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Odano I, Maeyatsu F, Hosoya T, Asari M, Oba K, Taki Y. Diagnostic approach with Z-score mapping to reduce artifacts caused by cerebral atrophy in regional CBF assessment of mild cognitive impairment (MCI) and Alzheimer's disease by [ 99mTc]-ECD and SPECT. Jpn J Radiol 2024; 42:508-518. [PMID: 38351252 PMCID: PMC11056337 DOI: 10.1007/s11604-023-01526-8] [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] [Received: 10/25/2023] [Accepted: 12/21/2023] [Indexed: 04/30/2024]
Abstract
PURPOSE The aim of this study was to develop a novel approach that enhanced diagnostic accuracy in the diagnosis of mild cognitive impairment (MCI) and early Alzheimer's disease (AD) using cerebral perfusion SPECT by minimizing artifacts caused by cerebral atrophy. MATERIALS AND METHODS [99mTc]-ECD and SPECT studies were performed on 15 cognitively normal patients, 40 patients with MCI, and 16 patients with AD. SPECT images were compared using SPM. The atrophy correction method was incorporated to reduce artifacts through the MRI masking procedure. Regional Z-score, percent extent, and atrophy correction rate were obtained and compared. The Z-score mapping program was structured as a single package that ran semi-automatically. RESULTS The method significantly reduced regional Z-score in most regions, leading to improved estimates. The mean atrophy correction rate ranged from 10.4 to 12.0%. In MCI and AD, the convexities of the frontal and parietal lobes and the posterior medial cerebrum were particularly sensitive to cerebral atrophy, and the Z-scores were overestimated, whereas the posterior cingulate cortex and the cerebellum were less sensitive. The diagnostic accuracy for MCI increased from 67 to 69% and for AD from 78 to 82%. CONCLUSION The proposed approach provided more precise Z-scores with less over- or underestimation, artifacts, and improved diagnostic accuracy, being recommended for clinical studies.
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Affiliation(s)
- Ikuo Odano
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan.
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan.
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan.
| | - Fumio Maeyatsu
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan
| | - Tetsuo Hosoya
- Department of Software Development. Division of Quality, Safety Management and Regulatory Affairs, PDRadiopharma. Inc., Tokyo, Japan
| | - Mami Asari
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan
| | - Kentaro Oba
- Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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Sakurai Y. Tactually-related cognitive impairments: sharing of neural substrates across associative tactile agnosia, agraphesthesia, and kinesthetic reading difficulty. Acta Neurol Belg 2023; 123:1893-1902. [PMID: 36336779 DOI: 10.1007/s13760-022-02130-9] [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] [Received: 01/07/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION A precise understanding of the neural substrates underlying tactually-related cognitive impairments such as bilateral tactile agnosia, bilateral agraphesthesia, kinesthetic alexia and kinesthetic reading difficulty is currently incomplete. In particular, recent data have implicated a role for the lateral occipital tactile visual region, or LOtv, in tactile object naming (Amedi et al. Cerebral Cortex 2002). Thus, this study set out to examine the degree to which the LOtv may be involved in tactually-related cognitive impairments by examining two unique cases. METHODS To assess whether LOtv or the visual word form area (VWFA) is involved in tactually-related cognitive impairments, the average activation point of LOtv and that of VWFA were placed on the single-photon emission computed tomography (SPECT) cerebral blood flow images of two patients: one with bilateral associative tactile agnosia, bilateral agraphesthesia, and ineffective kinesthetic reading, and the other with kinesthetic reading difficulty. RESULTS The average LOtv coordinate was involved in the area of hypoperfusion in both patients, whereas that of VWFA was not included in any of the hypoperfused areas. CONCLUSIONS The results support the view that interruption of LOtv or disconnection to LOtv and to VWFA may cause these tactually-related cognitive impairments. Further, bilateral associative tactile agnosia and bilateral agraphesthesia are attributable toward the damage of the occipital lobe, whereas unilateral or predominantly one-sided associative tactile agnosia and agraphesthesia are attributable toward the damage of the parietal lobe.
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Affiliation(s)
- Yasuhisa Sakurai
- Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, Tokyo, 101-8643, Japan.
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Michopoulou SK, Dickson JC, Gardner GG, Gee TR, Fenwick AJ, Melhuish T, Monaghan CA, O’Brien N, Prosser AM, Scott CJ, Staff RT, Taylor J. Brain PET and SPECT imaging and quantification: a survey of the current status in the UK. Nucl Med Commun 2023; 44:834-842. [PMID: 37464866 PMCID: PMC10498883 DOI: 10.1097/mnm.0000000000001736] [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] [Received: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES With disease-modifying therapies in development for neurological disorders, quantitative brain imaging techniques become increasingly relevant for objective early diagnosis and assessment of response to treatment. The aim of this study was to evaluate the use of Brain SPECT and PET scans in the UK and explore drivers and barriers to using quantitative analysis through an online survey. METHODS A web-based survey with 27 questions was used to capture a snapshot of brain imaging in the UK. The survey included multiple-choice questions assessing the availability and use of quantification for DaTscan, Perfusion SPECT, FDG PET and Amyloid PET. The survey results were reviewed and interpreted by a panel of imaging experts. RESULTS Forty-six unique responses were collected and analysed, with 84% of responses from brain imaging sites. Within these sites, 88% perform DaTscan, 50% Perfusion SPECT, 48% FDG PET, and 33% Amyloid PET, while a few sites use other PET tracers. Quantitative Brain analysis is used in 86% of sites performing DaTscans, 40% for Perfusion SPECT, 63% for FDG PET and 42% for Amyloid PET. Commercial tools are used more frequently than in-house software. CONCLUSION The survey showed variations across the UK, with high availability of DaTscan imaging and quantification and lower availability of other SPECT and PET scans. The main drivers for quantification were improved reporting confidence and diagnostic accuracy, while the main barriers were a perception of a need for an appropriate database of healthy controls and a lack of training, time, and software availability.
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Affiliation(s)
- Sofia K. Michopoulou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
- Imaging Physics, University Hospital Southampton, Southampton
| | - John C. Dickson
- Institute of Nuclear Medicine, University College London Hospitals, London
| | | | - Thomas R. Gee
- Imaging Physics, University Hospital Southampton, Southampton
| | | | | | | | - Neil O’Brien
- Imaging Physics, University Hospital Southampton, Southampton
| | - Angus M.J. Prosser
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
| | - Catherine J. Scott
- Institute of Nuclear Medicine, University College London Hospitals, London
| | | | - Jonathan Taylor
- Nuclear Medicine & 3DLab, Sheffield Teaching Hospitals, Sheffield, UK
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Adachi H, Numata J, Nishida K, Yamasaki H, Futamura N. Dystextia and dystypia due to phonological errors after ischemic stroke: a case report in a Japanese patient. Neurocase 2023; 29:50-57. [PMID: 38676356 DOI: 10.1080/13554794.2024.2345403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
A 69-year-old Japanese male presented with acute dystextia and dystypia, defined as texting and typing impairments, respectively. His text input speed decreased due to a phonologically incorrect kana flick input on his smartphone. Additionally, dystypia occurred due to phonemic paragraphia of Romaji. Brain MRI revealed a new left lenticulostriate infarction sparing the cerebral cortex. SPECT showed reduced cerebral blood flow in the left inferior precentral frontal gyrus as well as in the infarction area. It was concluded that his abnormal phonological processes resulted from hypoperfusion in the left inferior precentral gyrus that is assumed to be an endpoint of the arcuate fasciculus.
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Affiliation(s)
| | - Jun Numata
- Department of Neurology, National Hospital Organization Hyogo-Chuo National Hospital, Hyogo, Japan
- Department of Gastroenterology, Sanda City Hospital, Hyogo, Japan
| | - Katsuya Nishida
- Department of Neurology, National Hospital Organization Hyogo-Chuo National Hospital, Hyogo, Japan
| | - Hiroshi Yamasaki
- Department of Neurology, National Hospital Organization Hyogo-Chuo National Hospital, Hyogo, Japan
| | - Naonobu Futamura
- Department of Neurology, National Hospital Organization Hyogo-Chuo National Hospital, Hyogo, Japan
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Kawakatsu S, Kobayashi R, Morioka D, Hayashi H, Utsunomiya A, Kabasawa T, Ohe R, Futakuchi M, Otani K. Clinicopathological diversity of semantic dementia: Comparisons of patients with early-onset versus late-onset, left-sided versus right-sided temporal atrophy, and TDP-type A versus type C pathology. Neuropathology 2023; 43:5-26. [PMID: 36336915 DOI: 10.1111/neup.12859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/09/2022]
Abstract
Semantic dementia (SD) is a unique clinicopathological entity associated with TDP-type C pathology. We present four cases of SD that illustrate the clinicopathological diversity of TDP-43 pathology, including early-onset cases of TDP-type C with corticospinal tract (CST) and motor neuron pathology and late-onset cases of TDP-type A with combined pathology. Case 1 was a 62-year-old man with semantic variant of primary progressive aphasia (svPPA) with left-predominant temporal atrophy and TDP-type C pathology with low Alzheimer's disease neuropathologic changes (ADNC). Case 2 was a 63-year-old woman with right-predominant temporal atrophy and TDP-type C pathology who had prosopagnosia and personality changes. Phosphorylated(p)-TDP-43-positive long dystrophic neurites (DNs) were observed throughout the cerebral cortex; they were more abundant in the relatively spared cortices and less so in the severely degenerated cortices. We observed CST degeneration with TDP-43 pathology in the upper and lower motor neurons, without apparent motor symptoms, in SD with TDP-type C pathology. Case 3 was a 76-year-old man who had svPPA and personality changes, with left-predominant temporal atrophy and TDP-type A pathology with high ADNC and argyrophilic grain (AG) stage 3. Case 4 was an 82-year-old man who had prosopagnosia and later developed symptoms of dementia with Lewy bodies (DLB) with right-predominant temporal atrophy and TDP-type A pathology with high ADNC, DLB of diffuse neocortical type, and AG stage 3. The distribution of p-TDP-43-positive NCIs and short DNs was localized in the anterior and inferior temporal cortices. An inverse relationship between the extent of TDP pathology and neuronal loss was also observed in SD with TDP-type A pathology. In contrast, the extent of AD, DLB, and AG pathology was greater in severely degenerated regions. CST degeneration was either absent or very mild in SD with TDP-type A. Understanding the clinicopathological diversity of SD will help improve its diagnosis and treatment.
