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Washida K, Saito S, Tanaka T, Nakaoku Y, Ishiyama H, Abe S, Kuroda T, Nakazawa S, Kakuta C, Omae K, Tanaka K, Minami M, Morita Y, Fukuda T, Shindo A, Maki T, Kitamura K, Tomimoto H, Aso T, Ihara M. A multicenter, single-arm, phase II clinical trial of adrenomedullin in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100211. [PMID: 38375188 PMCID: PMC10875187 DOI: 10.1016/j.cccb.2024.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/21/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
Background Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), the most common form of hereditary cerebral small vessel disease (SVD), currently lacks disease-modifying treatments. Adrenomedullin (AM), a vasoactive peptide with angiogenic, vasodilatory, anti-inflammatory, and anti-oxidative properties, shows potential effects on the neuro-glial-vascular unit. Objective The AdrenoMedullin for CADASIL (AMCAD) study aims to assess the efficacy and safety of AM in patients with CADASIL. Sample size Overall, 60 patients will be recruited. Methods The AMCAD is a multicenter, investigator-initiated, single-arm phase II trial. Patients with a confirmed CADASIL diagnosis, based on NOTCH3 genetic testing, will receive an 8-h AM treatment (15 ng/kg/min) for 14 days following a baseline assessment (from day 1 to day 14). Follow-up evaluations will be performed on days 15, 28, 90, and 180. Study outcomes The primary endpoint is the cerebral blood flow change rate in the frontal cortex, evaluated using arterial spin labeling magnetic resonance imaging, from baseline to day 28. Summary statistics, 95% confidence intervals, and a one-sample t-test will be used for analysis. Conclusion The AMCAD study aims to represent the therapeutic potential of AM in patients with CADASIL, addressing an unmet medical need in this challenging condition. Clinical Trial Registration jRCT 2,051,210,117 (https://jrct.niph.go.jp/en-latest-detail/jRCT2051210117).
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Affiliation(s)
- Kazuo Washida
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soichiro Abe
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takehito Kuroda
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shinsaku Nakazawa
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chikage Kakuta
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Katsuhiro Omae
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenta Tanaka
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Manabu Minami
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tetsuya Fukuda
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akihiro Shindo
- Department of Neurology, Mie University Graduate school of Medicine, Tsu, Japan
| | - Takakuni Maki
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Kitamura
- Department of Projects Research, Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University Graduate school of Medicine, Tsu, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Ueda N, Higashiyama Y, Saito A, Kimura K, Nakae Y, Endo M, Joki H, Kugimoto C, Kishida H, Doi H, Takeuchi H, Koyano S, Tanaka F. Relationship between motor learning and gambling propensity in Parkinson's disease. J Clin Exp Neuropsychol 2022; 44:50-61. [PMID: 35658796 DOI: 10.1080/13803395.2022.2083083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The basal ganglia and related dopaminergic cortical areas are important neural systems underlying motor learning and are also implicated in impulse control disorders (ICDs). Motor learning impairments and ICDs are frequently observed in Parkinson's disease (PD). Nevertheless, the relationship between motor learning ability and ICDs has not been elucidated. METHODS We examined the relationship between motor learning ability and gambling propensity, a possible symptom for prodromal ICDs, in PD patients. Fifty-nine PD patients without clinical ICDs and 43 normal controls (NC) were administered a visuomotor rotation perturbation task and the Iowa Gambling Task (IGT) to evaluate motor learning ability and gambling propensity, respectively. Participants also performed additional cognitive assessments and underwent brain perfusion SPECT imaging. RESULTS Better motor learning ability was significantly correlated with lower IGT scores, i.e., higher gambling propensity, in PD patients but not in NC. The higher scores on assessments reflecting prefrontal lobe function and well-preserved blood perfusion in prefrontal areas were correlated with lower IGT scores along with better motor learning ability. CONCLUSIONS Our findings suggest that better motor learning ability and higher gambling propensity are based on better prefrontal functions, which are in accordance with the theory that the prefrontal cortex is one of the common essential regions for both motor learning and ICDs.
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Affiliation(s)
- Naohisa Ueda
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan.,Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yuichi Higashiyama
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Asami Saito
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Yoshiharu Nakae
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Masanao Endo
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Chiharu Kugimoto
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hitaru Kishida
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Shigeru Koyano
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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Murayama T, Kobayashi S, Ishida T, Utsumi K, Kawanishi C. Associations Between Regional Cerebral Blood Flow and Psychiatric Symptoms in Dementia With Lewy Bodies Without Parkinsonism. Am J Alzheimers Dis Other Demen 2022; 37:15333175221075109. [PMID: 35171729 PMCID: PMC10581150 DOI: 10.1177/15333175221075109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Because dementia with Lewy bodies (DLB) has various psychiatric symptoms, early diagnosis in patients without parkinsonism is difficult. To reveal associations between regional brain perfusion and psychiatric symptoms in DLB patients without parkinsonism, we quantified brain perfusion using an automated brain perfusion single-photon emission computed tomography analysis program, FineSRT. We statistically analyzed the differences in brain perfusion between groups, divided by the presence or absence of psychiatric symptoms. In DLB patients with depression, there were significant brain perfusion increases in the left angular gyrus and right upper precuneus. In DLB patients with visual hallucinations, there were significant decreases in the left inferior parietal lobule, left superior temporal gyrus, and right primary visual cortex. In DLB patients with auditory hallucinations, there were significant increases in the right middle occipital and right inferior occipital gyri. Our findings provide clues about the pathomechanisms of psychiatric symptoms and may enable early diagnosis of DLB in the future.
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Affiliation(s)
- Tomonori Murayama
- Department of Neuropsychiatry, Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Psychiatry, Kushiro Red Cross Hospital, Kushiro, Japan
| | - Seiju Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
- Shinyukai Nakae Hospital, Sapporo, Japan
| | - Tomotaka Ishida
- Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan
| | - Kumiko Utsumi
- Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
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Tripathi M. Gamma camera imaging in ischemic diseases of CNS. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00192-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Whole-body vibration exercise and training increase regional CBF in mild cognitive impairment with enhanced cognitive function. Ann Nucl Med 2021; 36:82-94. [PMID: 34762232 DOI: 10.1007/s12149-021-01687-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Preclinical and non-medicinal interventions are essential for preventing and treating cognitive decline in patients with mild cognitive impairment (MCI). Whole-body vibration (WBV) exercise is conducted on a platform that generates vertical sinusoidal vibrations, and WBV training may improve regional cerebral blood flow (rCBF) and cognitive function, however, the underlying mechanism remains unclear. The aim of the present study was to investigate whether WBV exercise and a 24-week WBV training protocol increased rCBF and enhanced cognitive function in patients with amnestic MCI (aMCI). METHODS [99mTc]-ECD and SPECT studies were performed on 16 aMCI patients at baseline, during WBV exercise, and on 6 of the 16 patients after 24-week WBV training. To diagnose SPECT images and select the patients, a Z-score mapping approach was used, which revealed pathological hypoperfusion in the parietal association cortex, precuneus and/or posterior cingulate gyrus for MCI at baseline. rCBF was semi-quantitatively measured and underestimation in the high flow range was corrected. Since it is difficult to quantitatively measure rCBF during WBV exercise, the rCBFratio was obtained by standardizing with the average of individual mean SPECT counts with correcting underestimation in the high flow range. The rCBFratios at baseline and after WBV training were also obtained in a similar manner. Since the changes in rCBF were regarded as corresponding to the changes in rCBFratio, the ratios were compared. Cognitive function was also evaluated and compared. RESULTS We found that the rCBFratio changed with an average range of 11.5% during WBV exercise, and similar changes were observed after 24-week WBV training with a 13.0% change, resulting in improved cognitive function (MoCA-J, P = 0.028). The rCBFratio increased in the parietal association cortex and occipital lobes, including the precuneus and posterior cingulate gyrus, at which hypoperfusion was detected at baseline, but decreased in the frontal lobe and anterior cingulate gyrus. The rCBFratio increased on the right side of several motion-suppressive nuclei by WBV exercise; the bilateral red nuclei and right medial globus pallidus by WBV training. CONCLUSION WBV exercise and training increase rCBF in aMCI patients, and WBV training enhances cognitive function and may increase the cognitive reserve. Further investigation is necessary.
