Relationship between the regional cerebral blood flow and the cognitive function and anosmia in patients with Parkinson disease and Alzheimer disease

• Published in: Brain and nerve = Shinkei kenkyū no shinpo Vol. 61; no. 6; p. 683
• Main Authors: Imamura, Kazuhiro, Matumoto, Shinjirou, Mabuchi, Naoki, Kobayashi, Yasushi, Okayasu, Naoki, Watanabe, Kenichi
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.06.2009
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - complications; Alzheimer Disease - physiopathology; Alzheimer Disease - psychology; Cognition; Cognition Disorders - etiology; Cognition Disorders - physiopathology; Female; Humans; Male; Olfaction Disorders - etiology; Olfaction Disorders - physiopathology; Olfactory Pathways - blood supply; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson Disease - psychology; Regional Blood Flow
• ISSN: 1881-6096

We compared the relationship between regional cerebral blood flow (rCBF) of the olfactory area and the cognitive function and anosmia in patient with Parkinson disease (PD) and in those with Alzheimer disease (AD). UPDRS III, MMSE, HDS-R, CDR, Beck Depression Inventory (BDI) were employed in this study. The subjects included 56 PD patients (average age 71.4+/-9.69 years), 23 AD patients (average age 73.3+/-7.12 years), 12 patients with mild cognitive impairment (MCI) (average age 72.5+/-6.89 years), and 9 age-matched controls (NC) (average age 73.8+/-6.61 years). Next we intravenously injected 1 ampule of thiamine propyldisulphide (Alinamin) and confirmed anosmia. In addition, we performed 123I-IMP SPECT (SEE methods) and satistically determined rCBF of the olfactory area based on the basis of the Z scores of the interest area. Anosima was detected in approximately 40% of the PD and AD patients. The HDS-R and MMSE scores were significantly higher in patients with anosima than in those without anosima; the CDR scores were significantly higher in the former than in the latter. Further, the incidence of anosima in PD patients and AD patients with MCI increased with an increase in the CDR scores. In order to determine the rCBF of the olfactory area of the PD and AD patients. As to rCBF of the olfactory area, we examined left and right Z scores of hippocampus, parahippocampus, amygdala, and uncus at Talairach level 3 and the scores of the Brodmann area 28, 34, 35, and 36 at Talairach level 5. In patients with anosmia, the Z scores were significantly high in cases with anosmia in all areas except the right Brodmann area 34 in PD patients and the right Brodmann area 28 and bilateral the Brodmann area 34 of both sides in AD patients. Some parts of the olfactory area are closely related to cognitive function, and it appeares that a reduced rCBF in the olfactory areas may lead to a functional decline in these regions which may cause anosmia and cognitive decline in PD and AD patients.