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Affiliation(s)
- Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu City, Japan.,Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Daichi Morioka
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Hiroshi Hayashi
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima City, Japan
| | - Aya Utsunomiya
- Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takanobu Kabasawa
- Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
| | - Rintaro Ohe
- Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
| | - Mitsuru Futakuchi
- Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
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Sakurai Y, Uchiyama Y, Takeda A, Terao Y. On-Reading (Chinese-Style Pronunciation) Predominance Over Kun-Reading (Native Japanese Pronunciation) in Japanese Semantic Dementia. Front Hum Neurosci 2021; 15:700181. [PMID: 34421561 PMCID: PMC8374332 DOI: 10.3389/fnhum.2021.700181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
Japanese kanji (morphograms) have two ways of reading: on-reading (Chinese-style pronunciation) and kun-reading (native Japanese pronunciation). It is known that some Japanese patients with semantic dementia read kanji with on-reading but not with kun-reading. To characterize further reading impairments of patients with semantic dementia, we analyzed data from a total of 9 patients who underwent reading and writing tests of kanji and kana (Japanese phonetic writing) and on-kun reading tests containing two-character kanji words with on-on reading, kun-kun reading, and specific (so-called Jukujikun or irregular kun) reading. The results showed that on-reading preceding (pronouncing first with on-reading) and kun-reading deletion (inability to recall kun-reading) were observed in nearly all patients. In the on-kun reading test, on-reading (57.6% correct), kun-reading (46.6% correct), and specific-reading (30.0% correct) were more preserved in this decreasing order (phonology-to-semantics gradient), although on-reading and kun-reading did not significantly differ in performance, according to a more rigorous analysis after adjusting for word frequency (and familiarity). Furthermore, on-substitution (changing to on-reading) errors in kun-reading words (27.0%) were more frequent than kun-substitution (changing to kun-reading) errors in on-reading words (4.0%). These results suggest that kun-reading is more predominantly disturbed than on-reading, probably because kun-reading and specific-reading are closely associated with the meaning of words.
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Affiliation(s)
| | - Yumiko Uchiyama
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.,Department of Neurology, Kudanzaka Hospital, Tokyo, Japan
| | - Akitoshi Takeda
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuo Terao
- Department of Cell Physiology, Faculty of Medicine, Kyorin University, Tokyo, Japan
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Yu CC, Chan HP, Ting CY. Evaluation of the Image Feature Analysis Techniques by Image Strength Fluctuation for Alzheimer’s Disease. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article compares the effectiveness of both image strength fluctuation (ISF) and statistical parametric mapping (SPM), which is used for analyzing cerebral blood flow traced by single photon emission computed tomography (SPECT) in patients with Alzheimer’s disease (AD). This
is a retrospective study that uses the built-in SPECT template of the SPM software to analyze the differences in cerebral blood flow (CBF) between two groups after using the ISF and SPM software to normalize and smooth the data. Using Z score analysis, the ISF method revealed unusual fluctuations
in the range of image strength. The hot and cold areas were considered to be the difference between normal and abnormal images and the analysis of the gray intensities of cold and hot areas was used to show that cold and hot were in characteristic locations that correlate with brain functional
areas. The results of the SPM analysis revealed significantly reduced blood flow in the bilateral inferior parietal lobule, the middle or superior gyrus of the left temporal lobe, the superior gyrus and the sub-lobar insula of the right temporal lobe. The results from SPM were similar to those
obtained with the ISF and indicated the same regions (83.3%).
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Affiliation(s)
- Chang-Ching Yu
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, 813414, Taiwan
| | - Hung-Pin Chan
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, 813414, Taiwan
| | - Chien-Yi Ting
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, 821004, Taiwan
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8
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Sakurai Y, Kakumoto T, Takenaka Y, Matsumoto H. Asymmetric Bálint's syndrome with multimodal agnosia, bilateral agraphesthesia, and ineffective kinesthetic reading due to subcortical hemorrhage in the left parieto-occipito-temporal area. Neurocase 2020; 26:328-339. [PMID: 33103577 DOI: 10.1080/13554794.2020.1831546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report a patient with asymmetric Bálint's syndrome (predominantly right-sided oculomotor apraxia and simultanagnosia and optic ataxia for the right hemispace), and multimodal agnosia (apperceptive visual agnosia and bilateral associative tactile agnosia) with accompanying right hemianopia, bilateral agraphesthesia, hemispatial neglect, global alexia with unavailable kinesthetic reading, and lexical agraphia for kanji (Japanese morphograms), after hemorrhage in the left parieto-occipito-temporal area. The coexistence of tactile agnosia, bilateral agraphesthesia, and ineffective kinesthetic reading suggests that tactile-kinesthetic information can be interrupted because of damage to the fiber connection from the parietal lobe to the occipito-temporal area, leading to these tactually related cognitive impairments.
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Affiliation(s)
- Yasuhisa Sakurai
- Department of Neurology, Mitsui Memorial Hospital , Tokyo, Japan
| | - Toshiyuki Kakumoto
- Department of Neurology, Mitsui Memorial Hospital , Tokyo, Japan.,Department of Neurology, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan
| | - Yuto Takenaka
- Department of Nephrology, Mitsui Memorial Hospital , Tokyo, Japan
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Quandt LM, Raji CA. Going against the norm: validation of a novel alternative to brain SPECT normative datasets. EXPLORATION OF MEDICINE 2020. [DOI: 10.37349/emed.2020.00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aim:
Quantitative analysis of brain single photon emission computed tomography (SPECT) perfusion imaging is dependent on normative datasets that are challenging to produce. This study investigated the combination of SPECT neuroimaging from a large clinical population rather than small numbers of controls. The authors hypothesized this “population template” would demonstrate noninferiority to a control dataset, providing a viable alternative for quantifying perfusion abnormalities in SPECT neuroimaging.
Methods:
A total of 2, 068 clinical SPECT scans were averaged to form the “population template”. Validation was three-fold. First, the template was imported into SPECT brain analysis software, MIMneuro®, and compared against its control dataset of 90 individuals through its region and cluster analysis tools. Second, a cohort of 100 cognitively impaired subjects was evaluated against both the population template and MIMneuro®’s normative dataset to compute region-based metrics. Concordance and intraclass correlation coefficients, mean square deviations, total deviation indices, and limits of agreement were derived from these data to measure agreement and test for noninferiority. Finally, the same patients were clinically read in CereMetrix® to confirm that expected perfusion patterns appeared after comparison to the template.
Results:
MIMneuro®’s default threshold for normality is ± 1.65 z-score and this served as our noninferiority margin. Direct comparison of the template to controls produced no regions that exceeded this threshold and all clusters identified were far from statistically significant. Agreement measures revealed consistency between the softwares and that CereMetrix® results were noninferior to MIMneuro®, albeit with proportional bias. Visual analysis also confirmed that expected perfusion patterns appeared when individual scans were compared to the population template within CereMetrix®.
Conclusions:
The authors demonstrated a population template was noninferior to a smaller control dataset despite inclusion of abnormal scans. This suggests that our patient-based population template can serve as an alternative for identifying and quantifying perfusion abnormalities in brain SPECT.
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Affiliation(s)
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
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10
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Sakurai Y, Furukawa E, Kurihara M, Sugimoto I. Dorsal type letter-by-letter reading accompanying alexia with agraphia due to a lesion of the lateral occipital gyri. Neurocase 2020; 26:285-292. [PMID: 32804589 DOI: 10.1080/13554794.2020.1803922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report a patient with alexia with agraphia accompanied by letter-by-letter reading after hemorrhage in the left middle and inferior occipital gyri that spared the angular gyrus and the fusiform gyrus. Kanji (Japanese morphograms) and kana (Japanese phonetic writing) reading and writing tests revealed that alexia with agraphia was characterized by kana-predominant alexia and kanji-predominant agraphia. This type of "dorsal" letter-by-letter reading is discernable from conventional ventral type letter-by-letter reading that is observed in pure alexia in that (1) kinesthetic reading is less effective, (2) kana or literal agraphia coexists, and (3) fundamental visual discrimination is nearly normal.
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Affiliation(s)
- Yasuhisa Sakurai
- Department of Neurology, Mitsui Memorial Hospital , Tokyo, Japan
| | - Emi Furukawa
- Department of Nephrology, Mitsui Memorial Hospital , Tokyo, Japan.,Department of Health Communication, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan
| | - Masanori Kurihara
- Department of Neurology, Mitsui Memorial Hospital , Tokyo, Japan.,Department of Neurology, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan
| | - Izumi Sugimoto
- Department of Neurology, Mitsui Memorial Hospital , Tokyo, Japan.,Department of Neurology, Toranomon Hospital Kajigaya , Kawasaki, Japan
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11
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Ohba M, Kokubo Y, Suzuki K, Kanoto M, Sonoda Y. Influence of a Headrest on Reconstruction and Attenuation Correction of Human Brain SPECT Images. J Nucl Med Technol 2020; 49:54-57. [PMID: 32887765 DOI: 10.2967/jnmt.120.244731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/25/2020] [Indexed: 11/16/2022] Open
Abstract
Previous reports suggest that a headrest significantly influences anterior and posterior cerebral blood flow. The present study aimed to clarify the influence of a headrest on reconstruction and attenuation correction (AC) of brain SPECT images. Methods: We evaluated the influence on cerebral blood flow in the anterior region (brain segments A + B), middle region (segments D + F), and posterior region (segment G) of the brain using filtered backprojection-AC based on the method of Chang (FBP-ChangAC), ordered-subset expectation maximization-ChangAC (OSEM-ChangAC), OSEM CT-based AC (OSEM-CTAC), and OSEM with no attenuation correction (OSEM-NoAC) with and without a headrest. The subjects were 17 healthy volunteers who underwent 99mTc-ECD SPECT. We compared the A + B/G and the D + F/G ratios of 99mTc-ECD SPECT images in each group. Results: For FBP-ChangAC, OSEM-ChangAC, and OSEM-NoAC, there were significant differences in A + B/G ratio between images obtained with a headrest and those obtained without. On the other hand, for OSEM-CTAC, there were no significant differences in A + B/G ratio regardless of whether a headrest was used. For FBP-ChangAC and OSEM-NoAC, there were significant differences in D + F/G ratio between images with a headrest and those without. For OSEM-CTAC and OSEM-ChangAC, there were no significant differences in D + F/G ratio regardless of whether a headrest was used. Conclusion: The influence of a headrest on image reconstruction and AC should be considered if FBP-ChangAC, OSEM-ChangAC, or OSEM-NoAC is used but not if OSEM-CTAC is used.
