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Sample records for narcolepsy regional cerebral

  1. Narcolepsy

    DEFF Research Database (Denmark)

    Kornum, Birgitte R; Knudsen, Stine; Ollila, Hanna M

    2017-01-01

    Narcolepsy is a chronic sleep disorder that has a typical onset in adolescence and is characterized by excessive daytime sleepiness, which can have severe consequences for the patient. Problems faced by patients with narcolepsy include social stigma associated with this disease, difficulties...... and safety profiles. However, to date, no treatment hinders or slows disease development. Improved diagnostic tools and increased understanding of the pathogenesis of narcolepsy type 1 are needed and might lead to therapeutic or even preventative interventions....

  2. Narcolepsy

    Science.gov (United States)

    ... nih.gov/pubmed/25700880 . Mignot E. Narcolepsy: genetics, immunology, and pathophysiology. In: Kryger M, Roth T, Dement ... Read more NIH MedlinePlus Magazine Read more Health Topics A-Z Read more A.D.A.M., ...

  3. Narcolepsy

    Science.gov (United States)

    Mitler, Merrill M.; Hajdukovic, Roza; Erman, Milton; Koziol, James A.

    2008-01-01

    Summary Narcolepsy is a neurological condition with a prevalence of up to 1 per 1,000 that is characterized by irresistible bouts of sleep. Associated features include the pathological manifestations of rapid-eye-movement (REM) sleep: cataplexy, sleep paralysis, hypnagogic hallucinations, and abnormal sleep-onset REM periods and disturbed nocturnal sleep. The condition is strongly associated with the HLA-DR2 and DQw1 phenotype. The phenomenology of narcolepsy is discussed, and diagnostic procedures are reviewed. Treatment modalities involving central nervous system stimulants for somnolence and tricyclic drugs for REM-sleep abnormalities are discussed. Sleep laboratory studies on the treatment efficacy of methylphenidate, pemoline, dextroamphetamine, protriptyline, and viloxazine are presented. Data suggest that: (1) methylphenidate and dextro-amphetamine objectively improve somnolence; (2) pemoline, at doses up to 112.5 mg, is less effective in controlling somnolence but may improve certain aspects of performance; and (3) protriptyline and viloxazine are effective anticataplectic agents that produce little improvement in somnolence. PMID:1968069

  4. Evaluation of regional metabolic abnormality and treatment effect in patients with narcolepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Yoon, In Young; Shin, Youn Kyung; Eo, Jae Sean; Won, Oh So; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    The aim of the present study was to evaluated regional metabolic abnormalities in untreated narcoleptic patients and the changes in regional cerebral metabolism after treatment with modafinil. Eight drug free narcoleptic patients (mean age of 17{+-}1 yr) participated in this study. Two [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans before and after a 2-week titrated modafinil treatment (target dose = 100{approx}400 mg/day). The PET data were analyzed by using statistical parametric mapping methods to identify the regional cerebral abnormalities compared with those of healthy young controls. In addition, treatment effect was evaluated by comparison between before and after treatment scan. In narcolepsy patients, a significant reduction of regional metabolism was demonstrated in the brain stem, bilateral hypothalamus, posterior thalamus, hippocampus, parahippocampal gyrus, and adjacent perihinal area on pretreatment scans compared with those of healthy subjects. The decrease glucose metabolism was also found in the occipital cortex and cerebellum. The patients could control daytime sleepiness after treatment. Posttreatment scan showed a significant increase in regional metabolism in the left hippocampus. This study demonstrated the metabolic abnormalities and the effect of modafinil treatment in narcoleptic patients in the sleep associated regions. This results could be helpful to understand the pathophysiology of the narcolepsy and treatment mechanism.

  5. Cerebellar malformations alter regional cerebral development.

    Science.gov (United States)

    Bolduc, Marie-Eve; Du Plessis, Adre J; Evans, Alan; Guizard, Nicolas; Zhang, Xun; Robertson, Richard L; Limperopoulos, Catherine

    2011-12-01

    The aim of this study was to compare total and regional cerebral volumes in children with isolated cerebellar malformations (CBMs) with those in typically developing children, and to examine the extent to which cerebellar volumetric reductions are associated with total and regional cerebral volumes. This is a case-control study of children diagnosed with isolated CBMs. Each child was matched on age and sex to two typically developing children. Using advanced three-dimensional volumetric magnetic resonance imaging, the cerebrum was segmented into tissue classes and partitioned into eight regions. Analysis of variance was used to compare cerebral volumes between children with CBMs and control children, and linear regressions to examine the impact of cerebellar volume reduction on cerebral volumes. Magnetic resonance imaging was performed at a mean age of 27 months in 20 children (10 males, 10 females) with CBMs and 40 typically developing children. Children with CBMs showed significantly smaller deep grey matter nuclei (p developing children. Greater cerebellar volumetric reduction in children with CBMs was associated with decreased total cerebral volume and deep grey matter nuclei (p = 0.02), subgenual white/grey matter (p = 0.001), midtemporal white (p = 0.02) and grey matter (p = 0.01), and parieto-occipital grey matter (p = 0.004). CBMs are associated with impaired regional cerebral growth, suggesting deactivation of principal cerebello-cerebral pathways. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  6. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  7. Regional cerebral blood flow in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, J.; Ohta, Y.; Nakane, Y.; Mori, H.; Hirota, N.; Yonekura, M.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of /sup 133/X in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., hypofrontality); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms.

