脳疾患患者における高次脳機能障害と脳血流量とこれらの関連性について—99mTc-HMPAO SPECTによる検討

Study of correlation between neuropsychological function and cerebral blood flow in patients who have brain damage : 99mTc-HMPAO SPECT study

要旨：高次脳機能と脳血流量の関係を明らかにするために，脳疾患患者128例に高次脳機能検査を行い，その内93例の平均脳血流量(mCBF)を測定した．その結果，高次脳機能得点とmCBFは対照群より有意に低下し，これら2つは有意な相関を示した．疾患別検討でも，高次脳機能得点は全ての疾患群で対照群より有意に低下していたが，mCBFは疾患によっては低下を示さなかった．疾患別での高次脳機能得点とmCBFとの関連では，脳梗塞など発症時に脳実質に出血のない疾患群で有意な相関が示されたが，脳出血など脳実質に出血のある疾患群では有意でなかった．高次脳機能は，mCBFの影響を受ける可能性がある疾患とそうでない疾患が示唆された．

　The purpose of this study was to investigate the relationship between neuropsychological function and the mean cerebral blood flow (mean CBF) in patients who have brain damage. One hundredtwenty eight patients were evaluated using the mental status examination for dementia. The mean CBF of 93 patients in 128 patients was measured by the Patlak-plot method using technetium-99m hexamethylpropylene amine oxime single-photon emission tomography (99m-Tc-HMPAO SPECT). Neuropsychological scores of 128 patients were significantly lower than those of control subjects. And the mean CBF of 93 patients was significantly reduced compared with that of control subjects. A significant correlation between the score of neuropsychological test and the mean CBF in patients (n=93) was observed. Furthermore, to analyze the difference of types of brain damage, we divided 128 patients into seven groups ; cerebral infarction, intracerebral haemorrhage, subarachnoid haemorrhage, normal pressure hydrocephalus : NPH, cerebral contusion, brain tumor, and central nervous degeneration. The score of the neuropsychological test of each group was significantly reduced. However, a significant reduction of the mean CBF was not observed in two groups (subarachnoid haemorrhage and central nervous degeneration). Significant relationships between the mean CBF and the score of neuropsychological test were shown in four groups (cerebral infarction, NPH, brain tumor, and central nervous degeneration). However, there were no relationships in three groups (intracerebral haemorrhage, subarachnoid haemorrhage, and cerebral contusion). The result of the present study suggested that neuropsychological function was easily damaged by brain insults. And, there were differences in the relationship between the mean CBF and neuropsychological function by brain disease types.