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Affiliation(s)
- Makoto Ohba
- Department of Radiology, Yamagata University Hospital, Yamagata, Japan
| | - Yasuaki Kokubo
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Japan; and
| | - Koji Suzuki
- Department of Radiology, Yamagata University Hospital, Yamagata, Japan
| | - Masafumi Kanoto
- Division of Diagnostic Radiology, Department of Radiology, Yamagata University Graduate School of Medical Science, Yamagata, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Japan; and
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12
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Fujishiro H, Okuda M, Iwamoto K, Miyata S, Torii Y, Iritani S, Ozaki N. Clinical profiles of late-onset psychiatric patients exhibiting incidental REM sleep without atonia. J Neural Transm (Vienna) 2019; 126:1095-1104. [DOI: 10.1007/s00702-019-02035-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 06/15/2019] [Indexed: 10/26/2022]
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13
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Yasuno F, Matsuoka K, Miyasaka T, Takahashi M, Kitamura S, Yoshikawa H, Hattori H, Kichikawa K, Kishimoto T. Decreased perfusion of the posterior cingulate gyri shown by a cingulate island score is a possible marker of vulnerability to behavioural and psychological symptoms of Alzheimer's disease: a pilot study. Psychogeriatrics 2019; 19:165-170. [PMID: 30276946 DOI: 10.1111/psyg.12379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/15/2018] [Accepted: 08/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The cingulate island score (CIScore), which indicates the Z-score ratio of the posterior cingulate gyri to the medial occipital area, has been shown to be useful for differentiating dementia with Lewy bodies from Alzheimer's disease (AD). Our aim was to investigate associations between the clinical symptoms of AD and the CIScore as an index of the relative decrease in perfusion of the posterior cingulate gyri that occurs in the early stages of AD. METHODS Seventeen patients with early-stage AD and 13 patients with amnesic mild cognitive impairment were examined. Z-score maps of technetium-99m ethyl cysteinate dimer single-photon emission computed tomography images acquired from the patients were converted, and the CIScore was determined by using the easy Z-score imaging system. The relationships between the CIScore and clinical symptom scores were tested. RESULTS A significant correlation was identified between the CIScore and the Neuropsychiatric Inventory Questionnaire score. No significant correlations were identified between the CIScore and other measures of cognitive function. Based on a CIScore of 0.39, we correctly differentiated patients with and without behavioural and psychological symptoms of dementia (BPSD), with a sensitivity of 72.2% and specificity of 75.0%. DISCUSSION Using technetium-99m ethyl cysteinate dimer single-photon emission computed tomography, we observed that decreased posterior cingulate gyri perfusion, relative to the medial occipital area, in prodromal and early AD was closely associated with behavioural and psychological symptoms of dementia. Therefore, our findings suggest that CIScore is not only useful for discriminating dementia with Lewy bodies from AD, but it can also be clinically used as a specific indicator of the vulnerability to behavioural and psychological symptoms of dementia in the early stages of AD.
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Affiliation(s)
- Fumihiko Yasuno
- Department of Psychiatry, Nara Medical University, Kashihara, Japan.,Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kiwamu Matsuoka
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | | | - Masato Takahashi
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | | | | | - Hideyuki Hattori
- Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Japan
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14
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Fujishiro H, Okuda M, Iwamoto K, Miyata S, Torii Y, Iritani S, Ozaki N. Early diagnosis of Lewy body disease in patients with late-onset psychiatric disorders using clinical history of rapid eye movement sleep behavior disorder and [ 123 I]-metaiodobenzylguanidine cardiac scintigraphy. Psychiatry Clin Neurosci 2018. [PMID: 29536584 DOI: 10.1111/pcn.12651] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM Rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms often antedate the clinical diagnosis of Parkinson's disease or dementia with Lewy bodies. The purpose of this study was to investigate RBD and its relevance to Lewy body disease (LBD) in patients with late-onset psychiatric disorders. METHODS Study subjects included 19 patients with late-onset psychiatric disorders who exhibited REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, at our psychiatric ward. Clinical profiles and radiological findings by cardiac [123 I]-metaiodobenzylguanidine ([123 I]-MIBG) scintigraphy and imaging for the dopamine transporter (DAT) were compared between patients with and without RBD symptoms. The correlations between the percentage of RWA in the total rapid eye movement sleep (%RWA) and radiological findings were also investigated. RESULTS Nine patients reported RBD symptoms only on specific questioning, but clinical profiles, including the prevalence of antipsychotropic usage, did not differ when compared to the remaining 10 patients without RBD (incidental RWA group). The median %RWA was significantly higher in the definite RBD group than in the incidental RWA group. Although the cardiac [123 I]-MIBG uptake was significantly lower in the definite RBD group than in the incidental RWA group, there was overlap in the specific binding ratio on DAT scan. CONCLUSION The severity of %RWA was highly correlated with the value of cardiac [123 I]-MIBG uptake, but not with specific binding ratio on DAT scan. Clinical history of RBD and cardiac [123 I]-MIBG scintigraphy are helpful for an early differential diagnosis of LBD from late-onset psychiatric disorders, even before parkinsonism or dementia appears.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Okuda
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiko Miyata
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Youta Torii
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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15
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Quantitation of specific binding ratio in 123I-FP-CIT SPECT: accurate processing strategy for cerebral ventricular enlargement with use of 3D-striatal digital brain phantom. Radiol Phys Technol 2018; 11:219-227. [PMID: 29700797 DOI: 10.1007/s12194-018-0459-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 10/17/2022]
Abstract
This study aimed to evaluate the effect of ventricular enlargement on the specific binding ratio (SBR) and to validate the cerebrospinal fluid (CSF)-Mask algorithm for quantitative SBR assessment of 123I-FP-CIT single-photon emission computed tomography (SPECT) images with the use of a 3D-striatum digital brain (SDB) phantom. Ventricular enlargement was simulated by three-dimensional extensions in a 3D-SDB phantom comprising segments representing the striatum, ventricle, brain parenchyma, and skull bone. The Evans Index (EI) was measured in 3D-SDB phantom images of an enlarged ventricle. Projection data sets were generated from the 3D-SDB phantoms with blurring, scatter, and attenuation. Images were reconstructed using the ordered subset expectation maximization (OSEM) algorithm and corrected for attenuation, scatter, and resolution recovery. We bundled DaTView (Southampton method) with the CSF-Mask processing software for SBR. We assessed SBR with the use of various coefficients (f factor) of the CSF-Mask. Specific binding ratios of 1, 2, 3, 4, and 5 corresponded to SDB phantom simulations with true values. Measured SBRs > 50% that were underestimated with EI increased compared with the true SBR and this trend was outstanding at low SBR. The CSF-Mask improved 20% underestimates and brought the measured SBR closer to the true values at an f factor of 1.0 despite an increase in EI. We connected the linear regression function (y = - 3.53x + 1.95; r = 0.95) with the EI and f factor using root-mean-square error. Processing with CSF-Mask generates accurate quantitative SBR from dopamine transporter SPECT images of patients with ventricular enlargement.
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16
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Sakurai Y, Furukawa E, Kurihara M, Sugimoto I. Frontal Phonological Agraphia and Acalculia with Impaired Verbal Short-Term Memory due to Left Inferior Precentral Gyrus Lesion. Case Rep Neurol 2018; 10:72-82. [PMID: 29681826 PMCID: PMC5903121 DOI: 10.1159/000487849] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/20/2018] [Indexed: 11/19/2022] Open
Abstract
We report a patient with phonological agraphia (selective impairment of kana [Japanese phonetic writing] nonwords) and acalculia (mental arithmetic difficulties) with impaired verbal short-term memory after a cerebral hemorrhage in the opercular part of the left precentral gyrus (Brodmann area 6) and the adjacent postcentral gyrus. The patient showed phonemic paragraphia in five-character kana nonword writing, minimal acalculia, and reduced digit and letter span. Mental arithmetic normalized after 8 months and agraphia recovered to the normal range at 1 year after onset, in parallel with an improvement of the auditory letter span score from 4 to 6 over a period of 14 months and in the digit span score from 6 to 7 over 24 months. These results suggest a close relationship between the recovery of agraphia and acalculia and the improvement of verbal short-term memory. The present case also suggests that the opercular part of the precentral gyrus constitutes the phonological route in writing that conveys phonological information of syllable sequences, and its damage causes phonological agraphia and acalculia with reduced verbal short-term memory.
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Affiliation(s)
| | - Emi Furukawa
- Department of Nephrology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Masanori Kurihara
- Department of Neurology, Mitsui Memorial Hospital, Tokyo, Japan.,Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Izumi Sugimoto
- Department of Neurology, Mitsui Memorial Hospital, Tokyo, Japan
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17
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Morihara R, Yamashita T, Deguchi K, Kurata T, Nomura E, Sato K, Nakano Y, Ohta Y, Hishikawa N, Ikeuchi T, Kitaguchi M, Abe K. Familial and sporadic chronic progressive degenerative parietal ataxia. J Neurol Sci 2018; 387:70-74. [PMID: 29571875 DOI: 10.1016/j.jns.2018.01.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND & OBJECTIVE Parietal ataxia has been mainly reported as a consequence of acute ischemic stroke, while degenerative parietal ataxia has not been reported. METHODS We investigated clinical characteristics, neuroimaging data, and genetic analysis of patients with cerebellar ataxia plus parietal atrophy. RESULTS We identified seven patients, including five patients from two families, with chronic progressive cerebellar ataxia due to degenerative parietal atrophy but not stroke. Age at onset of ataxia was 57.6 ± 6.9 years. All patients showed chronic progressive cerebellar ataxia with severity of ataxic gait > limb ataxia > dysarthria. Patients showed no cognitive dysfunction, muscle weakness, or parkinsonism, and only two patients showed mild sensory disturbances. The seven patients showed lateralized limb ataxia with greater contralateral parietal lobe atrophy by magnetic resonance imaging, and hypoperfusion by single photon emission computed tomography, without any abnormal cerebellar pathology (i.e., crossed cerebellar diaschisis). Pathogenic mutations in the microtubule-associated protein tau gene were not found using two single nucleotide polymorphisms. CONCLUSIONS This is the first description showing unique clinical features of familial and sporadic chronic progressive degenerative parietal ataxia.
