Parkinsonism in patients with vascular dementia: Clinical, computed- and positron emission-tomographic findings

Purpose: The present study investigates the vascular nature of parkinsonian features in patients with 'probable' vascular dementia. Patients and Metho ds: Forty patients with vascular dementia were studied with positron emissi on tomography (PET) using the steady state technique with O-15 in order to assess regional cerebral blood flow (rCBF), regional oxygen extraction rate (rOER) and regional metabolic rate for oxygen (rCMRO(2)) in different brai n regions. The findings in 10 patients with (VaDP) were compared to 30 with out parkinsonism (VaD). Results: The clinical and computed tomographic find ings in the parkinsonian patients were similar to those described in the li terature as probable vascular parkinsonism. The PET results showed decrease d rCBF and rCMRO(2) in the frontal and parietal cortices and in the striatu m of the VaDP compared to the VaD group. The decrease of rCBF and rCMRO(2) in frontal and parietal cortices is due to the more severe mental changes i n the VaDP group. In the VaDP patients rCBF and rCMRO(2) were more decrease d and rOER increased in the striatum contralateral to the most affected par kinsonian side. Conclusion: Our PET findings show that local ischemic chang es in the striatum contribute to parkinsonism in vascular dementia patients . Copyright (C) 2001 S. Karger AG, Basel.