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Bermo M, Saqr M, Hoffman H, Patterson D, Sharar S, Minoshima S, Lewis DH. Utility of SPECT Functional Neuroimaging of Pain. Front Psychiatry 2021; 12:705242. [PMID: 34393862 PMCID: PMC8358271 DOI: 10.3389/fpsyt.2021.705242] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
Functional neuroimaging modalities vary in spatial and temporal resolution. One major limitation of most functional neuroimaging modalities is that only neural activation taking place inside the scanner can be imaged. This limitation makes functional neuroimaging in many clinical scenarios extremely difficult or impossible. The most commonly used radiopharmaceutical in Single Photon Emission Tomography (SPECT) functional brain imaging is Technetium 99 m-labeled Ethyl Cysteinate Dimer (ECD). ECD is a lipophilic compound with unique pharmacodynamics. It crosses the blood brain barrier and has high first pass extraction by the neurons proportional to regional brain perfusion at the time of injection. It reaches peak activity in the brain 1 min after injection and is then slowly cleared from the brain following a biexponential mode. This allows for a practical imaging window of 1 or 2 h after injection. In other words, it freezes a snapshot of brain perfusion at the time of injection that is kept and can be imaged later. This unique feature allows for designing functional brain imaging studies that do not require the patient to be inside the scanner at the time of brain activation. Functional brain imaging during severe burn wound care is an example that has been extensively studied using this technique. Not only does SPECT allow for imaging of brain activity under extreme pain conditions in clinical settings, but it also allows for imaging of brain activity modulation in response to analgesic maneuvers whether pharmacologic or non-traditional such as using virtual reality analgesia. Together with its utility in extreme situations, SPECTS is also helpful in investigating brain activation under typical pain conditions such as experimental controlled pain and chronic pain syndromes.
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Affiliation(s)
- Mohammed Bermo
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
| | - Mohammed Saqr
- School of Computing, University of Eastern Finland, Joensuu Campus, Joensuu, Finland.,EECS - School of Electrical Engineering and Computer Science, Media Technology & Interaction Design, KTH Royal Institute of Technology, Stockholm, Sweden
| | | | | | - Sam Sharar
- University of Washington, Seattle, WA, United States
| | | | - David H Lewis
- University of Washington, Seattle, WA, United States
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Futamura A, Hieda S, Mori Y, Sugimoto A, Kasai H, Kuroda T, Yano S, Kasuga K, Murakami H, Ikeuchi T, Ono K. Cingulate Island Sign in Single Photon Emission Computed Tomography: Clinical Biomarker Correlations in Lewy Body Disease and Alzheimer's Disease. J Alzheimers Dis 2020; 79:1003-1008. [PMID: 33361600 DOI: 10.3233/jad-201145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We compared 'CIScore' determined by quantitative single photon emission computed tomography studies of the cingulate island sign to cerebrospinal fluid (CSF) biomarkers in Lewy body disease (LBD) and Alzheimer's disease (AD) to assess its usefulness and pathological background. Among the 16 each age-matched LBD and AD patients, the CIScore differed significantly but was not correlated with CSF biomarkers. In LBD, hippocampal atrophy significantly correlated with Clinical Dementia Rating and CSF p-tau and t-tau levels. Our results showed CIS was not related to CSF biomarkers in LBD and high CSF tau levels were related to clinical disease severity and hippocampal atrophy.
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Affiliation(s)
- Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Hideyo Kasai
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Hidetomo Murakami
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.,Department of Neurology, School of Medicine, The Jikei University, Minato-ku, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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Okamoto K, Shiga H, Nakamura H, Matsui M, Miwa T. Relationship Between Olfactory Disturbance After Acute Ischemic Stroke and Latent Thalamic Hypoperfusion. Chem Senses 2020; 45:111-118. [PMID: 31873732 DOI: 10.1093/chemse/bjz077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Odor detection, recognition, and identification were assessed in 19 acute ischemic stroke patients who had no magnetic resonance imaging-detectable thalamic lesions but in whom technetium-99m ethyl cysteinate dimer single photon emission tomography revealed thalamic hypoperfusion. Although these patients were unaware of reduced olfactory function, they exhibited significantly lower scores in tests for odor identification and recognition threshold as compared with 9 ischemic stroke controls that had normal thalamic hypoperfusion. However, absolute odor detection thresholds were similar in the 2 groups. These results demonstrate the usefulness of cerebral perfusion scintigraphy in assessing sensory loss after ischemic stroke and provide further evidence for the role of the thalamus in olfaction.
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Affiliation(s)
- Kazuhiro Okamoto
- Department of Medical Technology, Kanazawa Medical University Hospital, Uchinada, Japan
| | - Hideaki Shiga
- Department of Otolaryngology, Kanazawa Medical University, Uchinada, Japan
| | - Hisako Nakamura
- Department of Central Clinical Laboratory, Kanazawa Medical University Hospital, Uchinada, Japan
| | - Makoto Matsui
- Department of Neurology, Kanazawa Medical University, Uchinada, Japan
| | - Takaki Miwa
- Department of Otolaryngology, Kanazawa Medical University, Uchinada, Japan
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Kaneta T. PET and SPECT imaging of the brain: a review on the current status of nuclear medicine in Japan. Jpn J Radiol 2020; 38:343-357. [DOI: 10.1007/s11604-019-00901-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/31/2019] [Indexed: 01/07/2023]
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10
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Nomoto S, Kinno R, Ochiai H, Kubota S, Mori Y, Futamura A, Sugimoto A, Kuroda T, Yano S, Murakami H, Shirasawa T, Yoshimoto T, Minoura A, Kokaze A, Ono K. The relationship between thyroid function and cerebral blood flow in mild cognitive impairment and Alzheimer's disease. PLoS One 2019; 14:e0214676. [PMID: 30943231 PMCID: PMC6447192 DOI: 10.1371/journal.pone.0214676] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/18/2019] [Indexed: 11/18/2022] Open
Abstract
The thyroid hormones have been reported to be associated with cognitive decline and Alzheimer’s disease. The relationship between thyroid function within the normal range and cerebral blood flow in Alzheimer’s disease patients has been shown in a recent study. Mild cognitive impairment is often the first stage of Alzheimer’s disease; thus, early diagnosis is important. The present study investigated the relationship between thyroid function and regional cerebral blood flow in patients with mild cognitive impairment and Alzheimer’s disease. A total of 122 memory clinic outpatients who underwent thyroid function testing and single photon emission computed tomography were divided into mild cognitive impairment, Alzheimer’s disease, and Normal groups. Regional cerebral blood flow was calculated using a three-dimensional stereotactic region of interest template in an automated cerebral perfusion single photon emission computed tomography analysis system. Multiple regression analysis adjusted for age and sex was conducted to examine the relationships between thyroid hormones and regional cerebral blood flow. Thyroid stimulating hormone was significantly associated with regional cerebral blood flow in the bilateral temporal, bilateral pericallosal, and bilateral hippocampal regions in the mild cognitive impairment group. In the Alzheimer’s disease group, free triiodothyronine was significantly associated with regional cerebral blood flow in the bilateral parietal, right temporal, and bilateral pericallosal regions. The present study showed the association of thyroid stimulating hormone with regional cerebral blood flow in the mild cognitive impairment group and the association of free triiodothyronine with regional cerebral blood flow in the Alzheimer’s disease group. These study findings could contribute to the early diagnosis of mild cognitive impairment at general memory clinics and the prevention of subsequent progression to Alzheimer’s disease.
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Affiliation(s)
- Shohei Nomoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Ryuta Kinno
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satomi Kubota
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hidetomo Murakami
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- * E-mail:
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Kameyama M, Watanabe K. A new non-invasive graphical method for quantification of cerebral blood flow with[[Formula: see text]] IMP. Ann Nucl Med 2018; 32:620-626. [PMID: 30046997 PMCID: PMC6208854 DOI: 10.1007/s12149-018-1282-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/17/2018] [Indexed: 11/16/2022]
Abstract
Objective [\documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I] N-isopropyl-p-iodoamphetamine (\documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I-IMP) is an ideal perfusion tracer for single photon emission computed tomography, which shows good linearity between cerebral blood flow (CBF) and accumulation. However, quantification of CBF using \documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I-IMP without arterial blood sampling has been challenging, with previous methods requiring empirically obtained regression formulae to estimate CBF. Furthermore, the CBF value obtained via some of the previous methods would be affected by the clearance rate of \documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I-IMP from the lungs. This paper introduces a new non-invasive quantification method for CBF using \documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I-IMP and dynamic planar images. Methods We have developed a theory based on Microsphere model. This method does not involve regression formulae for estimation and allows for direct measurement of CBF, considering the clearance rate of \documentclass[12pt]{minimal}
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\begin{document}$$^{123}\hbox {I}$$\end{document}123I-IMP from the lungs. The study method is executed as easily as conventional Graph-Plot method. We compared the CBF values obtained by our study method and the established autoradiograph (ARG) method. Results CBF values obtained using the new method demonstrated significant correlation with values determined using ARG method. Conclusions The novel method described presents a reliable and more simple way of determining CBF when compared to current methods.
