and 19 age- and sex-matched controls.
- Neuropsychological testing and regression analysis to correlate rCBF with cognitive scores.
Main Results:
- Significant rCBF reductions observed in the caudate and lentiform nuclei (20% and 8%) and cerebral cortex (11-13%), particularly frontal and parietal areas.
- No significant reductions in thalamus, mesial temporal cortex, and occipital cortex.
- Wisconsin Card Sorting Test and Picture Arrangement Test scores correlated with caudate nucleus blood flow; other cognitive tests correlated with cortical blood flow.
Conclusions:
- Symptomatic Huntington's disease is associated with reduced blood flow in both cortical and subcortical brain structures.
- Both cortical and subcortical blood flow reductions may be linked to cognitive impairments in HD patients.
Abstract:
Regional cerebral blood flow (rCBF) was studied in 18 patients with Huntington's disease (HD) and 19 age- and sex-matched controls with high resolution single photon emission computerised tomography (SPECT), using Tc-99m-HMPAO. Significant reductions in tracer uptake were found in the caudate and lentiform nuclei (20 and 8%) and in the cerebral cortex, especially in the frontal and parietal areas (11-13%). No significant reductions were found in the thalamus, mesial temporal cortex, and occipital cortex. Fourteen patients had neuropsychological testing. Relationship between rCBF and cognitive function was tested by regression analysis. A linear relationship was found between test scores of Wisconsin Card Sorting Test, Picture Arrangement Test and blood flow in the caudate nucleus. Other tests of cognitive function (Block Design Test, Face and Word Recognition Test, Street Fragmented Pictures Test, and Similarities Test) correlated better with flow in the cortical regions believed to be involved in solving those particular tests. These findings indicate, that blood flow is reduced in both cortical and subcortical structures in symptomatic HD, and that both reductions in cortical and subcortical blood flow may be related to cognitive function in HD.