Brain SPECT analysis by 3D-SSP and phenotype of Parkinson's disease

J Neurol Sci. 2006 Feb 15;241(1-2):67-72. doi: 10.1016/j.jns.2005.10.017. Epub 2005 Dec 13.


Objectives: We hypothesize that the regional pattern of blood flow reduction in the brain is different between tremor-dominant Parkinson's disease (PD) and postural instability gait difficulty (PIGD)-dominant PD. We therefore investigated the association of phenotypes in untreated PD with brain perfusion on SPECT using three-dimensional stereotactic surface projection (3D-SSP) technique.

Patients and methods: Thirty-three patients who had PD without dementia (12 men and 21 women with a mean age of 67.1+/-6.4 years) were included in this study. Their symptoms were rated using the Unified Parkinson's Disease Rating Scale (UPDRS). Patients were grouped in two phenotypes: tremor and PIGD-dominant groups based on UPDRS components. Around the same time, all patients were examined by N-isopropyl-p[123I] iodoamphetamine single photon emission computed tomography (123I-IMP SPECT), and obtained images were analyzed with 3D-SSP using an image-analysis software, NEUROSTAT. Data on brain surface perfusion extracted by 3D-SSP analysis were compared between the PD patients and the normal control group. The same comparisons were made for subgroups of PD patients.

Results: Cerebral perfusion was decreased at the anterior cingulate cortex and primary visual cortex of the PD patients, and especially by the pixel-by-pixel comparison, perfusion was significantly decreased at the right anterior cingulate cortex compared with the normal controls. In the PIGD-dominant group, more severe hypoperfusion was seen at the same regions. In the tremor-dominant group, significant hypoperfusion was not seen compared with the normal controls.

Conclusions: The regional pattern of blood flow reduction in the brain was found to be different between tremor-dominant PD and PIGD-dominant PD. These regional differences were considered to suggest different and disease-specific combinations of underlying pathophysiological and neurochemical processes.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Mapping*
  • Female
  • Gait Disorders, Neurologic / diagnostic imaging
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Inosine Monophosphate / pharmacokinetics
  • Iodine Isotopes / pharmacokinetics
  • Male
  • Middle Aged
  • Parkinson Disease / classification
  • Parkinson Disease / complications
  • Parkinson Disease / diagnostic imaging*
  • Phenotype
  • Tomography, Emission-Computed, Single-Photon*
  • Tremor / diagnostic imaging
  • Tremor / etiology


  • Iodine Isotopes
  • Inosine Monophosphate