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Affiliation(s)
- Masashi Kameyama
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. .,Division of Nuclear Medicine, Department of Radiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kiyotaka Watanabe
- Department of Product Plannning, Nihon Medi-Physics Co. Ltd., 3-4-10 Shinsuna, Koto-ku, Tokyo, 136-0075, Japan
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Preventive Treatment with Lomerizine Increases Cerebral Blood Flows during the Interictal Phase of Migraine. J Stroke Cerebrovasc Dis 2018; 27:998-1002. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/22/2017] [Accepted: 11/02/2017] [Indexed: 01/03/2023] Open
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Saruwatari K, Motomura N, Ito S, Uchiyama Y, Tanaka M. [Basic Investigation of a Cerebral Blood Flow Quantification Method without Blood Sampling Method (Improved Brain Uptake Ratio (IBUR)) Using a Fan-beam Collimator]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:1302-1312. [PMID: 30464098 DOI: 10.6009/jjrt.2018_jsrt_74.11.1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We performed a basic evaluation for measuring the input function using a fan-beam collimator. Furthermore, we examined the validity of the brain blood flow quantitative measurement from the input function. Using the fanbeam collimator, we imaged syringes of various diameters containing 99 mTc as well as a virtual aorta inside a thoracic phantom. We changed the collimator distance and angle in relation to the sources, and the syringe was placed in vertical and horizontal positions as well. For evaluation, we used region of interest (ROI) of various sizes and positions. Furthermore, we conducted clinical evaluation for 19 subjects and calculated whole-brain mean cerebral blood flow using improved brain uptake ratio method by examination of 99 mTc-ECD cerebral blood flow. For ROIs smaller in size than diameter of the syringes and virtual ascending aorta, amount of change in the ROI counts by fan-beam collimator became smaller as distance to the source became closer, with less than 5% at 175 mm. Also, change with respect to angle of the collimator was less than 5% at 20°. In a clinical study, aortas could be imaged without truncation and input-functions could be measured in all 19 patients. By using ROIs smaller than the aorta diameter and placing the collimator close to the source, it was suggested that fan-beam collimator can be used to determine the input function.
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Affiliation(s)
| | | | - Shigeki Ito
- Faculty of Life Sciences, Kumamoto University
| | | | - Minoru Tanaka
- Department of Radiology, Fukuoka University Hospital
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14
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Kinno R, Shiromaru A, Mori Y, Futamura A, Kuroda T, Yano S, Murakami H, Ono K. Differential Effects of the Factor Structure of the Wechsler Memory Scale-Revised on the Cortical Thickness and Complexity of Patients Aged Over 75 Years in a Memory Clinic Setting. Front Aging Neurosci 2017; 9:405. [PMID: 29270122 PMCID: PMC5725440 DOI: 10.3389/fnagi.2017.00405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/24/2017] [Indexed: 11/26/2022] Open
Abstract
The Wechsler Memory Scale-Revised (WMS-R) is one of the internationally well-known batteries for memory assessment in a general memory clinic setting. Several factor structures of the WMS-R for patients aged under 74 have been proposed. However, little is known about the factor structure of the WMS-R for patients aged over 75 years and its neurological significance. Thus, we conducted exploratory factor analysis to determine the factor structure of the WMS-R for patients aged over 75 years in a memory clinic setting. Regional cerebral blood flow (rCBF) was calculated from single-photon emission computed tomography data. Cortical thickness and cortical fractal dimension, as the marker of cortical complexity, were calculated from high resolution magnetic resonance imaging data. We found that the four factors appeared to be the most appropriate solution to the model, including recognition memory, paired associate memory, visual-and-working memory, and attention as factors. Patients with mild cognitive impairments showed significantly higher factor scores for paired associate memory, visual-and-working memory, and attention than patients with Alzheimer's disease. Regarding the neuroimaging data, the factor scores for paired associate memory positively correlated with rCBF in the left pericallosal and hippocampal regions. Moreover, the factor score for paired associate memory showed most robust correlations with the cortical thickness in the limbic system, whereas the factor score for attention correlated with the cortical thickness in the bilateral precuneus. Furthermore, each factor score correlated with the cortical fractal dimension in the bilateral frontotemporal regions. Interestingly, the factor scores for the visual-and-working memory and attention selectively correlated with the cortical fractal dimension in the right posterior cingulate cortex and right precuneus cortex, respectively. These findings demonstrate that recognition memory, paired associate memory, visual-and-working memory, and attention can be crucial factors for interpreting the WMS-R results of elderly patients aged over 75 years in a memory clinic setting. Considering these findings, the results of WMS-R in elderly patients aged over 75 years in a memory clinic setting should be cautiously interpreted.
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Affiliation(s)
| | | | | | | | | | | | | | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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15
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Tabei KI, Kida H, Hosoya T, Satoh M, Tomimoto H. Prediction of Cognitive Decline from White Matter Hyperintensity and Single-Photon Emission Computed Tomography in Alzheimer's Disease. Front Neurol 2017; 8:408. [PMID: 28928704 PMCID: PMC5591322 DOI: 10.3389/fneur.2017.00408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/28/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND While several studies support an association of white matter hyperintensity (WMH) volume and regional cerebral blood flow (rCBF) with cognitive decline in Alzheimer's disease (AD), no reports have simultaneously considered the effects of both factors on cognitive decline. OBJECTIVE The purpose of the present study was to compare WMH volume and rCBF in relation to cognitive function by developing a new software program to fuse magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) data. METHOD We used MRI, SPECT, and neuropsychological data from 182 serial outpatients treated at the memory clinic of our hospital. RESULTS Twenty-nine AD patients fulfilled the inclusion criteria (18 females, mean age: 73.1 ± 7.9 years, mean Mini-Mental State Examination: 23.1 ± 3.0). Analysis of variance revealed that posterior deep WMH (DWMH) volume was significantly larger than both anterior periventricular hyperintensity (PVH) and DWMH, and posterior PVH volumes. Multivariate regression analysis showed that increased volumes of the anterior PVH and the posterior DWMH and decreased rCBF of the parietal cortex negatively affected cognitive function. The other areas had no significant negative effects on cognitive function. CONCLUSION Our findings show that the volume of the posterior WMH was significantly larger than that of other areas, and the increased posterior WMH volume and decreased rCBF of the parietal cortex negatively affected cognitive function. Therefore, the posterior WMH volume and the parietal rCBF are key parameters of cognitive decline in AD patients.
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Affiliation(s)
- Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | | | - Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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Shibutani T, Onoguchi M, Miyamoto N, Yamamoto Y, Kinuya S. Influence of Attenuation Correction by Brain Perfusion SPECT/CT Using a Simulated Abnormal Bone Structure: Comparison Between Chang and CT Methods. J Nucl Med Technol 2017; 45:208-213. [PMID: 28705930 DOI: 10.2967/jnmt.117.189506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022] Open
Abstract
Brain perfusion SPECT has physical phenomena such as attenuation, scatter, and degradation of resolution that impair accuracy on data acquisition. Chang and CT methods have spread application for attenuation correction (AC) and indicate the utility of AC using a brain phantom without a bone or with a normal bone structure. However, nonuniform AC of an abnormal bone structure such as postoperative bone defect after burr-hole surgery has not yet been evaluated. Therefore, we evaluated the influence of nonuniform AC of an abnormal bone structure between the 2 AC methods. Methods: We created 5 brain phantoms simulating an abnormal bone structure such as frontal, occipital, and right temporal bone defects as well as with and without a bone, which compared the influence among 3-dimensional ordered-subset expectation maximization (OSEM) incorporating scatter, attenuation, and resolution recovery corrections, and obtained 3 reconstruction processing images: OSEM (non-AC; NAC), OSEM (Chang), and OSEM (CTAC). The average counts of the 5 brain phantoms by OSEM (NAC), OSEM (Chang), and OSEM (CTAC) were evaluated by a count profile curve and counts ratio in the region of interest. Results: The counts of OSEM (NAC) and OSEM (Chang) with a bone were approximately 7% higher than those without a bone, whereas OSEM (CTAC) had a similar count ratio. The count ratio of frontal or occipital lobes with a bone defect on both OSEM (NAC) and OSEM (Chang) was 5%-10% higher than that in frontal or occipital lobes without a bone defect; however, OSEM (CTAC) had nearly identical frontal or occipital lobes with and without a bone defect. Conclusion: We conducted a phantom study simulated with and without a bone defect to demonstrate the influence of brain counts between 2 different AC methods. Although the Chang method did not correct the influence of the bone defect due to the use of a uniform attenuation coefficient, the CTAC method correctly conducted AC regardless of the presence of a bone defect.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno, Kanazawa, Ishikawa, Japan.,Department of Nuclear Medicine, Graduate School of Medical Science, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Nanako Miyamoto
- Department of Radiology, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan; and
| | - Yasushi Yamamoto
- Department of Radiology, Shimane University Hospital, Enya, Izumo, Shimane, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Graduate School of Medical Science, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan
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17
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Kobayashi S, Makino K, Hatakeyama S, Ishii T, Tateno M, Iwamoto T, Tsujino H, Kawasaki K, Mikuni K, Ukai W, Murayama T, Hashimoto E, Utsumi K, Kawanishi C. The usefulness of combined brain perfusion single-photon emission computed tomography, Dopamine-transporter single-photon emission computed tomography, and 123 I-metaiodobenzylguanidine myocardial scintigraphy for the diagnosis of dementia with Lewy bodies. Psychogeriatrics 2017; 17:247-255. [PMID: 28130808 DOI: 10.1111/psyg.12227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/08/2016] [Accepted: 08/31/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Current diagnostic criteria recommend neuroimaging as a diagnostic support tool for the clinical diagnosis of dementia with Lewy bodies (DLB). Because DLB causes characteristic impairments and disabilities, such as neuroleptic hypersensitivity, which may significantly increase morbidity and mortality, its prompt and correct diagnosis is very important. The aim of this study was to evaluate the extent to which diagnostic accuracy can be increased by using different combinations of brain perfusion single-photon emission computed tomography (bp-SPECT), 123 I-metaiodobenzylguanidine myocardial scintigraphy (MIBG scintigraphy), and DAT-SPECT. Taking finances and patient burden into consideration, we compared the tests to determine priority. METHODS Thirty-four patients with probable DLB (75.0 ± 8.3 years old; 14 men, 20 women) underwent bp-SPECT, MIBG scintigraphy, and DAT-SPECT. RESULTS Our comparison of three functional imaging techniques indicated that MIBG scintigraphy (79%) and Dopamine-transporter (DAT) SPECT (79%) had better sensitivity for characteristic abnormalities in DLB than bp-SPECT (53%). The combination of the three modalities could increase sensitivity for diagnosis of DLB to 100%. Additionally, the ratio of patients with rapid eye movement sleep behaviour disorder was significantly higher in the positive finding group on MIBG scintigraphy than in the negative finding group. CONCLUSIONS In terms of stand-alone diagnostic means, priority should be placed on MIBG scintigraphy or DAT-SPECT for the diagnosis of DLB. However, our results suggest that the combination of bp-SPECT, MIBG scintigraphy, and DAT-SPECT increased the accuracy of the clinical diagnosis of DLB.
