Redistribution in I-123 N-isopropyl-p iodoamphetamine single-photon emission computed tomography in cerebrovascular disease and the effects of rehabilitation

Abstract

We performed N-isopropyl-p (I-123) iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) on 28 patients with severe cerebrovascular disease before rehabilitation, and compared the degree of redistribution and the assessment of activities of daily living (ADL). We calculated a redistribution (RD) ratio in the central and peripheral parts of the lesions: RD ratio (c) and RD ratio (p). We classified the patients into four groups based on the degree of redistribution: complete: both RD ratio (c) and (p) ≥ 75; peripheral: RD ratio (c) < 75, RD ratio (p) ≥ 75; incomplete: both RD ratio (c) and (p) < 75 and at least one of RD ratio (c) or (p) ≥ 25; no redistribution: both RD ratio (c) and (p) < 25. We assessed the ADL using the modified Barthel index (BI). ΔBI was defined as BI after rehabilitation–BI before rehabilitation (BIpost–BIpre). The ΔBI of the four groups were as follows: complete-redistribution group (40.8 ± 22.8), peripheral-redistribution group (40.0 ± 15.8), incomplete-redistribution group (27.2 ± 22.6), no-redistribution group (8.8 ± 12.3). The ΔBI of the complete and peripheral redistribution groups were significantly higher than that of the no-redistribution group. However, ΔBI was almost the same in the complete- and peripheral-redistribution groups. This suggests that the effect of rehabilitation might be closely related to the viability of the peripheral part of the lesion.