Regional cerebral blood flow in aged diabetic patients without a history of cerebrovascular accident, determined by N-isopropyl-123I-p-iodoamphetamine with single photon emission CT

N-isopropyl-123I-p-iodoamphetamine (IMP) was used to determine the regional cerebral blood flow in 9 diabetic patients (average age: 71.8 years) and 9 non-diabetic subjects (average age: 71.7 years), none of whom had a history of cerebrovascular accident. There were no significant differences in the physiological or laboratory data between the diabetic and non-diabetic groups except in fasting plasma glucose and HbA1c levels. Areas of hypoperfusion of the cerebral hemispheres were observed in 7 diabetic patients, 5 of whom showed multiple lesions. On the other hand, areas of hypoperfusion were observed only in 4 of the non-diabetic subjects and only 1 of these demonstrated multiple lesions. We evaluated the cerebral blood flow semiquantitatively as follows: the area where the radioactive count was 65% or more of the maximum count of the slice was defined as a region of normal cerebral blood flow (ROI-A); the area where the count was 45% or more as region of brain tissue except for ventricles (RUI-B). The numbers of pixels of ROI-A and ROI-B were counted in each slice and the ROI-A/B ratios of 16 slices were averaged individually. The average percent ROI-A/B ratio was significantly lower in the diabetic group than that in the control group (49.4±1.9 (Mean±SEM) vs 56.6±1.9%, p<0.05). These observations suggest that the area of normal regional cerebral blood flow is reduced in aged diabetics, even in the absence of a history of cerebrovascular accident. (author)