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Affiliation(s)
- Seiju Kobayashi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Kanae Makino
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | | | - Takao Ishii
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Masaru Tateno
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.,Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan
| | - Tomo Iwamoto
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Hanako Tsujino
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Kazuhito Kawasaki
- Department of Radiology, Sunagawa City Medical Center, Sunagawa, Japan
| | - Kouhei Mikuni
- Department of Radiology, Sunagawa City Medical Center, Sunagawa, Japan
| | - Wataru Ukai
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Tomonori Murayama
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Eri Hashimoto
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
| | - Kumiko Utsumi
- Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan
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18
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Imabayashi E, Yokoyama K, Tsukamoto T, Sone D, Sumida K, Kimura Y, Sato N, Murata M, Matsuda H. The cingulate island sign within early Alzheimer's disease-specific hypoperfusion volumes of interest is useful for differentiating Alzheimer's disease from dementia with Lewy bodies. EJNMMI Res 2016; 6:67. [PMID: 27620458 PMCID: PMC5020033 DOI: 10.1186/s13550-016-0224-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 09/06/2016] [Indexed: 11/12/2022] Open
Abstract
Background In addition to occipital hypoperfusion, preserved metabolism of the posterior cingulate gyri (PCG) relative to the precunei is known as the cingulate island sign (CIS) in the patients with dementia with Lewy bodies (DLB). CIS has been detected using [18F]fluorodeoxyglucose positron emission tomography but not using brain perfusion single-photon emission computed tomography (SPECT). The purpose of this study was to optimize brain perfusion SPECT to enable differentiation of DLB from Alzheimer’s disease (AD) using CIS and occipital hypoperfusion. Eighteen patients with probable DLB and 17 age-matched Pittsburgh compound B-positive patients with AD underwent technetium-99m ethyl cysteinate dimer SPECT. SPECT Z-score maps were generated using the easy Z-score imaging system (eZIS) analysis software (Matsuda H, Mizumura S, Nagao T, Ota T, Iizuka T, Nemoto K, Takemura N, Arai H, Homma A, AJNR Am J Neuroradiol 28(4):731–6, 2007), which included volumes of interest (VOIs) in which a group comparison between patients with AD and cognitively normal subjects revealed significant relative hypoperfusion. We used the Montreal Neurological Institute (MNI) space anatomical border to divide the bilateral PCG to precunei VOIs into two parts, the PCG and precunei. Z-scores in the PCG, precunei, and occipital areas and ratios were analysed and compared with receiver operating characteristic (ROC) curve analyses. Results The largest area under the curve (AUC) value for use in differentiating DLB from AD with the ratio of PCG to medial occipital was 0.87; the accuracy, sensitivity, and specificity were 85.7, 88.9, and 82.4 %, respectively. The AUC with the ratio of PCG to the precuneus was smaller, and it was 0.85, though no significant difference was observed between these two AUCs. Conclusions The Z-score ratio of the PCG within the early-AD-specific VOI to medial-occipital area is clinically useful in discriminating demented patients with DLB from those with AD. Electronic supplementary material The online version of this article (doi:10.1186/s13550-016-0224-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan.
| | - Kota Yokoyama
- Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, 162-8655, Shinjuku, Tokyo, Japan
| | - Tadashi Tsukamoto
- Department of Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
| | - Daichi Sone
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
| | - Kaoru Sumida
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, 113-8654, Bunkyoku, Tokyo, Japan
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
| | - Miho Murata
- Department of Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, 187-8551, Kodaira, Tokyo, Japan
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19
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Miyoshi F, Kanasaki Y, Shinohara Y, Fujii S, Kaminou T, Tanabe Y, Ogawa T. Significance of combined use of MRI and perfusion SPECT for evaluation of multiple system atrophy, cerebellar type. Acta Radiol 2016; 57:742-9. [PMID: 26253930 DOI: 10.1177/0284185115598810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/12/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Multiple system atrophy, cerebellar type (MSA-C) sometimes shows asymmetrical findings on magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). PURPOSE To assess the frequency and clinical significance of asymmetrical MRI and (99m)Tc-ethyl cysteinate dimer perfusion (ECD) SPECT findings of the cerebellum, middle cerebellar peduncle (MCP), and pons in MSA-C patients. MATERIAL AND METHODS We retrospectively reviewed 28 patients with MSA-C who underwent MRI and (99m)Tc-ECD SPECT and evaluated laterality of atrophy and signal changes on MRI, and laterality of perfusion on (99m)Tc-ECD SPECT transversely and longitudinally. RESULTS Laterality was identified for 64%, 61%, and 21% of atrophy in the cerebellum, MCP, and pons, respectively, on MRI and for 71% of atrophy in the cerebellum on perfusion SPECT. Concerning comparisons between the latest MRI and SPECT findings, laterality of cerebellar/MCP atrophy on MRI and decreased cerebellar perfusion on SPECT was matched in 57%, mismatched in 11%, and absent in 25% of patients. On past images, MRI and SPECT showed matched laterality in 33%, mismatched laterality in 27%, no laterality in 13%, and SPECT precedent laterality in 27% of patients. Including the latest and past images, asymmetrical changes were observed in 75% of patients. We could not identify any correlation between laterality of image findings and cerebellar symptoms in most patients. CONCLUSION Asymmetrical changes on MRI and perfusion SPECT are common in MSA-C patients. Perfusion SPECT is useful for diagnosing MSA-C in the early stages from a functional perspective.
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Affiliation(s)
- Fuminori Miyoshi
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Yoshiko Kanasaki
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Yuki Shinohara
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Shinya Fujii
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Toshio Kaminou
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Yoshio Tanabe
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University, Faculty of Medicine
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20
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Orita Y, Onodera A, Natsume T. [Devised a New Preoperative Simulation Using (99m)Tc-GSA SPECT Quantitative Method for Liver Resection]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2016; 72:50-57. [PMID: 26796933 DOI: 10.6009/jjrt.2016_jsrt_72.1.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE We developed a new imaging method to assess liver function by analyzing the amount of liver asialo single photon emission computed tomography (SPECT) using technetium-99m diethylenetriamine pentaacetic acid galactosyl human serum albumin ((99m)Tc-GSA) injection. A preoperative simulation using various regions of interest (ROIs) was performed, and the usefulness of the method for predicting the residual liver function was examined. METHODS Ninety-three patients were enrolled who underwent both asialo scintigraphy and dynamic computed tomography (CT) scanning. The two-dimensional dynamic data were analyzed using the Patlak plot method to calculate Kup and perfusion index (PI). The PIi (the quantity of GSA in a reference slice) was calculated using the PI. The qualitative SPECT data were analyzed using the quantitative images and the PIi, and we calculated the amount of asialo uptake per unit, which we named asialo uptake index (AUI). Volume registration was done between the collected breath holding SPECT data and CT images. RESULTS We were able to obtain AUI images and calculate the liver sparing ability by analyzing the two-dimensional data. The AUI and each of the liver counts (HH15, LHL15, LU15, and PI) were correlated, and we could perform the preoperative simulation using any ROI. CONCLUSION Preoperative simulation for the outcome of hepatectomy could be done using our new method employing quantitative SPECT.