  8. Regional cerebral blood flow in schizophrenics

    International Nuclear Information System (INIS)

    Uchino, Jun; Ohta, Yasuyuki; Nakane, Yoshibumi; Mori, Hiroyuki; Hirota, Noriyoshi; Yonekura, Masahiro.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of X-133 in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., ''hypofrontality''); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms. (Namekawa, K.)

  9. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    International Nuclear Information System (INIS)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S.; Lee, Kyung Han; Lee, Myung Chul

    1996-01-01

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p 0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  10. Postradiation regional cerebral blood flow in primates

    International Nuclear Information System (INIS)

    Cockerham, L.G.; Cerveny, T.J.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with hypotension and a dramatic release of mast cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomenon and the postradiation decrease in cerebral blood flow, primates were exposed to 100 Gy (1 Gy = 100 rads), whole-body, gamma radiation. Pontine and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. Systemic arterial histamine levels were determined preradiation and postradiation. Data obtained indicated that radiated animals showed a decrease in blood flow of 63% in the motor cortex and 51% in the pons by 10 min postradiation. Regional cerebral blood flow of radiated animals showed a slight recovery 20 min postradiation, followed by a fall to the 10 min nadir by 60 min postradiation. Immediately, postradiation systemic blood pressure fell 67% and remained at that level for the remainder of the experiment. Histamine levels in the radiated animals increased a hundredfold 2 min postradiation. This study indicates that regional cerebral blood flow decreases postradiation with the development of hypotension and may be associated temporally with the postradiation release of histamine

  11. Regional cerebral flows in hypertensive patients

    International Nuclear Information System (INIS)

    Britton, K.E.; Granowska, M.; Lee, T.Y.; Nimmon, C.C.; Rutland, M.

    1978-01-01

    The aim of this study is to develop a method for assessing the natural history of cerebrovascular disease in patients with hypertension in order that the effects of controlling hypertension may be judged. By developing a quantitative noninvasive method for measuring regional cerebral flow and internal carotid appearance times it is hoped that drugs intended to inhibit the continued formation of atheroma and drugs intended to aid the dissolution of atheroma, may be objectively evaluated. (Auth.)

  12. Regional cerebral blood flow in Angelman syndrome

    International Nuclear Information System (INIS)

    Guecueyener, K.; Goekcora, N.; Ilgin, N.; Buyan, N.; Sayli, A.

    1993-01-01

    A patient with typical features of Angelman syndrome - a genetically inherited disorder involving developmental delay, ataxia, episodes of paroxysmal laughter and brachiocephaly - was studied with single-photon emission tomography. Hyperfusion found in the left frontal and left temporoparietal regions can provide insights into the functional cerebral pathology, which may be due to a disturbance of the developmental process related to a chromosomal abnormality. (orig.)

  13. Regional cerebral blood flow in Angelman syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Guecueyener, K [Dept. of Pediatric Neurology, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Goekcora, N [Dept. of Nuclear Medicine, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Ilgin, N [Dept. of Nuclear Medicine, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Buyan, N [Dept. of Pediatric Neurology, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Sayli, A [Dept. of Molecular Biology and Genetics, Faculty of Medicine, Gazi Univ., Ankara (Turkey)

    1993-07-01

    A patient with typical features of Angelman syndrome - a genetically inherited disorder involving developmental delay, ataxia, episodes of paroxysmal laughter and brachiocephaly - was studied with single-photon emission tomography. Hyperfusion found in the left frontal and left temporoparietal regions can provide insights into the functional cerebral pathology, which may be due to a disturbance of the developmental process related to a chromosomal abnormality. (orig.)

  14. A Means for the Scintigraphic Imaging of Regional Brain Dynamics. Regional Cerebral Blood Flow and Regional Cerebral Blood Volume

    Energy Technology Data Exchange (ETDEWEB)

    Potchen, E. J.; Bentley, R.; Gerth, W.; Hill, R. L.; Davis, D. O. [Washington University School Of Medicine, St. Louis, MO (United States)

    1969-05-15

    The use of freely diffusable inert radioactive gas as a washout indicator to measure regional cerebral blood flow has become a standardized kinetic procedure in many laboratories. Recent investigations with this technique have led us to conclude that we can reliably distinguish regional flow with perfusion against regional flow without perfusion from the early portion of the curve. Based on a detailed study of the early curve kinetics in patients with and without cerebral vascular disease we have defined the sampling duration necessary for application of the Anger gamma camera imaging process to regional changes in cerebral radioactivity. Using a standard camera and a small computer, a procedure has been developed and based upon entire field to determine the time of maximum height followed by analysis of the data in a matrix. This will permit a contour plot presentation of calculated regional cerebral blood flow in millilitres per 100 grams perfused brain per minute. In addition, we propose to augment this data by the display of regional non-perfusion blood flow versus regional cerebral flow with perfusion. Preliminary investigation on sampling duration, and Compton scattering were prerequisite to clinical scintigraphy of regional cerebral blood flow. In addition, the method of interface for the conventional Anger gamma camera to digital computers used in this procedure are discussed. Applications to further assess regional cerebral dynamics by scintigraphy are presented. (author)