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Affiliation(s)
- Ryuta Morihara
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Toru Yamashita
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Kentaro Deguchi
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Tomoko Kurata
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Emi Nomura
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Kota Sato
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Yumiko Nakano
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Yasuyuki Ohta
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Bioresource Science Branch, Center of Bioresource, Brain Research Institute Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata 951-8585, Japan
| | - Masataka Kitaguchi
- Department of Neurology, Baba Memorial Hospital, 4-244 Hamaderahunao-cho Higashi nishi-ku, Sakai 592-8555, Japan
| | - Koji Abe
- Department of Neurology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama 700-8558, Japan.
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18
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Sakurai Y, Fujimoto M, Hamada K, Sugimoto I. Asymmetric oculomotor apraxia, optic ataxia, and simultanagnosia with right hemispatial neglect from a predominantly left-sided lesion of the parieto-occipital area. Cogn Neuropsychiatry 2018; 23:1-14. [PMID: 29199507 DOI: 10.1080/13546805.2017.1407304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Bálint's syndrome involves bilateral damage to the parieto-occipital area. The extent of the effect of unilateral damage on the Bálint's triad (oculomotor apraxia, optic ataxia, and simultanagnosia) remains unknown. METHODS We examined a 63-year-old, right-handed woman who developed right hemianopia, oculomotor apraxia, optic ataxia, simultanagnosia, and hemispatial neglect (HSN) for the right after a cerebral infarction, with detailed neuropsychological tests, magnetic resonance imaging, and single photon emission computed tomography (SPECT). RESULTS Neuropsychological examination showed that oculomotor apraxia, optic ataxia, and simultanagnosia were more pronounced in the right hemi-space, probably due to the limited eye movement in the right visual field, whereas HSN was restricted to the right hemi-space. Diffusion-weighted MR images revealed hyperintensity in the left parieto-temporo-occipital region, and several spotty areas of the bilateral frontal and parietal subcortical regions. SPECT revealed hypoperfusion in the left parieto-occipital region and frontal operculum and small areas of the right superior parietal lobule. CONCLUSIONS The case suggests that asymmetric (more pronounced in the right hemi-space) oculomotor apraxia, optic ataxia, and simultanagnosia occur in an extensive lesion of the left parieto-occipital cortices. Although HSN is not a prerequisite for simultanagnosia, the coexistence of HSN aggravates simultanagnosia in the hemi-space opposite the lesion.
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Affiliation(s)
- Yasuhisa Sakurai
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
| | - Masanori Fujimoto
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan.,b Department of Diabetes, Metabolism, and Endocrinology, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Kensuke Hamada
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan.,c Department of Neurology, Graduate School of Medicine , University of Tokyo , Tokyo , Japan
| | - Izumi Sugimoto
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
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19
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Hayashi R, Yamaguchi S, Narimatsu T, Miyata H, Katsumata Y, Mimura M. Statokinetic Dissociation (Riddoch Phenomenon) in a Patient with Homonymous Hemianopsia as the First Sign of Posterior Cortical Atrophy. Case Rep Neurol 2017; 9:256-260. [PMID: 29422846 PMCID: PMC5803707 DOI: 10.1159/000481304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
Abstract
We report a 60-year-old woman with posterior cortical atrophy (PCA) who presented with left homonymous hemianopsia persisting for 5 years; the patient's condition was observed using static, but not kinetic, perimetry. This statokinetic dissociation of hemianopsia, which is often called Riddoch syndrome, might have been caused by a dysfunction of the right primary visual and visual association cortices, representing a functional imbalance within a disturbed visual cortex. In patients with PCA and visual field defects, both static and kinetic perimetry may be useful for understanding the extent of degeneration in the visual cortex, in addition to examinations of unilateral neglect.
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Affiliation(s)
- Ryuichiro Hayashi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Shigeki Yamaguchi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Toshio Narimatsu
- Department of Ophthalmology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroshi Miyata
- Department of Ophthalmology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yasushi Katsumata
- Department of Radiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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20
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Kozuka J, Uno A, Matsuda H, Toyoshima Y, Hamano SI. Relationship between the change of language symptoms and the change of regional cerebral blood flow in the recovery process of two children with acquired aphasia. Brain Dev 2017; 39:493-505. [PMID: 28159458 DOI: 10.1016/j.braindev.2017.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/08/2016] [Accepted: 01/03/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between the change of language symptoms and the change of regional cerebral blood flow (rCBF) in the recovery process of two children with acquired aphasia caused by infarctions from Moyamoya disease with an onset age of 8years. METHODS We compared the results for the Standard Language Test of Aphasia (SLTA) with rCBF changes in 7 language regions in the left hemisphere and their homologous regions in the right hemisphere at 4 time points from 3weeks for up to 5years after the onset of aphasia, while controlling for the effect of age. RESULTS In both cases, strong correlations were seen within a hemisphere between adjacent regions or regions that are connected by neuronal fibers, and between some language regions in the left hemisphere and their homologous regions in the right hemisphere. Conversely, there were differences between the two cases in the time course of rCBF changes during their recovery process. CONCLUSION Consistent with previous studies, the current study suggested that both hemispheres were involved in the long-term recovery of language symptoms in children with acquired aphasia. We suggest that the differences between both cases during their recovery process might be influenced by the brain states before aphasia, by which hemisphere was affected, and by the timing of the surgical revascularization procedure. However, the changes were observed in the data obtained for rCBF with strong correlations with the changes in language performance, so it is possible that rCBF could be used as a biomarker for language symptom changes.
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Affiliation(s)
- Junko Kozuka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; Graduate School of Human and Social Sciences, Musashino University, Japan; Children's Development and Human Health Department, Saitama Children's Medical Center, Japan.
| | - Akira Uno
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Japan
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21
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Validation of the cingulate island sign with optimized ratios for discriminating dementia with Lewy bodies from Alzheimer's disease using brain perfusion SPECT. Ann Nucl Med 2017; 31:536-543. [PMID: 28547521 PMCID: PMC5517560 DOI: 10.1007/s12149-017-1181-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/15/2017] [Indexed: 12/31/2022]
Abstract
Objective Dementia with Lewy bodies (DLB) is often cited as the second most common dementia after Alzheimer’s disease (AD). It is clinically important to distinguish DLB from AD because specific side effects of antipsychotic drugs are limited to DLB. The relative preservation of cingulate glucose metabolism in the posterior cingulate gyri versus that in the precuni, known as the cingulate island sign (CIS), in patients with DLB compared with AD is supposed to be highly specific for diagnosing DLB. In a previous study, using brain perfusion SPECT, the largest value (0.873) for the area under the receiver operating characteristic (ROC) curve (AUC) for differentiating DLB from AD was obtained with the ratio of the posterior cingulate gyri from an early Alzheimer’s disease-specific hypoperfusion volume of interest (VOI) versus the medial occipital lobe. Two purposes of this study are as follows: one is optimization of VOI setting for calculating CIS values and the other is to evaluate their accuracy and simultaneously to retest the method described in our previous paper. Methods We conducted a retest of this SPECT method with another cohort of 13 patients with DLB and 13 patients with AD. Furthermore, we optimized VOIs using contrast images obtained from group comparisons of DLB and normal controls; the same 18 patients with DLB and 18 normal controls examined in our previous study. We obtained DLB-specific VOIs from areas where brain perfusion was significantly decreased in DLB. As the numerators of these ratios, early Alzheimer’s disease-specific VOIs were used after subtracting DLB-specific VOIs. The DLB-specific VOIs were used as the denominator. Results In retest, the obtained AUC was 0.858 and the accuracy, sensitivity, and specificity were 84.6, 84.6, and 84.6%, respectively. The ROC curve analysis with these optimized VOIs yielded a higher AUC of 0.882; and the accuracy, sensitivity, and specificity of these new CIS ratios were 84.6, 92.3, and 76.9%, respectively, with a threshold value of 0.281. Conclusion Optimized CISs using brain perfusion SPECT are clinically useful for differentiating DLB from AD.
