Tokuzo Miyazaki

Initial Symptoms of Parkinson’s Disease with Elderly Onset

Background/Objective: As the incidence of Parkinson’s disease (PD) is related to aging, we consider it important to determine how the initial symptoms change with age in order to diagnose early elderly cases of PD accurately. Methods: 84 patients (age at onset 70.7 ± 9.0 years; mean ± 1 SD) were studied to see whether the initial symptoms change according to age. Results: The prevalence of resting tremor was significantly lower in patients of advanced age (p = 0.041). In contrast, the incidence of postural and gait disorders increased significantly with aging (p = 0.032). The prevalences of rigidity and kinetic disorders, which are important clinical features of PD, were not influenced by aging. Conclusion: These findings suggest that the cause of PD is not related to the aging process itself, since the prevalences of all symptoms were not influenced by aging. Knowledge of the prevalence of the inital symptoms of PD may contribute to the accurate diagnosis in early and elderly cases.

Classification of acute ischemic stroke in the elderly by single photon emission computed tomography using 99mTc-hexamethylpropylene-amine-oxime. For management of acute stroke.

脳血管撮影施行が困難である高齢脳梗塞患者におけるHMPAO SPECTの超急性期病型診断に対する有用性の検証を行った.対象は高齢脳梗塞患者47例 (78.7±7.8歳) で, 入院時HMPAO SPECTより求めた虚血部の健側に対する血流低下の程度であるAsymmetric Index (AI) と退院時の診断病型との関係を検討した.AIは脳塞栓症群51.7±16.3%, 脳血栓症群19.0±10.0%であった (p<0.01).また脳塞栓症と脳血栓症との鑑別AI値を30%に設定すると脳塞栓症診断における敏感度は0.95, 特異度は0.86であり, 鑑別可能と考えられた.非侵襲的なHMPAO SPECTによるAIの評価は高齢者超急性期脳梗塞病型診断に有用と思われた.