Reza Nemati - Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Mohamad Ali Nayeri - The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine , Bushehr University of Medical Sciences, Bushehr, Iran
Negar Chabi - The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine , Bushehr University of Medical Sciences, Bushehr, Iran
Zahra Akbari - Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Esmail Jafari - The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine , Bushehr University of Medical Sciences, Bushehr, Iran
Hossein Shooli - The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine , Bushehr University of Medical Sciences, Bushehr, Iran
Habibollah Dadgar - Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Majid Assadi - The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine , Bushehr University of Medical Sciences, Bushehr, Iran

Objective(s): The purpose of this study was to investigate regional cerebral blood flow (rCBF) reduction in patients with dizziness and perfusion-related clinical impairment using brain perfusion single photon emission tomography (SPECT).Methods: Thirty-four patients with subjective dizziness and ۱۳ age- and sex-matched healthy controls were studied. Dizziness-related impairments were assessed using the Dizziness Handicap Inventory (DHI) and Short Physical Performance Battery (SPPB). Brain perfusion SPECT scan was acquired from all participants. The carotid intima-media thickness (CIMT) was also measured. Brain perfusion data were qualitatively interpreted in all cases. Voxel-wise analysis was also conducted in ۱۱ patients compared to healthy controls.Results: Thirty-four patients (mean age=۵۳.۸±۱۳.۴ years, m/f: ۱۹/۱۵) and ۱۳ age- and sex-matched controls (mean age=۵۱.۵±۱۳.۱, m/f: ۷/۶) were included. The dizziness severity was mild in ۵۸.۸% (n=۲۰), moderate in ۲۶.۵% (n=۹), and severe in ۱۴.۷% (n=۵). Qualitative interpretation of SPECT images showed normal scans in ۴ (۱۱.۲%) patients and abnormal scans in ۳۰ (۸۸.۲%) patients. Patients with dizziness showed a significantly decreased brain perfusion in the precuneus, cuneus, occipital lobe (superior and inferior parts), frontal lobe (inferior and middle parts), temporal lobe, parietal lobe (inferior and superior parts), cerebellum, insula, and putamen nucleus. Based on both qualitative SPECT interpretation and voxel-wise analysis, perfusion defect had a significant association with the total SPPB score and the scores of two sub-domains (p<۰.۰۵), but not with the DHI (p>۰.۰۵) score .Conclusion: The perfusion- and atherosclerosis-related impairments of gait and balance were largely independent of subjective dizziness and dizziness severity. Moreover, this study provided support for contribution of perfusion impairment to the disturbance of gait and balance in older populations along with other pathologic processes.

dizziness, Brain Perfusion SPECT, Gait, Balance, voxel-based morphometry (VBM),