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Affiliation(s)
- Yoshiko Orita
- Division of Radiology, Funabashi Municipal Medical Center
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21
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Shibutani T, Onoguchi M, Noguchi A, Yamada T, Tsuchihashi H, Nakajima T, Kinuya S. Reproducibility Between Brain Uptake Ratio Using Anatomic Standardization and Patlak-Plot Methods. J Nucl Med Technol 2015; 43:261-6. [DOI: 10.2967/jnmt.115.162115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 11/16/2022] Open
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22
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Watanabe M, Umezaki Y, Miura A, Shinohara Y, Yoshikawa T, Sakuma T, Shitano C, Katagiri A, Takenoshita M, Toriihara A, Uezato A, Nishikawa T, Motomura H, Toyofuku A. Comparison of cerebral blood flow in oral somatic delusion in patients with and without a history of depression: a comparative case series. BMC Psychiatry 2015; 15:42. [PMID: 25886053 PMCID: PMC4364484 DOI: 10.1186/s12888-015-0422-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 02/19/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A significant number of patients visit dental clinics because of unusual oral sensations for which no physical cause can be found. Such patients are recognized as having oral somatic delusion (OSD). OSD may be either primary (monosymptomatic) or secondary to another disease, such as depression or cerebral infarction. Although the presenting complaints of patients with primary and secondary OSD are nearly indistinguishable, symptoms in patients with secondary OSD seem to be resistant to treatment compared with those in patients with primary OSD. Moreover, right dominant cerebral blood flow (CBF) has been reported in patients with primary OSD, but the difference in CBF between patients with primary and secondary OSD remains unclear. The aim of this study was to assess the differences in clinical characteristics and CBF distribution between patients with monosymptomatic OSD (non-depression group) and OSD in conjunction with remitted depression (depression group). METHODS Participants were 27 patients of a psychosomatic dentistry clinic, all diagnosed with OSD. They were categorized into either the non-depression group (17 patients) or the depression group (10 patients) on the basis of assessments by their personal medical providers. CBF was examined using single-photon emission computed tomography. RESULTS There was no difference in clinical presentation between the two groups. A significant right dominant asymmetry in the temporal and posterior cerebral regions was observed in both groups. In the central region, a right dominance was seen in the non-depression group, while a left dominance was seen in the depression group. Moreover, the mean regional CBF values for patients in the depression group were significantly lower in several regions (including bilateral callosomarginal, precentral, angular, temporal, posterior cerebral, pericallosal, lenticular nucleus, thalamus, and hippocampus; and right central and cerebellum) than for patients in the non-depression group. CONCLUSION These results suggest that the temporal and posterior cerebral regions are involved in in the pathophysiology of OSD, regardless of depression history, and that widespread CBF reduction is a characteristic of remitted depression.
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Affiliation(s)
- Motoko Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Yojiro Umezaki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Anna Miura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Yukiko Shinohara
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Tatsuya Yoshikawa
- Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Tomomi Sakuma
- Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Chisa Shitano
- Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Ayano Katagiri
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Akira Toriihara
- Department of Diagnostic Radiology and Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Akihito Uezato
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Toru Nishikawa
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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Kaneda S, Takemura N, Yoshimura R. [Prediction of hyperperfusion after carotid artery stenting based on preoperative estimation of the cerebral blood flow (according to the Kuroda grading system) by single photon emission computed tomography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2015; 71:208-215. [PMID: 25797663 DOI: 10.6009/jjrt.2015_jsrt_71.3.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate whether preoperative estimation of the cerebral blood flow (CBF) by single photon emission computed tomography (SPECT) can allow identification of patients at risk for hyperperfusion (HP) after carotid artery stenting (CAS). In 40 patients scheduled to undergo CAS, the CBF and cerebral vascular reserve (CVR) were measured prior to the intervention by resting and acetazolamide loading SPECT. The SPECT findings were classified into 4 types: Type 1, normal CBF in the resting state (CBFrest) and normal CVR; Type 2, normal CBFrest and reduced CVR; Type 3, reduced CBFrest and reduced CVR; and Type 4, reduced CBFrest and normal CVR. Four patients presented with HP after CAS. Patients with high proportions of Type 2 and Type 3 had high risk of HP after CAS. (ROC analysis: AUC=0.94, cutoff value of 75.8% had PPV of 75.0%, NPV of 97.2% and odds ratio of 105.0). The proportions of Type 2 and Type 3 in preoperative SPECT may identify patients at risk for the development of HP.
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Takahashi S, Ukai S, Tsuji T, Ueyama T, Kono M, Yamanaka N, Shinosaki K. Reduction of cortical excitability and increase of thalamic activity in a low-frequency rTMS treatment for chronic tinnitus. Neurocase 2015; 21:339-44. [PMID: 24606019 DOI: 10.1080/13554794.2014.893000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has received increasing attention for the treatment of tinnitus, but its therapeutic mechanisms are unclear. We performed low-frequency rTMS treatment for a patient with chronic tinnitus and examined changes of cortical excitability and cerebral blood flow using paired-pulse TMS and single-photon emission computed tomography. After the rTMS treatment, tinnitus loudness was decreased, cortical excitability was reduced, and blood flow in the thalamus was increased. Our results suggest that low-frequency rTMS treatment reduces tinnitus loudness by an inhibitory effect on the cortical excitability and a remote activation effect on the thalamus through the corticothalamic networks.
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Affiliation(s)
- Shun Takahashi
- a Department of Neuropsychiatry , Wakayama Medical University , Wakayama , Japan
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25
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Imasaka KI, Yasaka M, Tayama E, Tomita Y. Obstructive carotid and/or intracranial artery disease rarely affects the incidence of haemodynamic ischaemic stroke during cardiac surgery: a study on brain perfusion single-photon emission computed tomography with acetazolamide. Eur J Cardiothorac Surg 2014; 48:739-46. [DOI: 10.1093/ejcts/ezu502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/26/2014] [Indexed: 11/14/2022] Open
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26
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Misch MR, Mitchell S, Francis PL, Sherborn K, Meradje K, McNeely AA, Honjo K, Zhao J, Scott CJ, Caldwell CB, Ehrlich L, Shammi P, MacIntosh BJ, Bilbao JM, Lang AE, Black SE, Masellis M. Differentiating between visual hallucination-free dementia with Lewy bodies and corticobasal syndrome on the basis of neuropsychology and perfusion single-photon emission computed tomography. ALZHEIMERS RESEARCH & THERAPY 2014; 6:71. [PMID: 25484929 PMCID: PMC4256921 DOI: 10.1186/s13195-014-0071-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 10/08/2014] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Dementia with Lewy bodies (DLB) and Corticobasal Syndrome (CBS) are atypical parkinsonian disorders with fronto-subcortical and posterior cognitive dysfunction as common features. While visual hallucinations are a good predictor of Lewy body pathology and are rare in CBS, they are not exhibited in all cases of DLB. Given the clinical overlap between these disorders, neuropsychological and imaging markers may aid in distinguishing these entities. METHODS Prospectively recruited case-control cohorts of CBS (n =31) and visual hallucination-free DLB (n =30), completed neuropsychological and neuropsychiatric measures as well as brain perfusion single-photon emission computed tomography and structural magnetic resonance imaging (MRI). Perfusion data were available for forty-two controls. Behavioural, perfusion, and cortical volume and thickness measures were compared between the groups to identify features that serve to differentiate them. RESULTS The Lewy body with no hallucinations group performed more poorly on measures of episodic memory compared to the corticobasal group, including the delayed and cued recall portions of the California Verbal Learning Test (F (1, 42) =23.1, P <0.001 and F (1, 42) =14.0, P =0.001 respectively) and the delayed visual reproduction of the Wechsler Memory Scale-Revised (F (1, 36) =9.7, P =0.004). The Lewy body group also demonstrated reduced perfusion in the left occipital pole compared to the corticobasal group (F (1,57) =7.4, P =0.009). At autopsy, the Lewy body cases all demonstrated mixed dementia with Lewy bodies, Alzheimer's disease and small vessel arteriosclerosis, while the corticobasal cases demonstrated classical corticobasal degeneration in five, dementia with agyrophilic grains + corticobasal degeneration + cerebral amyloid angiopathy in one, Progressive Supranuclear Palsy in two, and Frontotemporal Lobar Degeneration-Ubiquitin/TAR DNA-binding protein 43 proteinopathy in one. MRI measures were not significantly different between the patient groups. CONCLUSIONS Reduced perfusion in the left occipital region and worse episodic memory performance may help to distinguish between DLB cases who have never manifested with visual hallucinations and CBS at earlier stages of the disease. Development of reliable neuropsychological and imaging markers that improve diagnostic accuracy will become increasingly important as disease modifying therapies become available.