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22
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Fujishiro H, Okuda M, Iwamoto K, Miyata S, Otake H, Noda A, Iritani S, Ozaki N. REM sleep without atonia in middle-aged and older psychiatric patients and Lewy body disease: a case series. Int J Geriatr Psychiatry 2017; 32:397-406. [PMID: 27108917 DOI: 10.1002/gps.4477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/05/2016] [Accepted: 03/08/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Rapid eye movement (REM) sleep behavior disorder (RBD) is commonly associated with Lewy body disease, narcolepsy, or depression. In contrast, the relationship between REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, and clinical characteristics remains unclear. The purpose of this study is to investigate the clinical features of psychiatric patients exhibiting RWA and its relevance to Lewy body disease. METHODS Of 55 consecutive patients who underwent polysomnography at the psychiatric ward, 25 patients with sleep apnea syndrome were excluded, and 12 patients exhibiting RWA were identified. The clinical profiles were compared between the groups with and without RWA. RESULTS The mean age and the frequency of neurocognitive disorders were significantly higher in 12 patients with RWA than in 18 without. Only five of the 12 patients exhibiting RWA had episodes of dream-enactment behavior, and fulfilled the clinical criteria for RBD. Two young patients were diagnosed with narcolepsy, while the other middle-aged and older patients fulfilled the clinical criteria for Parkinson's disease (n = 1), dementia with Lewy bodies (n = 4), idiopathic RBD (n = 2), and major depressive disorder (MDD) (n = 3). The patients with MDD exhibited constipation and/or olfactory dysfunction. Moreover, neuroimaging examinations in the patients with MDD revealed isolated occipital hypoperfusion in three patients and mild dopamine transporter deficit in one patient. CONCLUSIONS Rapid eye movement sleep without atonia itself may be associated with specific clinical profiles, even when dream-enactment behavior is absent. Continued follow-up of the patients with MDD exhibiting RWA is warranted to determine if they represent the prodromal Parkinson's disease/dementia with Lewy bodies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Okuda
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiko Miyata
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hironao Otake
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Noda
- Department of Biomedical Science, Chubu University Graduate School of Life and Health Sciences, Kasugai, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Negus IS, Holmes RB, Jordan KC, Nash DA, Thorne GC, Saunders M. Technical Note: Development of a 3D printed subresolution sandwich phantom for validation of brain SPECT analysis. Med Phys 2017; 43:5020. [PMID: 27587032 DOI: 10.1118/1.4960003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To make an adaptable, head shaped radionuclide phantom to simulate molecular imaging of the brain using clinical acquisition and reconstruction protocols. This will allow the characterization and correction of scanner characteristics, and improve the accuracy of clinical image analysis, including the application of databases of normal subjects. METHODS A fused deposition modeling 3D printer was used to create a head shaped phantom made up of transaxial slabs, derived from a simulated MRI dataset. The attenuation of the printed polylactide (PLA), measured by means of the Hounsfield unit on CT scanning, was set to match that of the brain by adjusting the proportion of plastic filament and air (fill ratio). Transmission measurements were made to verify the attenuation of the printed slabs. The radionuclide distribution within the phantom was created by adding (99m)Tc pertechnetate to the ink cartridge of a paper printer and printing images of gray and white matter anatomy, segmented from the same MRI data. The complete subresolution sandwich phantom was assembled from alternate 3D printed slabs and radioactive paper sheets, and then imaged on a dual headed gamma camera to simulate an HMPAO SPECT scan. RESULTS Reconstructions of phantom scans successfully used automated ellipse fitting to apply attenuation correction. This removed the variability inherent in manual application of attenuation correction and registration inherent in existing cylindrical phantom designs. The resulting images were assessed visually and by count profiles and found to be similar to those from an existing elliptical PMMA phantom. CONCLUSIONS The authors have demonstrated the ability to create physically realistic HMPAO SPECT simulations using a novel head-shaped 3D printed subresolution sandwich method phantom. The phantom can be used to validate all neurological SPECT imaging applications. A simple modification of the phantom design to use thinner slabs would make it suitable for use in PET.
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Affiliation(s)
- Ian S Negus
- Department of Medical Physics and Bioengineering, University Hospitals Bristol NHS Foundation Trust, Bristol BS28HW, United Kingdom
| | - Robin B Holmes
- Department of Medical Physics and Bioengineering, University Hospitals Bristol NHS Foundation Trust, Bristol BS28HW, United Kingdom
| | - Kirsty C Jordan
- Department of Biomedical Engineering, University of Strathclyde, Glasgow G11XQ, United Kingdom
| | - David A Nash
- Department of Medical Physics, Portsmouth Hospitals NHS Trust, Portsmouth PO63LY, United Kingdom
| | - Gareth C Thorne
- Department of Medical Physics and Bioengineering, University Hospitals Bristol NHS Foundation Trust, Bristol BS28HW, United Kingdom
| | - Margaret Saunders
- Department of Medical Physics and Bioengineering, University Hospitals Bristol NHS Foundation Trust, Bristol BS28HW, United Kingdom
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Abstract
We herein report a 65-year-old man demonstrating dementia with Lewy bodies who first presented with Bálint's syndrome. Two years later, a mild cognitive impairment was noted. From three years after onset, he developed progressive parkinsonism, visual hallucination, and autonomic dysfunction, in line with the deterioration of the cognitive function. Single photon emission computed tomography with a 99mTc-ethylcysteinate dimer performed two years after onset revealed hypoperfusion in the restricted area of the bilateral superior parietal lobule, which extended to the lateral occipital cortices within two years. It is suggested that the pathological process can extend from the parietal to occipital lobes.
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Wei CY, Chen TY, Shih I, Chiu PY, Hung GU, Matsuda H. The value of eZIS analysis of Tc-99m ECD SPECT on identifying cerebellar hypoperfusion in a patient with superficial siderosis: A case report. Medicine (Baltimore) 2016; 95:e5416. [PMID: 27893680 PMCID: PMC5134873 DOI: 10.1097/md.0000000000005416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Brain perfusion single photon computed tomography (SPECT) is a functional imaging modality and has been widely utilized in evaluation of various kinds of neurological disorders. Easy z-score imaging system (eZIS) is a computer-assisted statistical analysis, based on the comparison with age-classified ethyl cysteinate dimer (ECD) normal database, which provides objectively interpretation of Tc-99m ECD brain perfusion SPECT.Here we presented a 64-year-old male with dizziness, spin sensation, nausea, and vomiting in the emergency room, and brain computed tomography scan showed only small hypodensity lesion in cerebellum. Tc-99m ECD SPECT was performed for evaluating occult cerebral ischemia, infarction, and/or degeneration, but no remarkable abnormality could be identified by experienced readers on conventional display. The result of eZIS showed remarkable hypoperfusion in cerebellum and mild hypoperfusion in bilateral frontal and parietal lobes. Magnetic resonance imaging (MRI) confirmed severe atrophy of anterior cerebellar lobe. In addition, MRI showed diffuse hypointensity signals along with cerebrospinal fluid spaces, especially those areas with hypoperfusion on SPECT, compatible with typical appearances of superficial siderosis. CONCLUSION This presented case demonstrates the value of software analysis with eZIS on enhancing the diagnostic value of brain perfusion SPECT for detecting brain lesions at an uncommon location due to a rare disease.
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Affiliation(s)
- Cheng-Yu Wei
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua
- Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei
| | - Tai-Yi Chen
- Department of Radiology, Chang Bing Show Chwan Memorial Hospital, Changhua
| | - Ian Shih
- Department of Neurology, Cheng Ching Hospital Chung Kang Branch, Taichung
| | - Pai-Yi Chiu
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua
| | - Guang-Uei Hung
- Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
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Funayama M, Kato M, Mimura M. Disappearance of treatment-resistant depression after damage to the orbitofrontal cortex and subgenual cingulate area: a case study. BMC Neurol 2016; 16:198. [PMID: 27756252 PMCID: PMC5069923 DOI: 10.1186/s12883-016-0717-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
Background Although post-stroke depression is a well-characterized disorder, there is less understanding of how pre-existence of depression is affected by a stroke. Case presentation We describe a patient with treatment-resistant major depression, which had been ongoing for 14 years but disappeared shortly after onset of a subarachnoid hemorrhage. Her cognitive function and functional status were mostly unaffected by the stroke. However, she no longer excessively regretted past events. Lesions were found in the orbitofrontal cortex, which is involved in feeling regret, and in the adjacent subgenual cingulate area, which is metabolically hyperactive in treatment-resistant depression and is the target for deep-brain stimulation for relief of treatment-resistant depression. The lesions from the stroke may have caused the disappearance of the patient’s treatment-resistant depression by alleviating excessive regret and decreasing the elevated activity in these areas. Conclusions This patient’s clinical course may shed light on the neuropsychological and neurophysiological mechanisms of major depression of the melancholic subtype.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, 326-0843, Japan.
| | - Motoichiro Kato
- Department of Neuropsychiatry, Keio University School of Medicine, 160-8582, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 160-8582, Tokyo, Japan
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Oka M, Nakaaki S, Negi A, Miyata J, Nakagawa A, Hirono N, Mimura M. Predicting the neural effect of switching from donepezil to galantamine based on single-photon emission computed tomography findings in patients with Alzheimer's disease. Psychogeriatrics 2016; 16:121-34. [PMID: 26114924 DOI: 10.1111/psyg.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/26/2015] [Accepted: 03/30/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND A number of neuroimaging studies have addressed the specific effect of treatment with cholinesterase inhibitors on the frontal lobe in patients with Alzheimer's disease (AD). However, the neural effects of cholinesterase inhibitors on both apathy and executive dysfunction remain unclear. We examined whether baseline regional cerebral blood flow, as determined by using single-photon emission computed tomography, is capable of predicting changes in apathy and executive dysfunction in response to AD patients switching from donepezil to galantamine therapy. METHODS We conducted a 24-week, prospective, open-label study of AD patients treated with galantamine who did not respond to previous treatment with donepezil. Single-photon emission computed tomography was performed at baseline, and behaviour and cognitive assessments including the Mini-Mental State Examination, the Japanese version of the Alzheimer's Disease Assessment Scale-cognitive subscale, the Frontal Assessment Battery, the Neuropsychiatry Inventory Brief Questionnaire Form, and the Dysexecutive Questionnaire were conducted at three time points (baseline and after 12 and 24 weeks of galantamine therapy). RESULTS After galantamine therapy, the Neuropsychiatry Inventory Brief Questionnaire Form scores (apathy, irritability, and aberrant motor symptoms) and the Dysexecutive Questionnaire score improved significantly. The single-photon emission computed tomography findings showed that lower baseline regional cerebral blood flow values in several frontal areas, including the dorsolateral and ventrolateral prefrontal cortex, the anterior cingulate, and the orbitofrontal cortex, predicted greater reductions in the score for apathy (distress) on the Neuropsychiatry Inventory Brief Questionnaire Form and the Dysexecutive Questionnaire score after patients switched from donepezil to galantamine therapy. CONCLUSIONS Our study suggests that galantamine therapy, unlike donepezil, is characterized by a dual mechanism of action that may increase acetylcholine and the nicotinic receptor-modulation effect within the frontal lobe, both of which are associated with apathy and executive dysfunction in AD patients.
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Affiliation(s)
- Mizuki Oka
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Shutaro Nakaaki
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Atsushi Negi
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Japan.,Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Atsuo Nakagawa
- Center for Clinical Research, Keio University School of Medicine, Shinjuku-ku, Japan
| | | | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Japan
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Sakurai Y, Hamada K, Tsugawa N, Sugimoto I. Ventral simultanagnosia and prosopagnosia for unfamiliar faces due to a right posterior superior temporal sulcus and angular gyrus lesion. Neurocase 2016. [PMID: 26207875 DOI: 10.1080/13554794.2015.1066827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report a patient with ventral simultanagnosia, prosopagnosia for "unfamiliar faces" (dorsal prosopagnosia), spatial agraphia, and constructional disorder, particularly on the left spatial side, due to a lesion in the right posterior superior and middle temporal gyri and angular gyrus. The patient showed impairment of fundamental visual and visuospatial recognition, such as in object size, configuration, and horizontal point location, which probably underlay the mechanism of simultanagnosia and prosopagnosia. This case also suggests that the coexistence of simultanagnosia and prosopagnosia results from a right hemispheric insult, and damage to the temporoparietal area interrupts the incorporation of spatial information into object recognition. This disconnection of information flow, together with impaired object recognition per se, may impair the parallel processing of multiple objects, leading to object-by-object or part-by-part recognition.
