Laser Doppler spectroscopy has been evaluated for the measurement of cerebral blood flow (CBF) by correlation with simultaneous measurements by radionuclide labelled microspheres. The experimental procedures were carried out on five anaesthetised rabbits. The cortical tissue was exposed by means of a small burr hole and illuminated by a helium neon laser (632.8 nm). Reflected light was detected using a silicon photodiode, and CBF was calculated continuously from the power of the frequency weighted Doppler spectrum in the reflected light. Three successive measurements of CBF were made using the microsphere technique. Following an initial baseline measurement, CBF was increased by an infusion of metaraminol and then reduced by controlled haemorrhage. Laser Doppler spectroscopy provided continuous monitoring of blood flow fluctuations and during the haemorrhage it was possible to demonstrate CBF autoregulation until the mean blood pressure fell below 6.7 kPa (50 mmHg). A regression analysis was performed between the simultaneous CBF measurements from the two techniques using a least squares best fit straight line analysis (r = 0.92, P less than 0.001). It was concluded that the flow computed from laser Doppler spectroscopy varied linearly with CBF and offers the unique advantage of continuous and instantaneous measurements even during nonsteady state flow.

Single photon emission computerised tomography (SPECT) was used to measure regional brain uptake of technetium-99m hexamethylpropyleneamine oxine (Tc99m-HMPAO) in elderly patients with Alzheimer's disease (AD), multi-infarct dementia (MID) and normals (n = 20 in each group). Different patterns of uptake were found between groups when cortical uptake was normalised to cerebellar uptake. Reductions occurred in all regions in AD, being most marked in temporal and posterior parietal areas. Significant correlations were found in AD between memory impairment and decreased temporal uptake bilaterally, and between duration of illness and reduced uptake in most brain regions. MID patients showed higher uptake in the anterior parietal region than did the other groups. A variable comparing anterior to posterior uptake significantly discriminated the two patient groups.

Our observations show that withholding an antithyroid drug in excess of just over 2 weeks prior to administering a fixed administered activity of radioiodine in patients with thyrotoxicosis leads to the lowest reported failure rate, irrespective of the underlying cause. One possible mechanism for this could be the avoidance of drug induced radio-resistance.

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Electrical impedance plethysmography (EIP) is a noninvasive method that may be useful for both the continuous and serial measurement of changes in pulsatile cerebral blood volume and perhaps cerebral blood flow (CBF). It has not been well validated by comparison with other methods. To attempt to validate the EIP technique, the relationship between the peak amplitude of the transcranial, cardiac-synchronous impedance waveform (dZp) and cerebral blood flow measured by the radiolabelled microsphere technique (CBFrlm) and laser Doppler spectroscopy (CBFlds) was studied in rabbits. CBF was altered by inducing hypertension using metaraminol, hypotension by controlled haemorrhage or hypocarbia by hyperventilation. Twenty-three comparisons between dZp and CBFlds and 19 comparisons with CBFrlm were made in eight rabbits. The percentage change between each measurement using the three techniques in each animal was calculated. Using pooled data from all the animals, the linear regression equations were dZp = 0.5 CBFrlm + 33 (r = 0.38, p = 0.22, SE = 79) and dZp = 0.84 CBFlds + 19.6 (r = 0.46, p = 0.09, SE = 72). It is concluded that, in the anaesthetised rabbit, when large changes in CBF are induced by the manoeuvres described above, changes in dZp correlate very weakly with changes in either cortical or global CBF, and are influenced by other factors such as pulsatile intracranial blood volume.