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Affiliation(s)
- Michael R Misch
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Sara Mitchell
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Philip L Francis
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Kayla Sherborn
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Katayoun Meradje
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Alicia A McNeely
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Kie Honjo
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Jiali Zhao
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Christopher Jm Scott
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Curtis B Caldwell
- Department of Medical Biophysics, Sunnybrook Health Sciences Centre, University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Lisa Ehrlich
- Department of Nuclear Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Prathiba Shammi
- Neuropsychology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, Sunnybrook Health Sciences Centre, University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Juan M Bilbao
- Department of Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ; Department of Medicine (Neurology), Brain Sciences Research Program, Sunnybrook Health Sciences, Centre University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ; Department of Medicine (Neurology), Brain Sciences Research Program, Sunnybrook Health Sciences, Centre University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ; Cognition & Movement Disorders Clinic, Sunnybrook Health Sciences Centre, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ; Neurogenetics Section, Centre for Addiction and Mental Health, University of Toronto, Room A4 42, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
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Development of an automatic ROI setting program for input function determination in 99mTc-ECD non-invasive cerebral blood flow quantification. Phys Med 2014; 30:513-20. [DOI: 10.1016/j.ejmp.2014.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 12/21/2013] [Accepted: 01/09/2014] [Indexed: 11/22/2022] Open
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Ihara Y, Takata H, Tanabe Y, Nobukuni K, Hayabara T. Influence of Repetitive Transcranial Magnetic Stimulation on Disease Severity and Oxidative Stress Markers in the Cerebrospinal Fluid Of Patients with Spinocerebellar Degeneration. Neurol Res 2013; 27:310-3. [PMID: 15845214 DOI: 10.1179/016164105x39897] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Ataxia severity, cerebellar hemispheric blood flow (CHBF), ascorbate free radical (AFR), superoxide dismutase protein, superoxide scavenging activity, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in cerebrospinal fluid (CSF) were compared before and after an 8-week course of repetitive transcranial magnetic stimulation (rTMS) in 20 patients with spinocerebellar degenerations (SCD). SCD patients showed higher AFR, 8-OHdG, and superoxide scavenging activity than 19 controls. In SCD patients, AFR and ataxia severity declined, and CHBF increased after rTMS. As the SCD patients showed negative correlations between ataxia severity and CHBF or superoxide scavenging activity, the therapeutic mechanism of rTMS may involve decreased oxidative stress and increased CHBF.
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Affiliation(s)
- Yuetsu Ihara
- Clinical Research Institute and Department of Neurology, National Hospital Organization Minami-Okayama Medical Center, 4066 Hayashima-cho, Tsukubo-gun, Okayama 701-0304, Japan.
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Jung YJ, Kim MS, Choi BY, Chang CH. Fusiform aneurysm on the basilar artery trunk treated with intra-aneurysmal embolization with parent vessel occlusion after complete preoperative occlusion test. J Korean Neurosurg Soc 2013; 53:235-40. [PMID: 23826480 PMCID: PMC3698234 DOI: 10.3340/jkns.2013.53.4.235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 10/17/2012] [Accepted: 04/08/2013] [Indexed: 11/27/2022] Open
Abstract
Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a 7.1×11.0 mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.
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Affiliation(s)
- Young-Jin Jung
- Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea
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Takahashi S, Ukai S, Tsuji T, Kose A, Shoyama M, Yamamoto M, Okumura M, Shinosaki K. Cerebral blood flow in the subgenual anterior cingulate cortex and modulation of the mood-regulatory networks in a successful rTMS treatment for major depressive disorder. Neurocase 2013; 19:262-7. [PMID: 22512803 DOI: 10.1080/13554794.2012.667121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The subgenual anterior cingulate cortex (Cg25) has been reported to be a node of mood-regulatory networks. Using a responder and a non-responder of repetitive transcranial magnetic stimulation (rTMS) for depression, we examined pre/post-treatment cerebral blood flow (CBF) in the Cg25 and treatment-related CBF changes in cortical/subcortical regions. In the responder, pre-treatment Cg25 perfusion was higher and was decreased after treatment, in addition, CBF was increased in the frontal and parietal regions and decreased in the hippocampus and basal ganglia. Our results suggest that rTMS treatment response may be related to pre-treatment Cg25 activity and modulation of the Cg25 and mood-regulatory networks.
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Affiliation(s)
- Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.
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Brain perfusion asymmetry in patients with oral somatic delusions. Eur Arch Psychiatry Clin Neurosci 2013; 263:315-23. [PMID: 23354990 PMCID: PMC3668126 DOI: 10.1007/s00406-013-0390-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 01/15/2013] [Indexed: 12/15/2022]
Abstract
Oral cenesthopathy is a somatic delusion or hallucination involving the oral area and is categorized as a delusional disorder, somatic type. The pathophysiology of this intractable condition remains obscure. In this study, we clarified the pathophysiology of oral cenesthopathy by evaluating regional brain perfusion. We performed single photon emission computed tomography (SPECT) using (99m)Tc-ethylcysteinate dimer in 16 subjects (cenesthopathy:control = 8:8). The SPECT images were visually assessed qualitatively, and quantitative analyses were also performed using a three-dimensional stereotactic region-of-interest template. The visual assessment revealed a right > left perfusion asymmetry in broad areas of the brain among the patients. The quantitative analysis confirmed that the regional cerebral blood flow values on the right side were significantly larger than those on the left side for most areas of the brain in the patients. A comparison of the R/(R + L) ratios in both groups confirmed the significant brain perfusion asymmetry between the two sides in the callosomarginal, precentral, and temporal regions in the patients. Qualitative evaluation of the SPECT images revealed right > left brain perfusion asymmetry in broad regions of the brain. Moreover, the quantitative analyses confirmed the perfusion asymmetry between the two sides in the frontal and temporal areas. Those may provide the key for elucidation of the pathophysiology of oral cenesthopathy.
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Functional lesions in dysphagia due to acute stroke: discordance between abnormal findings of bedside swallowing assessment and aspiration on videofluorography. Neuroradiology 2012; 55:413-21. [DOI: 10.1007/s00234-012-1117-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
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Ito S, Takaki A, Inoue S, Tomiguchi S, Shiraishi S, Akiyama Y, Sasaki T, Odajima S, Teraoka S, Hosoya T, Soma T, Miyazaki Y, Kinuya S, Yamashita Y. Improvement of the 99mTc-ECD brain uptake ratio (BUR) method for measurement of cerebral blood flow. Ann Nucl Med 2012; 26:351-8. [DOI: 10.1007/s12149-012-0582-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Inoue S, Kabuto T, Masunaga S, Souma T, Takaki A, Hosoya T, Yoshioka K, Ito S. [Determination of the optimal ROI setting position of the input function for the ⁹⁹mTc-ethyl cysteinate dimmer brain uptake ratio method]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2012; 68:269-276. [PMID: 22449903 DOI: 10.6009/jjrt.2012_jsrt_68.3.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Determination of the input function for the (99m)Tc-ethyl cysteinate dimmer brain uptake ratio ((99m)Tc-ECD BUR) method as a non-invasive quantitative measurement of cerebral blood flow measurement is of critical importance in order to improve the accuracy of this method. The input functions were experimentally obtained by setting the regions of interest (ROIs) in the ascending aorta, aortic arch, and descending aorta on the 49 chest RI-angio images. rCBFs by the BUR method with 3 input functions of the 6 cases were compared with those by the (123)I-iodoamphetamine (IMP) continuous arterial blood sampling method in order to determine the best location for the ROI of the input function. The input function of the ascending aorta was higher than those of the aortic arch and the descending aorta. The input functions of the aortic arch and the descending aorta decreased due to the origin of the three branches of the right brachiocephalic artery, left subclavian artery, and left common carotid artery. A good correlation was found in the regional cerebral blood flow (rCBF) values between the (123)I-IMP continuous arterial blood sampling method and the (99m)Tc-ECD BUR method with the input function of the ascending aorta. Therefore, the ascending aorta is the best location for the ROI of the input function for the (99m)Tc-ECD BUR method.
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Affiliation(s)
- Shinya Inoue
- Graduate School of Health Sciences, Kumamoto University
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Kim MS, Kim JS, Yun SC, Lee CW, Song JK, Park SW, Park SJ, Kim JJ. Association of cerebral blood flow with the development of cardiac death or urgent heart transplantation in patients with systolic heart failure. Eur Heart J 2011; 33:354-62. [PMID: 21893490 DOI: 10.1093/eurheartj/ehr345] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Although cerebral blood flow (CBF) is known to be low in patients with advanced systolic heart failure (HF), little is known of the prognostic significance of this observation. We investigated whether CBF might be associated with the development of adverse outcomes in systolic HF, and whether it might provide prognostic information in addition to that provided by exercise tests. METHODS AND RESULTS We performed a prospective observational study involving 224 systolic HF patients (left ventricular ejection fraction ≤35%). The study endpoint was the occurrence of cardiac death or urgent heart transplantation. Global CBF was measured using radionuclide angiography. Clinical, biochemical, echocardiographic, and exercise data were also obtained. During follow-up (median 36 months), 52 patients experienced death or urgent transplantation. Multivariable analysis showed that global CBF, the minute ventilation/carbon dioxide production (VE/VCO(2)) slope, New York Heart Association functional class ≥III, symptom duration ≥12 months, serum sodium, and serum creatinine were associated with the development of the endpoint. Patients with a CBF <35.4 mL/min/100 g were at increased risk of death or urgent transplantation (hazard ratio = 2.47; 95% confidence interval, 1.35-4.52). The addition of global CBF to a prognostic model including the VE/VCO(2) slope increased the C-index for the prediction of adverse outcomes with borderline significance. CONCLUSION Cerebral blood flow was associated with the development of long-term outcomes in systolic HF, and therefore may be useful in identifying patients suitable for heart transplantation. This finding is especially relevant for patients in whom exercise tests may not be performed sufficiently.