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Affiliation(s)
- Yasuhisa Sakurai
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
| | - Kensuke Hamada
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
| | - Naoya Tsugawa
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
| | - Izumi Sugimoto
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
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Alterations of Regional Cerebral Blood Flow in Tinnitus Patients as Assessed Using Single-Photon Emission Computed Tomography. PLoS One 2015; 10:e0137291. [PMID: 26332128 PMCID: PMC4557829 DOI: 10.1371/journal.pone.0137291] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/14/2015] [Indexed: 12/12/2022] Open
Abstract
Tinnitus is the perception of phantom sound without an external auditory stimulus. Using neuroimaging techniques, such as positron emission tomography, electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI), many studies have demonstrated that abnormal functions of the central nervous system are closely associated with tinnitus. In our previous research, we reported using resting-state fMRI that several brain regions, including the rectus gyrus, cingulate gyrus, thalamus, hippocampus, caudate, inferior temporal gyrus, cerebellar hemisphere, and medial superior frontal gyrus, were associated with tinnitus distress and loudness. To reconfirm these results and probe target regions for repetitive transcranial magnetic stimulation (rTMS), we investigated the regional cerebral blood flow (rCBF) between younger tinnitus patients (<60 years old) and the age-matched controls using single-photon emission computed tomography and easy Z-score imaging system. Compared with that of controls, the rCBF of tinnitus patients was significantly lower in the bilateral medial superior frontal gyri, left middle occipital gyrus and significantly higher in the bilateral cerebellar hemispheres and vermis, bilateral middle temporal gyri, right fusiform gyrus. No clear differences were observed between tinnitus patients with normal and impaired hearing. Regardless of the assessment modality, similar brain regions were identified as characteristic in tinnitus patients. These regions are potentially involved in the pathophysiology of chronic subjective tinnitus.
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Nakashima H, Umegaki H, Makino T, Kato K, Abe S, Suzuki Y, Kuzuya M. Neuroanatomical correlates of error types on the Clock Drawing Test in Alzheimer's disease patients. Geriatr Gerontol Int 2015; 16:777-84. [DOI: 10.1111/ggi.12550] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Taeko Makino
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Katsuhiko Kato
- Department of Radiological and Medical Laboratory Sciences; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Shinji Abe
- Department of Radiological Technology; Nagoya University Hospital; Nagoya Japan
| | - Yusuke Suzuki
- Comprehensive Community Care Systems; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Masahumi Kuzuya
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
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Sakai T, Onishi H, Miyazoe K. [Evaluation of optimal threshold of Z score map for statistical brain image analysis]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2015; 71:325-31. [PMID: 25892419 DOI: 10.6009/jjrt.2015_jsrt_71.4.325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Aim of this study was to investigate optimal threshold of Z score when evaluating statistics image of Alzheimer's disease visually. METHOD We classified 53 clinical patients in control and target group, and evaluated the distribution of Z score calculated with statistical brain image analysis for magnetic resonance and perfusion single photon emission computed tomography (SPECT). The optimal Z score threshold was determined from statistical significance that compared previously mentioned groups. RESULTS Target group was able to classify significantly Z score at 1.25 from control group in wide region of parietal lobe with statistical brain image analysis for perfusion SPECT. DISCUSSION The optimal threshold is equal or less than 2.0, in the case of Z score variance is close to the standard normal distribution. In contrast, the threshold is over 2.0 in the case of Z score variance is more than 1.0, and then by using ordinary threshold 2.0, it cannot point out abnormality.
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Affiliation(s)
- Takayuki Sakai
- 1. Department of Radiology, Kyushu Rosai Hospital, Japan Labor Health and Welfare Organization; 2. Program in Health and Welfare Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima
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Sakurai Y, Itoh K, Sai K, Lee S, Abe S, Terao Y, Mannen T. Impaired laryngeal voice production in a patient with foreign accent syndrome. Neurocase 2015; 21:289-98. [PMID: 24592816 DOI: 10.1080/13554794.2014.892622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report a Japanese-speaking monolingual woman who developed foreign accent syndrome (FAS) following an infarction in the precentral and premotor cortices (Brodmann Area 6) at and around the inferior frontal sulcus. Her speech sounded Chinese or Korean to our bilingual coauthor who speaks Chinese and Japanese. Quantitative acoustic analyses of words and sentences showed that pitch (fundamental frequency variation) and intensity variances appeared lowered and fully voiced glottal pulses were reduced. These findings suggest laryngeal dysfunction that contributes to the unusual speech production in a case of FAS. This may be caused by damage to a restricted area of the motor and premotor cortices that controls laryngeal function.
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Affiliation(s)
- Yasuhisa Sakurai
- a Department of Neurology , Mitsui Memorial Hospital , Tokyo , Japan
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Significant differences of brain blood flow in patients with chronic low back pain and acute low back pain detected by brain SPECT. J Orthop Sci 2014; 19:384-9. [PMID: 24500293 DOI: 10.1007/s00776-014-0534-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 01/08/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND The aim of this study was to examine and compare the areas of brain blood flow in patients with chronic low back pain (CLBP) without structural abnormality and acute low back pain (ALBP) with lumber disc herniation (LDH). Functional neuroimaging studies provide evidence of abnormalities in the regional cerebral blood flow during low back pain. Recent studies have shown that CLBP is associated with plastic, pathophysiological changes in the brain. However, there has been no report yet statistically or by neuro-images on the compared brain single photon-emission computed tomography (SPECT) findings between CLBP and ALBP patients. METHODS The subjects comprised 14 patients, 7 CLBP and 7 ALBP patients. The CLBP group included the patients who had no or minor structural abnormality in the lumbar spine on magnetic resonance imaging (MRI) and met the criteria for a classification of "pain disorder" (chronic) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The ALBP group included the patients who had symptoms within 3 months of onset and LDH revealed by MRI. All patients were assessed using brain SPECT. We then performed a two-tailed view analysis using the easy Z score imaging system, determined the mean Z scores, and performed vBSEE software (Fujifilm RI Pharma, Tokyo, Japan) for both CLBP and ALBP patients. RESULTS The CLBP group showed significantly reduced blood flow in the bilateral prefrontal cortex of the frontal lobe and increased blood flow in the bilateral posterior lobe of the cerebellum. CONCLUSIONS SPECT images and statistical analyses revealed the brain blood flow alterations in the patients with ALBP and CLBP. These results may suggest that the dysfunction of the prefrontal cortex could lead to the appearance of unconscious pain behavior controlled by the cerebellum in the patients with CLBP.
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Yamagata B, Kobayashi H, Yamamoto H, Mimura M. Visual text hallucinations of thoughts in an alexic woman. J Neurol Sci 2014; 339:226-8. [DOI: 10.1016/j.jns.2014.01.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 01/15/2014] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
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Takahata K, Saito F, Muramatsu T, Yamada M, Shirahase J, Tabuchi H, Suhara T, Mimura M, Kato M. Emergence of realism: Enhanced visual artistry and high accuracy of visual numerosity representation after left prefrontal damage. Neuropsychologia 2014; 57:38-49. [PMID: 24631259 DOI: 10.1016/j.neuropsychologia.2014.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 02/01/2014] [Accepted: 02/24/2014] [Indexed: 10/25/2022]
Abstract
Over the last two decades, evidence of enhancement of drawing and painting skills due to focal prefrontal damage has accumulated. It is of special interest that most artworks created by such patients were highly realistic ones, but the mechanism underlying this phenomenon remains to be understood. Our hypothesis is that enhanced tendency of realism was associated with accuracy of visual numerosity representation, which has been shown to be mediated predominantly by right parietal functions. Here, we report a case of left prefrontal stroke, where the patient showed enhancement of artistic skills of realistic painting after the onset of brain damage. We investigated cognitive, functional and esthetic characteristics of the patient׳s visual artistry and visual numerosity representation. Neuropsychological tests revealed impaired executive function after the stroke. Despite that, the patient׳s visual artistry related to realism was rather promoted across the onset of brain damage as demonstrated by blind evaluation of the paintings by professional art reviewers. On visual numerical cognition tasks, the patient showed higher performance in comparison with age-matched healthy controls. These results paralleled increased perfusion in the right parietal cortex including the precuneus and intraparietal sulcus. Our data provide new insight into mechanisms underlying change in artistic style due to focal prefrontal lesion.
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Affiliation(s)
- Keisuke Takahata
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan; Clinical Neuroimaging Team, Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage, Chiba, Chiba 263-8555, Japan.
| | - Fumie Saito
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Taro Muramatsu
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Makiko Yamada
- Clinical Neuroimaging Team, Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage, Chiba, Chiba 263-8555, Japan.
| | - Joichiro Shirahase
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan; Center for Stress Research (CSR), Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Tetsuya Suhara
- Clinical Neuroimaging Team, Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage, Chiba, Chiba 263-8555, Japan.
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Motoichiro Kato
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan; Center for Stress Research (CSR), Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
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Evaluation of the difference-correction effect of the gamma camera systems used by easy Z-score Imaging System (eZIS) analysis. Ann Nucl Med 2014; 28:263-75. [PMID: 24464392 PMCID: PMC3988514 DOI: 10.1007/s12149-014-0807-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/21/2013] [Indexed: 11/24/2022]
Abstract
Objective
We examined the difference of the effect by data to revise a gamma camera difference. The difference-correction method of the camera is incorporated in eZIS analysis. Methods We acquired single photon emission computed tomography (SPECT) data from the three-dimensional (3D) Hoffman brain phantom (Hoffman), the three-dimensional brain phantom (3D-Brain), Pool phantom (pool) and from normal subjects (Normal-SPECT) to investigate compensating for a difference in gamma camera systems. We compared SPECT counts of standard camera with the SPECT counts that revised the difference of the gamma camera system (camera). Furthermore, we compared the “Z-score map (Z-score)”. To verify the effect of the compensation, we examined digitally simulated data designed to represent a patient with Alzheimer’s dementia. We carried out both eZIS analysis and “Specific Volume of interest Analysis (SVA)”. Results There was no great difference between the correction effect using Hoffman phantom data and that using 3D-Brain phantom data. Furthermore, a good compensation effect was obtained only over a limited area. The compensation based on the pool was found to be less satisfactory than any of the other compensations according to all results of the measurements examined in the study. The compensation based on the Normal-SPECT data resulted in a Z-score map (Z-score) for the result that approximated that from the standard camera. Therefore, we concluded that the effect of the compensation based on Normal-SPECT data was the best of the four methods tested. Conclusions Based on eZIS analysis, the compensation using the pool data was inferior to the compensations using the other methods tested. Based on the results of the SAV analysis, the effect of the compensation using the Hoffman data was better than the effect of the compensation using the 3D-Brain data. By all end-point measures, the compensation based on the Normal-SPECT data was more accurate than the compensation based on any of the other three phantoms.
