Longitudinal measurement of cerebral perfusion in patients with multi-infarct dementia

Longitudinal measurements of local cerebral blood flow (LCBF) were performed in 13 patients with multi-infarct dementia (MID) utilizing the xenon-enhanced computed tomography-CBF method. Subjects were divided into two groups: a group consisting of five patients with MID who deteriorated (aged 60.6 ± 5.3 years) and whose CCSE scores decreased and a stable group comprised of eight patients (aged 64.5 ± 4.5 years) whose CCSE scores did not change. Mean intervals between first and second LCBF measurements were 663 ± 182 days for the deteriorated group and 795 ± 495 days for the stable group. In the deteriorated group, LCBF values for frontal cortex, thalamus, and frontal white matter had declined further at the second measurement. In the stable group, LCBF values were not uniformly stable, but there were no overall mean decreases. The annual rate of decline among patients who deteriorated for frontal cortex, thalamus, and frontal white matter exceeded annual declines measured in elderly normal volunteers. Results suggest that progressive cerebral hypoperfusion contributes to cognitive declines in mild MID, but, if cerebral perfusion of frontal lobes and basal ganglia can become stabilized, further cognitive deterioration can be prevented.