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Affiliation(s)
- Min-Seok Kim
- Heart Failure and Cardiac Transplantation Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, Korea
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Iwata T, Mori T, Tajiri H, Miyazaki Y, Nakazaki M. Long-term Angiographic and Clinical Outcome Following Stenting by Flow Reversal Technique for Chronic Occlusions Older Than 3 Months of the Cervical Carotid or Vertebral Artery. Neurosurgery 2011; 70:82-90; discussion 90. [DOI: 10.1227/neu.0b013e31822e074c] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND
Long-term angiographic and clinical outcome following stenting by flow reversal technique (FRT) for chronic occlusions (COs) of the cervical internal carotid artery (ICA) or vertebral artery (VA) is unknown.
OBJECTIVE
The aim of our retrospective study was to investigate the feasibility, safety, and long-term outcome of stenting by FRT for COs of the cervical ICA or VA.
METHODS
Included for analysis were patients (1) who underwent stenting for COs of the ICA or VA older than 3 months by FRT, and (2) who finished at least 1-year follow-up angiographic and clinical investigation. Criteria of stenting for CO in the ICA or VA were patients (1) who experienced minor strokes, a transient ischemic attack, or transient symptoms probably due to hemodynamic compromise or insufficiency, (2) angiographic complete occlusion of the ICA or VA, and (3) occlusion limited in the cervical area of the affected artery.
RESULTS
During the study period, 6 patients underwent stenting by FRT for cervical COs successfully, ICAs in 4 cases and VAs in 2 cases. The prestenting angiographically estimated occlusion length ranged from 50 to 130 mm. Total length of the deployed stents ranged from 30 to 108 mm. No complications occurred during the periprocedural period. Neither transient ischemic events nor restenosis has occurred during the follow-up period.
CONCLUSION
COs of the cervical carotid or vertebral arteries older than 3 months can be opened safely with FRT, and 1-year angiographic and long-term clinical outcome is favorable.
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Affiliation(s)
- Tomonori Iwata
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Takahisa Mori
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Hiroyuki Tajiri
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Yuichi Miyazaki
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Masahito Nakazaki
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
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Kimura N, Kumamoto T, Masuda T, Nomura Y, Hanaoka T, Hazama Y, Okazaki T. Evaluation of the Effects of Thyrotropin Releasing Hormone (TRH) Therapy on Regional Cerebral Blood Flow in the Cerebellar Variant of Multiple System Atrophy Using 3DSRT. J Neuroimaging 2011; 21:132-7. [DOI: 10.1111/j.1552-6569.2009.00411.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Iwata T, Mori T, Tajiri H, Nakazaki M. Predictors of Hyperperfusion Syndrome Before and Immediately After Carotid Artery Stenting in Single-Photon Emission Computed Tomography and Transcranial Color-Coded Real-Time Sonography Studies. Neurosurgery 2011; 68:649-55; discussion 655-6. [DOI: 10.1227/neu.0b013e3182077ed8] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Hyperperfusion syndrome (HPS) is a critical complication after carotid artery stenting (CAS) and carotid endarterectomy (CEA).
OBJECTIVE:
To identify predictors of HPS before and immediately after CAS.
METHODS:
We analyzed patients who underwent elective CAS from 2005 to 2008, and underwent single-photon emission computed tomography (SPECT) and transcranial color-coded real-time sonography before and immediately after CAS. HPS was defined as post-CAS deteriorating neurological conditions with headache not secondary to cerebral ischemia. We assessed the measures of blood flow between the two cortical hemispheres by taking the ratio of cerebral blood flow (CBF) of the affected to unaffected hemisphere excluding any ischemic/infarcted areas (asymmetry index); the measures of blood flow within each cortical hemisphere by comparing the CBF in the affected cortical hemispheric area to the CBF in the ipsilateral cerebellar hemisphere (middle cerebral artery [MCA]-to-cerebellar activity ratio); cerebral vasoreactivity (CVR); MCA mean blood flow velocity in the affected hemisphere; and MCA mean blood flow velocity ratio (preoperative to postoperative).
RESULTS:
Sixty-four patients were analyzed retrospectively. Nine patients presented with HPS. Logistic regression analysis showed that CVR (P < .01) and MCA mean blood flow velocity (P < .05) were the significant predictors among the pre-CAS variables, and that MCA mean blood flow velocity ratio (P < .05) and MCA-to-cerebellar activity ratio change (P < .05) were significant predictors among the post-CAS variables.
CONCLUSION:
SPECT and transcranial color-coded real-time sonography studies are useful in predicting HPS.
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Affiliation(s)
- Tomonori Iwata
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura City, Kanagawa 247-8533, Japan
| | - Takahisa Mori
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura City, Kanagawa 247-8533, Japan
| | - Hiroyuki Tajiri
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura City, Kanagawa 247-8533, Japan
| | - Masahito Nakazaki
- Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura City, Kanagawa 247-8533, Japan
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Kishimoto Y, Terada S, Sato S, Yoshida H, Honda H, Takeda N, Oshima E, Ishihara T, Kuroda S. Repetitive questioning behavior in Alzheimer's disease: relationship to regional cerebral blood flow. Psychiatry Res 2010; 184:151-6. [PMID: 20971619 DOI: 10.1016/j.pscychresns.2010.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 04/29/2010] [Accepted: 06/08/2010] [Indexed: 10/18/2022]
Abstract
Repetitive questioning is among the most common and burdensome of the behavioral and psychological symptoms of Alzheimer's disease (AD). Regardless of the clinical significance of the repetitive questioning, the neural substrates involved remain unclear. Fifty-eight consecutive patients with AD participated in this study. The score of repetitive questioning behavior was evaluated by multiplying the severity by the frequency of the behavior. They underwent brain SPECT with (99m)Tc-ethylcysteinate dimer. Scores of repetitive questioning behavior had a significant positive correlation with regional cerebral blood flow (rCBF) in the bilateral pericallosal regions. After removing the effect of memory test scores, we found a significant positive correlation of scores of repetitive questioning behavior to rCBF in the left pericallosal region. The pericallosal region includes the upper precuneus, cingulate, and posterior cingulate cortices on 3DSRT. Repetitive questioning behavior among AD patients might be a manifestation of mental state associated with a relative increase or preservation of rCBF in the left pericallosal region.
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Affiliation(s)
- Yuki Kishimoto
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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Alleviation of brain hypoperfusion after preventative treatment with lomerizine in an elderly migraineur with aura. INTERNATIONAL JOURNAL OF MOLECULAR IMAGING 2010; 2011:782758. [PMID: 21490733 PMCID: PMC3065840 DOI: 10.1155/2011/782758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 12/06/2010] [Indexed: 11/17/2022]
Abstract
Previous studies of brain single-photon emission tomography (SPECT) showed changes of regional cerebral blood flow (rCBF) in migraineurs during prodromes or headache attacks. Little is known about how successful medication of migraine prevention can reflect rCBF in migraineurs. We highlighted alternation of brain SPECT findings in a migraineur with aura before and after prophylactic treatment with lomerizine, a calcium channel blocker. A 70-year-old man with migraine developed visual disturbance frequently at walking exercise for the recent 3 months. After this visual attack, a mild-degree of throbbing headache occured occasionally. Brain SPECT using 99mTc-ethyl cysteinate dimer was performed at interictal time of migraine. Brain SPECT before lomerizine treatment revealed hypoperfusion in the frontal, parietal, and occipital regions. He was diagnosed with recurrence of migraine with aura (MA). Lomerizine (10 mg/day, po) was administered for 3 months. MA and visual aura without headache were dramatically improved. Migraine attacks and visual disturbance were not induced at exercise. At 3 months after lomerizine medication, brain SPECT showed remarkable increase of rCBF. These SPECT changes of our patient indicated that antimigraine mechanism of lomerizine could contribute to restoration of cerebral hypoperfusion.
