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The relation between crossed cerebellar blood flow and severities of hemiplegia: a technetium-(99m)
1Department of Internal Medicine, Nanasawa Rehabilitation Hospital, Atugi.
Insights
Crossed cerebellar diaschisis (CCD) severity correlates with hemiplegia. Reduced cerebral blood flow and asymmetry indicate a strong link between hemiplegic limb function and cerebellar function.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Crossed cerebellar diaschisis (CCD) is a reduction in blood flow to the cerebellum, often seen in hemiplegic patients.
- The relationship between hemiplegia severity and the degree of CCD requires further investigation.
Purpose of the Study:
- To investigate the correlation between the severity of hemiplegia and the degree of crossed cerebellar diaschisis.
- To evaluate cerebral blood flow and asymmetry in patients with varying stages of hemiplegia.
Main Methods:
- Twenty consecutive patients with hemiplegia were studied.
- Hemiplegia severity was assessed using Brunnstrom stages (Br. stage) for lower limbs.
- Crossed cerebellar blood flow (CCBF) and asymmetry index (ASI) were quantified using technetium-(99m) hexamethylpropylene amine oxine ((99m)Tc HMPAO) SPECT and the Patlak plot method.
Main Results:
- Significant differences in CCBF and ASI were observed between different Brunnstrom stages of hemiplegia (e.g., II vs. IV, III vs. IV, III vs. V).
- Patients with lower Brunnstrom stages (II and III) showed significantly lower CCBF and ASI compared to those with higher stages (IV, V, and VI).
Conclusions:
- This study demonstrates a significant correlation between hemiplegia severity and the degree of crossed cerebellar diaschisis.
- Findings suggest that reduced cerebellar blood flow and increased asymmetry are associated with more severe hemiplegia.
Abstract:
Crossed cerebellar diaschisis (CCD), decrease in crossed cerebellar blood flow (CCBF) (ml/100g/min), is often observed in the cerebral blood flow imaging of hemiplegic patients. We studied the relations between severities of hemiplegia and degrees of CCD. Severities of hemiplegia were evaluated by Brunnstrom stages (Br. stage) of lower limbs. Degree of CCD was evaluated as CCBF and asymmetry index (ASI) (%) of CCBF, which were calculated from technetium-(99m) hexamethylpropylene amine oxine ((99m)Tc HMPAO) SPECT study using Patlak plot method (Matsuda et al. 1992, 1993). We have studied twenty consecutive patients. The CCBF was significantly different between Br. stage II and IV (p = 0.0357), III and IV (p < 0.001) and III and V (p < 0.001). ASI was significantly different between II and IV (p = 0.0357), III and IV (p < 0.001) and III and VI (p = 0.0238). Both of CCBF and ASI of the group of II and III were significantly lower than those of the group of IV, V and VI (p = 0.0033 for CCBF and p = 0.0087 for ASI). We conclude that this study indicate a close correlation between the sevreties of hemplegia and the degrees of CCD.