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Banno K, Nakaaki S, Sato J, Torii K, Narumoto J, Miyata J, Hirono N, Furukawa TA, Mimura M, Akechi T. Neural basis of three dimensions of agitated behaviors in patients with Alzheimer disease. Neuropsychiatr Dis Treat 2014; 10:339-48. [PMID: 24600224 PMCID: PMC3933703 DOI: 10.2147/ndt.s57522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Agitated behaviors are frequently observed in patients with Alzheimer disease (AD). The neural substrate underlying the agitated behaviors in dementia is unclear. We hypothesized that different dimensions of agitated behaviors are mediated by distinct neural systems. METHODS All the patients (n=32) underwent single photon emission computed tomography (SPECT). Using the Agitated Behavior in Dementia scale, we identified the relationships between regional cerebral blood flow (rCBF) patterns and the presence of each of three dimensions of agitated behavior (physically agitated behavior, verbally agitated behavior, and psychosis symptoms) in AD patients. Statistical parametric mapping (SPM) software was used to explore these neural correlations. RESULTS Physically agitated behavior was significantly correlated with lower rCBF values in the right superior temporal gyrus (Brodmann 22) and the right inferior frontal gyrus (Brodmann 47). Verbally agitated behavior was significantly associated with lower rCBF values in the left inferior frontal gyrus (Brodmann 46, 44) and the left insula (Brodmann 13). The psychosis symptoms were significantly correlated with lower rCBF values in the right angular gyrus (Brodmann 39) and the right occipital lobe (Brodmann 19). CONCLUSION Our results support the hypothesis that three different agitated behaviors may represent distinct neural networks in AD patients.
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Affiliation(s)
- Koichi Banno
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Junko Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Katsuyoshi Torii
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Jun Miyata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Toshi A Furukawa
- Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Mizuno Y, Sakurai Y, Sugimoto I, Ichinose K, Ishihara S, Sanjo N, Mizusawa H, Mannen T. Delayed leukoencephalopathy after carbon monoxide poisoning presenting as subacute dementia. Intern Med 2014; 53:1441-5. [PMID: 24990337 DOI: 10.2169/internalmedicine.53.2132] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report the case of a 65-year-old woman who presented with the subacute onset of dementia and subsequently developed abnormal behavior and a gait disturbance. Her condition transiently improved; however, within one month, she became drowsy and poorly responsive, with limb chorea and urinary incontinence. Her history of frequently using charcoal led us to diagnose her with carbon monoxide (CO) poisoning. The findings of this case and a literature review suggest that subacute dementia due to CO poisoning recovers late, after a year or more, in patients above sixty years of age, and both hyperbaric oxygen and corticosteroid pulse therapy should be considered in such cases, even after one month.
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Affiliation(s)
- Yu Mizuno
- Department of Neurology, Mitsui Memorial Hospital, Japan
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Mo SJ, Larsson A, Johansson L, Stenlund H, Forsgren L, Riklund K. Cross-camera comparison of ROI-based semi-quantitative ¹²³I-IBZM SPECT data in healthy volunteers using an anthropomorphic phantom for calibration. Acta Radiol 2013; 54:549-56. [PMID: 23463862 DOI: 10.1177/0284185113477392] [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: 11/16/2022]
Abstract
BACKGROUND In (123)I-Iolopride (IBZM) SPECT reference values may diverge between camera systems. If multicenter pooling of normal material databases is needed, differences in measured semi-quantitative data due to equipment performance and reconstruction parameters have to be investigated in each instance to determine the comparability. PURPOSE To explore the differences in (123)I-IBZM measured uptake ratios between two different gamma cameras in healthy controls, the intra-rater reproducibility of the image evaluation method and the possibility to equalize uptake ratios by calibration through an anthropomorphic phantom. MATERIAL AND METHODS Differences in ROI-based semi-quantitative data from two different gamma camera systems, the three-headed brain dedicated Neurocam and the two-headed multipurpose hybrid system Infinia Hawkeye, were studied using image data from a group of healthy volunteers and an anthropomorphic brain-phantom scanned with both cameras. Several reconstruction methods and corrections were applied. To test the reliability of the ROI method, the intra-observer reproducibility was determined for the ROI method in this study. RESULTS The ROI method had a high reliability. Differences in mean measured uptake (123)I-IBZM ratios in healthy controls varied between 2.9% and 6.5% depending on reconstruction and correction for attenuation and scatter. After calibration, the differences decreased. There were no statistically significant differences between corrected ratios from the two camera systems in the study when images were reconstructed with attenuation correction. CONCLUSION The conformity of uptake ratios in attenuation corrected (123)I-IBZM images derived from the two different cameras was improved by using an anthropomorphic phantom for calibration.
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Affiliation(s)
- Susanna Jakobson Mo
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå
| | - Anne Larsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå
| | - Lennart Johansson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå
| | - Hans Stenlund
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Lars Forsgren
- Department of Pharmacology and Clinical Neuroscience, Neurology, Umeå University, Umeå
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå
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Kouzuki M, Asaina F, Taniguchi M, Musha T, Urakami K. The relationship between the diagnosis method of neuronal dysfunction (DIMENSION) and brain pathology in the early stages of Alzheimer's disease. Psychogeriatrics 2013; 13:63-70. [PMID: 23909962 DOI: 10.1111/j.1479-8301.2012.00431.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 07/26/2012] [Accepted: 08/09/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine whether the diagnosis method of neuronal dysfunction (DIMENSION), a new electroencephalogram (EEG) analysis method, reflected pathological changes in the early stages of Alzheimer's disease (AD), we conducted a comparative study of cerebrospinal fluid markers and single-photon emission computed tomography. METHODS Subjects cincluded 32 patients in the early stages of AD with a Mini-Mental State Examination score ≥24 (14 men, 18 women; mean age, 77.3 ± 9.2 years). Cerebrospinal fluid samples were collected from AD patients, and cerebrospinal fluid levels of phosphorylated tau protein (p-tau) 181 and amyloid β (Aβ) 42 were measured with sandwich ELISA. EEG recordings were performed for 5 min with the subjects awake in a resting state with their eyes closed. Then, the mean value of the EEG alpha dipolarity (Dα) and the standard deviation of the EEG alpha dipolarity (Dσ) were calculated with DIMENSION. Single-photon emission computed tomography analyses were also performed for comparison with DIMENSION measures. RESULTS Patients with parietal hypoperfusion had significantly increasing p-tau181, decreasing Dα, and increasing Dσ. In addition, there was a negative correlation between Dα and p-tau181, p-tau181/Aβ42, and a positive correlation between Dσ and p-tau181/Aβ42. CONCLUSION Dα and Dσ were related to cerebral hypoperfusion and p-tau181/Aβ42. DIMENSION was able to detect changes in the early-stage Alzheimer's brain, suggesting that it is possibility as a useful examination for early-stage AD with a difficult discrimination in clinical conditions. Moreover, EEG measurement is a quick and easy diagnostic test and is useful for repeated examinations.
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Affiliation(s)
- Minoru Kouzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan.
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Generation of realistic HMPAO SPECT images using a subresolution sandwich phantom. Neuroimage 2013; 81:8-14. [PMID: 23664942 DOI: 10.1016/j.neuroimage.2013.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 04/04/2013] [Accepted: 05/03/2013] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED Traditional interpretation of rCBF SPECT data is of a qualitative nature and is dependent on the observer's understanding of the normal distribution of the tracer. The use of a normal database in quantitative regional analysis facilitates the detection of functional abnormality in individual and group studies by accounting for inter-subject variability. The ability to simulate realistic images would allow various important areas related to the use of normal databases to be studied. These include the optimisation of the detection of abnormal blood flow and the portability of normal databases between gamma camera systems. To investigate this further we have constructed a hardware phantom and scanned various configurations of radioactive brain patterns and simulated skull configurations. METHODS A subresolution sandwich phantom was constructed with a simulated skull which was assembled using a high-resolution segmented MR scan printed with a (99m)TcO₄ - mixture and scanned using a double-headed gamma camera with parallel-hole collimators. Various different grey-to-white matter (GM:WM) ratios and aluminium simulated skull configurations were used. A single difference measure between the phantom data and a control database mean image was used for optimisation. The realism of phantom data was assessed using statistical parametric mapping (SPM) and ROI analysis. RESULTS Optimisation was achieved with a range of WM:GM ratios from 1.9 to 2.4:1 with various simulated skull configurations. CONCLUSION The ability to simulate realistic HMPAO SPECT scans has been demonstrated using a subresolution sandwich phantom. Further work, involving scanning the optimised phantom on different gamma camera systems and comparison with camera-specific normal databases should further refine the phantom configuration.