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Abe A, Ueda T, Ueda M, Nogoshi S, Nishiyama Y, Katayama Y. Recovery of cerebrovascular reserves after stenting for symptomatic carotid artery stenosis. Interv Neuroradiol 2010; 16:420-8. [PMID: 21162772 DOI: 10.1177/159101991001600408] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 10/11/2010] [Indexed: 11/16/2022] Open
Abstract
Although a decrease in cerebrovascular reserves (CVR) is known to enhance the risk of stroke, changes in this parameter after carotid artery stenting (CAS) have rarely been investigated. The present study is the first to compare CVR recoveries after applying CAS to patients with symptomatic carotid artery disease. CAS was performed for 31 consecutive patients with symptomatic carotid artery disease. They underwent acetazolamide-challenged single photon emission computed tomography (SPECT) before and after CAS to obtain data on resting stage cerebral blood flow (CBF(rest) values) in various regions of interest (ROIs) defined by a three-dimensional stereotactic ROI template. CVR values on ipsilateral and contralateral hemispheric sides were then calculated based on the CBF(rest) data. The 31 patients were dichotomized into unilateral (n=22) and bilateral (n=9) lesion groups, and no significant between-group differences were observed in CBF(rest) before and after CAS. In the unilateral group, there were no differences in CVR values before and after CAS. In the bilateral group, however, the CVR values significantly increased in nearly all the investigated ROIs on the contralateral side. Also, the hemispheric CVR values on both sides significantly increased after CAS in the bilateral group, while no such increase was observed in the unilateral group. CAS in patients with symptomatic bilateral carotid artery disease has the potential utility for their haemodynamic improvement even on the contralateral hemispheric side.
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Affiliation(s)
- A Abe
- Department of Strokology, Yokohama Brain and Stroke Center, Kanagawa, Japan.
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Regional cerebral blood flow in healthy volunteers measured by the graph plot method with iodoamphetamine SPECT. Ann Nucl Med 2010; 25:255-60. [PMID: 21153452 DOI: 10.1007/s12149-010-0451-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The graph plot method, a technique that uses N-isopropyl-(123)I-p-iodoamphetamine (IMP) and single photon emission computed tomography (SPECT) for non-invasive measurement of regional cerebral blood flow (CBF), has been developed and applied in the clinical setting, although it has been performed without obtaining normal CBF values in normal, healthy subjects. The aim of this study was to measure normal regional CBF in older healthy subjects with IMP SPECT and the graph plot method. SUBJECTS AND METHODS Eleven healthy volunteers (mean age: 63.5 ± 8.9 years; six males and five females) were recruited and regional CBF was measured using IMP SPECT and the graph plot method. RESULTS The averaged global CBF was 45.4 ml/100 g/min. The distribution of regional CBF was almost homogenous in the cortices. There was no significant correlation between the global CBF and age in subjects aged 50-80 years. CONCLUSION We used the IMP graph plot method to measure regional CBF in normal healthy subjects, without arterial blood sampling, and obtained compatible CBF values. This method is non-invasive and convenient for determination of regional CBF in the clinical setting.
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Suzuki Y, Oishi M, Ogawa K, Mizutani T. Atrophy of the parahippocampal gyrus and regional cerebral blood flow in the limbic system in chronic alcoholic patients. Alcohol 2010; 44:439-45. [PMID: 20804943 DOI: 10.1016/j.alcohol.2010.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 05/06/2010] [Accepted: 05/06/2010] [Indexed: 10/19/2022]
Abstract
This study investigated regional cerebral flood flow (CBF) in chronic alcoholic patients, focusing primarily on the limbic system, including the hippocampus and the callosomarginal region, because of their susceptibility to damage in such patients. The degree of hippocampal atrophy in such patients was also examined. Regional CBF and the degree of parahippocampal gyrus atrophy were studied in 22 chronic alcoholic male patients with no neurological or psychological symptom (mean age, 59.3+/-4.1 years). Their findings were compared with those of 22 age-matched, male, normal controls (mean age, 59.7+/-3.9 years). Single-photon emission computed tomography was performed using the (99m)Tc-ethylcysteinate dimer ( (99m)Tc-ECD) Patlak Plot method, and the three-dimensional stereotaxic region of interest (ROI) template (3DSRT) and the fine stereotaxic ROI template (fine SRT) developed by Takeuchi et al were used to evaluate regional CBF, focusing primarily on the limbic system. These methods make it possible to precisely and objectively measure the details of regional CBF. The voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to determine the degree of parahippocampal gyrus atrophy in chronic alcoholic patients. VSRAD is a method developed by Hirata et al for evaluating the degree of atrophy of the parahippocampal gyrus. The results were analyzed using Z scores (>2 indicating significant atrophy). Blood flows in the callosomarginal region, pericallosal region, thalamus, hippocampus, parahippocampal gyrus, amygdaloid body, anterior cingulate gyrus, and middle cingulate gyrus were lower in the chronic alcoholic group than in the control group. Parahippocampal gyrus atrophy was not observed in the control group (average Z score, 0.62+/-0.29). In contrast, an atrophic tendency was observed in the chronic alcoholic group (average Z score, 1.88+/-0.44). Clinically intact, chronic alcoholic patients with no neurological or psychological symptom had decreased CBF in the limbic system and a tendency to parahippocampal gyrus atrophy.
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Evaluation of the effect of thyrotropin releasing hormone (TRH) on regional cerebral blood flow in spinocerebellar degeneration using 3DSRT. J Neurol Sci 2009; 281:93-8. [DOI: 10.1016/j.jns.2009.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 12/31/2008] [Accepted: 01/26/2009] [Indexed: 12/12/2022]
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Nagasawa N, Yamakado K, Yamada T, Nakanishi S, Ito M, Suzawa N, Kitano T, Takeda K. Three-dimensional stereotactic ROI template for measuring regional cerebral blood flow in 99mTc-ECD SPECT: comparison with the manual tracing method. Nucl Med Commun 2009; 30:155-9. [DOI: 10.1097/mnm.0b013e328314b8a8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sonohara K, Toba K, Nakai R, Kobayashi Y, Moriya Y, Hasegawa H, Kozaki K, Matsuda H. [Localized cerebral blood flow changes in response to ADL-related vitality in elderly patients with dementia using single photon emission computed tomography]. Nihon Ronen Igakkai Zasshi 2008; 45:615-621. [PMID: 19179793 DOI: 10.3143/geriatrics.45.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM To clarify the area in the brain related to responsible for vitality and volition. METHODS We studied 123 outpatients (39 men, 84 women, 77.7+/-6.7 years old) who visited the Center for comprehensive care on memory disorders in Kyorin University Hospital. No patients were prescribed with anti-depressants, anti-anxiety agents, psychomimetics, acetylcholinesterase inhibitors, Chinese herbal medicines or cerebrovascular circulation modifying drugs. Patients with frontotemporal dementia or depression were excluded. ADL-related vitality and volition was measured by a vitality index. Cerebral brain blood flow was measured by single photon emission computed tomography (99mTc-ECD SPECT). Relative blood flow changes were calculated by Statistical Parametric Mapping (SPM). Absolute blood flow changes were calculated by a three-dimensional stereotaxic ROI template on anatomically standardised 99mTc-ECD SPECT (3D SRT). Statistically significant correlations between semi-quantitatively measured scores of vitality index and blood flow changes in SPM and 3D-SRT were tested and displayed on a brain map. RESULTS Analysis of relative and absolute blood flow showed that the common responsible area in the brain related to vitality was the frontal lobe, fronto-cingulate gyrus, temporal lobe, basal ganglia (caudate nucleus) and thalamus. Blood flow changes in the orbital gyrus were strongly correlated with vitality index specially in the frontal lobe. CONCLUSION ADL-related vitality is affected mainly by the blood flow in the frontal-subcortical circuit. However, deep white matter was also important to determine vitality and volition.
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Affiliation(s)
- Kazuki Sonohara
- Department of Geriatric Medicine, Kyorin University School of Medicine
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Usefulness of rCBF analysis in diagnosing Parkinson’s disease: supplemental role with MIBG myocardial scintigraphy. Ann Nucl Med 2008; 22:557-64. [DOI: 10.1007/s12149-008-0156-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Accepted: 02/04/2008] [Indexed: 10/21/2022]
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Tateno M, Utsumi K, Kobayashi S, Takahashi A, Saitoh M, Morii H, Fujii K, Teraoka M. Usefulness of a blood flow analyzing program 3DSRT to detect occipital hypoperfusion in dementia with Lewy bodies. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1206-9. [PMID: 18433968 DOI: 10.1016/j.pnpbp.2008.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Revised: 02/18/2008] [Accepted: 03/10/2008] [Indexed: 10/22/2022]
Abstract
In the latest criteria for the clinical diagnosis of dementia with Lewy bodies (DLB), supportive features include generalized low uptake on SPECT/PET perfusion scan with reduced occipital activity. In this study, we investigated the usefulness of a cerebral blood flow (CBF) quantification program '3DSRT' in detecting occipital hypoperfusion in DLB. Twenty two patients with probable DLB, 38 patients with probable Alzheimer's disease (AD) and 16 normal controls underwent brain perfusion SPECT. Compared with AD, DLB patients had a bilateral lower CBF in the posterior cerebral segments. The correlation of clinical symptoms and brain blood perfusion was examined by dividing the subjects into subgroups. DLB patients with Parkinsonism, when compared to non-Parkinsonism subgroup, had a lower CBF throughout the cerebrum with statistical significance in the posterior cerebral segments. The quantitative analysis of brain perfusion SPECT by 3DSRT could be a useful supportive measurement in the diagnosis of DLB.
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Affiliation(s)
- Masaru Tateno
- Department of Neuropsychiatry, Sapporo Medical University, Sapporo, Japan.
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