B. Keymeulen et al., TC-99M HEXAMETHYLPROPYLENE AMINE OXIME SINGLE-PHOTON EMISSION TOMOGRAPHY OF REGIONAL CEREBRAL BLOOD-FLOW IN INSULIN-DEPENDENT DIABETES, European journal of nuclear medicine, 23(2), 1996, pp. 163-168
The study was performed to investigate sub-clinical abnormalities in r
egional cerebral blood flow (rCBF) in patients with insulin-dependent
diabetes mellitus (IDDM) and to correlate them with patients' characte
ristics. After intravenous injection of technetium-99m hexamethylpropy
lene amine oxime (HMPAO), tracer uptake of the prefrontal, frontal and
parieto-occipital zones was measured with a triple-head single-photon
emission tomography (SPET) camera system in 35 IDDM patients outside
an episode of hypoglycaemia. Tracer uptake values in 16 age- and sex-m
atched healthy volunteers served as reference values. Compared with he
althy subjects, increased tracer uptake of both prefrontal regions and
the left frontal region could be shown in diabetes. Tracer uptake was
negatively con-elated with the duration of diabetes in all investigat
ed regions. In diabetic patients with a disease duration of more than
5 years (n=26), stepwise regression analysis revealed a significant po
sitive correlation between their HbAlc levels and tracer uptake. Long-
term diabetic patients with reduced (pre)frontal tracer uptake (n=8) h
ad lower HbAlc levels than those without (8.4%+/-0.2% vs 9.3%+/-0.3%,
P<0.05) and tended to have more frequently a history of hypoglycaemic
coma (6/8 vs 6/18, P=0.06). It can be concluded that duration of diabe
tes contributes to subclinical changes in basal rCBF in IDDM as detect
ed with HMPAO SPET of the brain. The positive correlation between the
presence of regional hypoperfusion and lower HbAlc levels in long-term
diabetic patients may be interpreted in the light of a presumed highe
r incidence of hypoglycaemia as metabolic control improves.