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Progressive apraxic agraphia with micrographia presenting as corticobasal syndrome showing extensive Pittsburgh compound B uptake. J Neurol 2013; 260:1982-91. [DOI: 10.1007/s00415-013-6908-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/25/2013] [Accepted: 03/27/2013] [Indexed: 10/27/2022]
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Ogura A, Suzuki J, Imai K, Nishida S, Kato T, Yasuda T, Ito Y. [Reversible cerebral vasoconstriction syndrome with cortical subarachnoid hemorrhage presenting as thunderclap headache-a long followed up case]. Rinsho Shinkeigaku 2013; 53:618-623. [PMID: 23965853 DOI: 10.5692/clinicalneurol.53.618] [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: 06/02/2023]
Abstract
A 59-year-old woman presented with thunderclap headache. Cranial CT showed cortical subarachnoid hemorrhage (cSAH) at the right parietal lobe and cerebral angiography on day 5 revealed multiple cerebral arterial constriction, diagnosed as reversible cerebral vasoconstriction syndrome (RCVS). We could not detect vasoconstriction in MRA at the first examination on day 4, and vasoconstrictive finding appeared around Willis circle 8 days later. There was a temporal difference in a cephalalgic symptom and vasoconstrictive appearance. Clinical symptoms completely recovered and head CT, MRI/MRA findings were reversible after two months, reflecting a rather good RCVS outcome. However, we also followed up this case precisely using single photon emission computed tomography (SPECT) with easy Z-score imaging system (e-ZIS), and hypoperfusion at the locus of cSAH persisted for more than one year. This finding strongly suggests that tissue damage in the cSAH locus induced by RCVS may be subclinicaly irreversible, even though clinical symptoms and abnormalities in cranial MRI and MRA completely recover.SPECT may be a high sensitive technique to detect the irreversible lesion in RCVS.
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Affiliation(s)
- Aya Ogura
- Department of Neurology, Stroke Center, Toyota Memorial Hospital, Japan
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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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Uruma G, Hashimoto K, Abo M. A new method for evaluation of mild traumatic brain injury with neuropsychological impairment using statistical imaging analysis for Tc-ECD SPECT. Ann Nucl Med 2012; 27:187-202. [PMID: 23255125 DOI: 10.1007/s12149-012-0674-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 11/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study was to identify specific brain lesions with regional perfusion abnormalities possibly associated with neuropsychological impairments (NPI), as sequela after mild traumatic brain injury (MTBI), using 99mTc-ethylcysteinate dimer single photon emission computed tomography (Tc-99m ECD SPECT) and its novel analytic software. METHODS We studied 23 patients with diffuse axonal injury with NPI group (Impaired-DAI), 26 with MTBI with NPI group (Impaired-MTBI) and 24 with MTBI without NPI group (Healthy-MTBI). In each subject, Tc-99m ECD SPECT images were analyzed by easy Z score imaging system (eZIS) and voxel-based stereotactic extraction estimation (vbSEE). Segmented into lobule levels, ROIs were set in 140 areas in whole brain, and relative regional low Tc-99m ECD uptake was computed as "extent" (rate of coordinates with Z score >2.0 in the ROI). Receiver operating characteristic analysis was performed using "extent" to discriminate the three groups. RESULTS The highest area under the curve (AUC) value for data of Impaired-DAI and Healthy-MTBI groups was obtained in ROI on the left anterior cingulate gyrus (LtACG), with AUC of 0.93, optimal "extent" cutoff value of 10.9%, sensitivity 87.0%, specificity 83.3%. The highest AUC value for data of Impaired-MTBI and Healthy-MTBI groups was also in the LtACG, with AUC of 0.87, optimal "extent" cutoff value of 9.2%, sensitivity 73.1%, specificity 83.3%. CONCLUSIONS Using two analytic software packages, eZIS and vbSEE, we identified specific lesions with low regional Tc-99m ECD uptake possibly associated with NPIs after MTBI. Especially, this trend was most marked in the left anterior cingulate gyrus in MTBI patients with NPIs and those with DAI. The optimal "extent" cutoff value, as a criterion for SPECT abnormality, might help the diagnosis of NPIs after MTBI.
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Affiliation(s)
- Go Uruma
- Department of Rehabilitation Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-Ku, Tokyo, Japan.
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Nagafusa Y, Okamoto N, Sakamoto K, Yamashita F, Kawaguchi A, Higuchi T, Matsuda H. Assessment of cerebral blood flow findings using 99mTc-ECD single-photon emission computed tomography in patients diagnosed with major depressive disorder. J Affect Disord 2012; 140:296-9. [PMID: 22682101 DOI: 10.1016/j.jad.2012.03.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 02/28/2012] [Accepted: 03/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Single-photon emission computed tomography (SPECT) is used as an ancillary diagnostic tool in clinical psychiatry. A variety of SPECT studies has been conducted on the findings and the factors that affect the findings, and there is a possibility that age has an effect on cerebral blood flow. We used SPECT to verify the cerebral blood flow findings of patients with major depressive disorder (MDD) considering the effect of age on the findings. METHODS We conducted a retrospective survey of inpatients who fulfilled the DSM-IV diagnostic criteria for MDD and who had undergone imaging by technetium-99m ethyl cysteinate dimer ((99m)Tc-ECD) SPECT (N=98, 37 males). After excluding organic factors and comorbidities, we established a depression group (N=61, 24 males) and conducted an inter-group comparison with a normal control group by using SPM software considering the effect of age. RESULTS The depression group showed the reduction of cerebral blood flow in the prefrontal area bilaterally, predominantly on the left, including the orbitofrontal cortex, anterior portion of the gyrus cinguli, and dorsolateral prefrontal area, in the left temporal lobe, and in the occipital lobe bilaterally, predominantly on the left. The findings were common to all age groups and that age-specific pattern was not detected. LIMITATIONS The facts that this was a retrospective study and small sample size in each age group were limitations of this research. Although it also seems important to evaluate the impact of medication on cerebral blood flow and conduct an evaluation according to the subtype of depression, but we couldn't in this study. In the future it will be necessary to accumulate additional cases and conduct additional studies, including a prospective survey. CONCLUSION The results of this study may suggest the existence of a common biological background in patients with MDD that is unaffected by age.
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Affiliation(s)
- Yuko Nagafusa
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
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Sohmiya M, Wada N, Tazawa M, Okamoto K, Shirakura K. Immediate effects of physical therapy on gait disturbance and frontal assessment battery in Parkinson's disease. Geriatr Gerontol Int 2012; 13:630-7. [DOI: 10.1111/j.1447-0594.2012.00953.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Koreki A, Takahata K, Tabuchi H, Kato M. Increased left anterior insular and inferior prefrontal activity in post-stroke mania. BMC Neurol 2012; 12:68. [PMID: 22866872 PMCID: PMC3482600 DOI: 10.1186/1471-2377-12-68] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 08/01/2012] [Indexed: 11/10/2022] Open
Abstract
Background Post-stroke mania is an infrequent complication after stroke, and the mechanisms underlying this disorder remain unclear. Although a contralesional release phenomenon has been implicated in post-stroke mania, empirical findings are lacking. Case presentation We present a case report of post stroke mania. Single photon emission tomography (SPECT) was performed twice, during the manic state and during the remitted euthymic state. The first SPECT study performed during the manic state demonstrated hypoperfusion in the right temporal and frontal regions due to right putaminal hemorrhage. It also showed hyperperfusion in the inferior lateral prefrontal lobe, the temporal lobe, and the medial and lateral parts of the parietal lobe in the left hemisphere. The second SPECT study performed during the euthymic state demonstrated moderate improvement in the hypoperfusion in the right fronto-temporal regions. Furthermore, compared to the findings on the first SPECT study, the second study showed that the focal hyperperfusion in the anterior insular cortex, inferior lateral prefrontal lobes, and superior-middle temporal gyrus in the left hemisphere had vanished. Conclusion Increased left inferior prefrontal and anterior insular activity and reduced extensive right fronto-temporal lobe activity are involved in the development of post-stroke mania.
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Affiliation(s)
- Akihiro Koreki
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
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Baker JG, Williams AJ, Ionita CC, Lee-Kwen P, Ching M, Miletich RS. Cerebral small vessel disease: cognition, mood, daily functioning, and imaging findings from a small pilot sample. Dement Geriatr Cogn Dis Extra 2012; 2:169-79. [PMID: 22590477 PMCID: PMC3347879 DOI: 10.1159/000333482] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cerebral small vessel disease, a leading cause of cognitive decline, is considered a relatively homogeneous disease process, and it can co-occur with Alzheimer's disease. Clinical reports of magnetic resonance imaging (MRI)/computed tomography and single photon emission computed tomography (SPECT) imaging and neuropsychology testing for a small pilot sample of 14 patients are presented to illustrate disease characteristics through findings from structural and functional imaging and cognitive assessment. Participants showed some decreases in executive functioning, attention, processing speed, and memory retrieval, consistent with previous literature. An older subgroup showed lower age-corrected scores at a single time point compared to younger participants. Performance on a computer-administered cognitive measure showed a slight overall decline over a period of 8–28 months. For a case study with mild neuropsychology findings, the MRI report was normal while the SPECT report identified perfusion abnormalities. Future research can test whether advances in imaging analysis allow for identification of cerebral small vessel disease before changes are detected in cognition.
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Affiliation(s)
- John G Baker
- Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, N.Y., USA
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Onishi H, Hatazawa J, Nakagawara J, Ito K, Ha-Kawa SK, Masuda Y, Sugibayashi K, Takahashi M, Kikuchi K, Katsuta N. [Availability of normal database by single photon emission computed tomography system with use of 3 dimensional-stereotactic surface projections]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2012; 68:1608-1616. [PMID: 23257590 DOI: 10.6009/jjrt.2012_jsrt_68.12.1608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE The present study aims to quantitatively investigate a normal database (NDB) created under the same acquisition and reconstruction conditions for three gamma camera systems (four types of collimator systems) with use of three-dimensional stereotactic surface projections (3D-SSP). We rebuilt a NDB with use of the N-isopropyl-p-(123)I-iodoamphetamine ((123)I-IMP) SPECT data derived from 30 healthy individuals at 20 institutions nationwide. We standardized the acquisition and reconstruction conditions, evaluated Z scores using patient data (PD) and examined each compensation effect. RESULTS Z scores determined using the advanced NDB were the same value. Artifacts were often generated in Z score maps derived from the conventional NDB (CONDB). The Z score of the own site NDB (OWNDB) was 70% of that calculated based on the CONDB. The combinatorial difference in compensation (scatter and attenuation) resulted in many artifacts being generated in Z score map images. DISCUSSIONS More artifacts were generated in Z score map images using the novel NDB compared with the CONDB. The novel NDB was comparable to the performance of OWNB. The accuracy of brain function image analysis can be improved the reconstruction conditions and correcting for scatter and attenuation on both the novel NDB and PD.
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Affiliation(s)
- Hideo Onishi
- Prefectual University of Hiroshima Graduate School of Comprehensive Scientific Research
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