EFFECT OF PROPENTOFYLLINE AND PENTOXIFYLLINE ON CEREBRAL BLOOD-FLOW USING I-123 IMP SPECT IN PATIENTS WITH CEREBRAL ARTERIOSCLEROSIS

Propentofylline and pentoxifylline were administered to patients age 6 5 years or older who were suffering from chronic cerebrocirculatory in sufficiency. Changes in clinical symptoms and the level of cerebral bl ood flow before and after drug administration were compared. I-123-IMP single photon emission computed tomography was used to compare cerebr al blood flow before treatment with that 3 months after initiation of therapy. Focal regions of interest were established in the cerebellum, the frontal, temporal, parietal, and occipital lobes, and the thalamu s. Comparisons were made between patients age 75 years or older (very old age group) (n = 5) and those age, 65 to 74 years (old age group) ( n = 7). Complaints of dizziness and slight headache disappeared by the eighth week after the start of therapy in both age groups. Two of the five patients in the very old age group showed elimination of memory disturbance symptoms at the 12th week of treatment. Six of the seven p atients in the old age group had no memory disturbance symptoms by the eighth week of treatment, which indicates a high therapeutic effect i n this group. In the cerebral blood flow studies, no increases in bloo d flow after drug administration were observed in the very old age gro up. This finding is probably related to the poor level of recovery ach ieved in disturbances in memory in this group. In contrast, improvemen ts in blood flow were observed for all regions of the brain monitored in the old age group, which is consistent with the amelioration of cli nical symptoms observed in these patients. Our findings suggest that t herapy for chronic cerebral circulatory insufficiency should be initia ted in elderly patients as early as possible. This view is supported b y the clinical evidence of improvements in symptoms and blood circulat ion in the younger age group.