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Edward Mallinckrodt Institute of Radiology, the McDonnell Center for Studies of Higher Brain Function, and the Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, MO.
Positron emission tomography was used to measure global and local blood flow in 11 patients with hemiparkinsonism (before and after an acute oral dose of L-dopa) and in 26 normal subjects. Global hemispheric blood flow was not significantly different between the patients [45 ± 11 ml/(min. 100 g)] and the controls [49 ± 8 ml/(min. 100 g)]. After L-dopa, the patients' mean global hemispheric flow did not change. Measurements of local blood flow from specific, anatomically defined cortical and basal ganglia regions were performed using a newly developed stereotactic localization technique. Before L-dopa, mesocortical blood flow contralateral to the patients' symptoms was significantly less than controls (p < 0. 003), suggesting a specific abnormality in the (cortical dopaminergic projection from the ventral tegmental area. In addition, right and left pallidal blood flow were significantly less tightly coupled in patients than controls (p = 0. 0312). After L-dopa, the mesocortical blood flow remained below normal, whereas pallidal blood flow was no longer significantly different from controls (p > 0. 05).
Address correspondence and reprint requests to Dr. Perlmutter, Division of Radiation Sciences, Box 8131, Washington University School of Medicine, 510 South Kingshighway, St. Louis, MO 63110.
Supported by NIH Grants NS07205 and HL13851, and by Teacher Investigator Development Award NS00929 (J. S. P.).
Presented in part at the thirty-sixth annual meeting of the American Academy of Neurology, Boston, MA, April 1984.
Accepted for publication March 5, 1985.
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