ABSTRACT
BACKGROUND AND PURPOSE: Despite accumulating evidence for the clinical efficacy and neuroprotective properties of rasagiline in Parkinson's disease (PD), effects of rasagiline on brain perfusion in PD patients have not been elucidated. The present study aimed to investigate the effects of rasagiline on regional cerebral blood flow (rCBF) in patients with PD using single-photon emission computed tomography (SPECT). METHODS: A total of 44 PD patients were recruited and treated with dopamine agonist, either alone or in combination with levodopa. Twenty-two of these patients (referred to as the rasagiline group) additionally received rasagiline (1 mg/day). All patients underwent brain SPECT scans and clinical assessments at baseline and follow-up visits. The mean follow-up period was 2.2 years. Changes in rCBF were compared between the rasagiline group and the comparison group in a voxel-wise manner. RESULTS: Annual change in Unified Parkinson's Disease Rating Scale motor score was lower in the rasagiline group compared to the comparison group (P = .01). A significant group-by-time interaction effect on rCBF was found in the right precuneus (P = .001), where rCBF was decreased in the comparison group and remained stable in the rasagiline group. CONCLUSIONS: Our results show that adjunctive rasagiline treatment had beneficial effects on perfusion in the precuneus of PD patients, suggesting potential neuroprotective effects.
Subject(s)
Antiparkinson Agents/therapeutic use , Cerebrovascular Circulation/drug effects , Indans/therapeutic use , Neuroprotective Agents/therapeutic use , Parkinson Disease/drug therapy , Aged , Antiparkinson Agents/administration & dosage , Drug Therapy, Combination , Female , Humans , Indans/administration & dosage , Levodopa/administration & dosage , Levodopa/therapeutic use , Male , Middle Aged , Neuroprotective Agents/administration & dosage , Parkinson Disease/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Treatment OutcomeSubject(s)
Meningitis/complications , Sjogren's Syndrome/complications , Aged , Brain/diagnostic imaging , C-Reactive Protein/metabolism , Female , Humans , Magnetic Resonance Imaging , Meningitis/diagnostic imaging , Meningitis/drug therapy , Radionuclide Imaging , Salivary Glands/diagnostic imaging , Sjogren's Syndrome/diagnostic imaging , Sjogren's Syndrome/drug therapy , Steroids/therapeutic useABSTRACT
BACKGROUND AND PURPOSE: Apathy is one of the most common neuropsychiatric symptoms in patients with Alzheimer's disease (AD). It may have adverse impacts on the progression of AD. However, its neurobiological underpinnings remain unclear. The objective of this study was to investigate differences in regional cerebral blood flow (rCBF) between AD patients with apathy and those without apathy. METHODS: Sixty-six apathetic AD patients and 66 AD patients without apathy completed Neuropsychiatric Inventory (NPI) and underwent technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT) scans. Voxel-wise differences in rCBF between the 2 groups were examined. Association between rCBF and levels of apathy in the apathetic group was also assessed. RESULTS: AD patients with apathy showed lower rCBF in the bilateral orbitofrontal cortex, left putamen, left nucleus accumbens, left thalamus, and bilateral insula than those without (all p<0.005). Mean perfusion across all significant clusters showed a negative linear correlation with NPI apathy score in AD patients with apathy (ß=-0.25; p=0.04). CONCLUSIONS: Hypoperfusion in the prefrontal, striatal, and insular areas may be neural correlates of apathy in AD patients.
