Abstract

Objective: Current knowledge of intracranial fluid dynamics in Parkinson’s disease patients is limited. Magnetic Resonance Imaging, computerized tomography and Positron Emission Tomography provide important information of cranial fluid changes but are static. 

Materials and Methods: 20 Parkinson patients, stage I-III Hoehn and Yahr and 22 age and gender matched neurologically normal subjects were enrolled in a prospective 2 year study. Monitoring consisted of transcranial Doppler, bio-impedance, near infrared, Portapres^®, electrocardiogram, chest respiratory band, and galvanic skin response. Transcranial Doppler measured blood flow into each brain hemisphere and the and bioimpedance device measured the volumes of cerebrospinal fluid (CSF) within the cranium. Perturbations were orthostatic and cognitive challenges. 

Results: Parkinson patients utilized their right brain hemisphere in contrast to neurologically normal ageing subjects (left hemisphere was dominant) pre and post all cognitive and orthostatic tests, p = 0.0039.

Significantly increased diastolic volume of cerebrospinal fluid was measured in the neurologically normal subjects left hemispheres pre and post all orthostatic and cognitive tests compared to the PD patients, p = 0.0275. 

Conclusion: The left-brain hemisphere is normally associated with analytical reasoning, mathematical calculations and logic and all neurologically normal subjects. In contrast, all Parkinson subjects used their right brain hemispheres for solving the arithmetic cognitive tests.

Keywords: Cranium; Brain; Blood; Cerebrospinal Fluid (CSF); Bio-Impedance; Parkinson’s Disease; Ageing; Doppler; Cognition

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