Cerebral blood flow and metabolism in pernicious anemia.

P EIiNICIOUS ANEMIA is a deficiency disease which involves the metabolism of at least the hematologic, gastiointestinal and nervous systems. Signs and symptoms occurring from the disease may result directly from the effects of the deficiency on cell metabolism or more indirectly l)ecause of the anemia. The tongue and nervous system may he involved with little or no cvidence of hematologic disease, and specific therapy with refined liver extract or Vitamin B12 will correct or improve these defects, indicating that the anemia of pernicious anemia is simply one manifestation of an extensive disease. This study s’as undertaken in an effort to measure the effects of this deficiency state and its treatment on cerebral metabolism, and to gather data which might shed some light on the relative importance of the anemia and the specific deficiency in the pathogenesis of the cerebral metabolic defects. Cerebral blood flow and metabolism were measured by the nitrous oxide method of Kety and Schmidt’ in twenty-seven observations on 16 patients with pernicious anemia. The results indicate that a disturbance in cerebral metabolism in pernicious anemia is common, that the mental symptoms observed in these patients are related to the decrease in cerel)ral metabolism, and that this disturbance is the result of the deficiency state and is not pro(luced by the anemia.