  15. Regional cerebral blood flow in schizophrenia

    International Nuclear Information System (INIS)

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions

  16. Regional cerebral blood flow in schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  17. Narcolepsy: a review

    Directory of Open Access Journals (Sweden)

    Akintomide GS

    2011-09-01

    Full Text Available Gbolagade Sunmaila Akintomide1, Hugh Rickards21Department of Neuropsychiatry, University of Birmingham, 2Department of Neuropsychiatry, The Barberry, Edgbaston, Birmingham, UKAbstract: Narcolepsy is a lifelong sleep disorder characterized by a classic tetrad of excessive daytime sleepiness with irresistible sleep attacks, cataplexy (sudden bilateral loss of muscle tone, hypnagogic hallucination, and sleep paralysis. There are two distinct groups of patients, ie, those having narcolepsy with cataplexy and those having narcolepsy without cataplexy. Narcolepsy affects 0.05% of the population. It has a negative effect on the quality of life of its sufferers and can restrict them from certain careers and activities. There have been advances in the understanding of the pathogenesis of narcolepsy. It is thought that narcolepsy with cataplexy is secondary to loss of hypothalamic hypocretin neurons in those genetically predisposed to the disorder by possession of human leukocyte antigen DQB1*0602. The diagnostic criteria for narcolepsy are based on symptoms, laboratory sleep tests, and serum levels of hypocretin. There is no cure for narcolepsy, and the present mainstay of treatment is pharmacological treatment along with lifestyle changes. Some novel treatments are also being developed and tried. This article critically appraises the evidence for diagnosis and treatment of narcolepsy.Keywords: narcolepsy, cataplexy, hypocretin, modafinil, gamma hydroxybutyrate

  18. Regional cerebral perfusion in cardiovascular reflex syncope

    International Nuclear Information System (INIS)

    Toeyry, J.P.; Kuikka, J.T.; Laensimies, E.A.

    1997-01-01

    Little is known about the regional cerebral perfusion in subjects with presyncope or syncope, and the impact that autonomic nervous dysfunction has on it. Seven subjects with cardiovascular vasodepressor reflex syncope were studied. A baseline test was performed with the patients standing in the 70 upright position, while the passive head-up tilt table test with and without isoprenaline infusion was employed for provocation. Regional cerebral perfusion was assessed by means of single-photon emission tomography with technetium-99m labelled V-oxo-1,2-N,N 1 -ethylenedylbis-l-cysteine diethylester (baseline, and during blood pressure decline in the provocation test) and the autonomic nervous function by means of spectral analysis of heart rate variability (baseline, and before blood pressure decline in the provocation test). Every subject showed an abrupt decline in blood pressure in the provocation test (five with presyncope and two with syncope). The systolic and diastolic blood pressures decreased significantly (P<0.001) between the baseline and the provocation study time points (radiopharmaceutical injection and lowest systolic blood pressure). Mean cerebral perfusion as average count densities decreased upon provocation as compared with baseline (190±63 vs 307±90 counts/voxel, respectively, P=0.013). Hypoperfusion was most pronounced in the frontal lobe. These results suggest that cerebral perfusion decreases markedly during presyncope or syncope with systemic blood pressure decline in subjects with cardiovascular vasodepressor syncope. Furthermore, the autonomic nervous function remains unchanged before the systemic blood pressure decline. (orig.). With 3 figs., 2 tabs

  19. EIF3G is associated with narcolepsy across ethnicities

    DEFF Research Database (Denmark)

    Holm, Anja; Lin, Ling; Faraco, Juliette

    2015-01-01

    conserved in mammals and zebrafish containing PPAN, EIF3G and DNMT1 (DNA methyltransferase 1). As mutations in DNMT1 cause a rare dominant form of narcolepsy in association with deafness, cerebellar ataxia and dementia, we questioned whether the association with P2RY11 in sporadic narcolepsy could...... be secondary to linkage disequilibrium with DNMT1. Based on genome-wide association data from two cohorts of European and Chinese ancestry, we found that the narcolepsy association signal drops sharply between P2RY11/EIF3G and DNMT1, suggesting that the association with narcolepsy does not extend into the DNMT......1 gene region. Interestingly, using transethnic mapping, we identified a novel single-nucleotide polymorphism rs3826784 (c.596-260A>G) in the EIF3G gene also associated with narcolepsy. The disease-associated allele increases EIF3G mRNA expression. EIF3G is located in the narcolepsy risk locus...

  20. Narcolepsy and pregnancy

    DEFF Research Database (Denmark)

    Maurovich-Horvat, Eszter; Kemlink, David; Högl, Birgit

    2013-01-01

    In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms...... of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P ...

  1. Narcolepsy: a review

    Science.gov (United States)

    Akintomide, Gbolagade Sunmaila; Rickards, Hugh

    2011-01-01

    Narcolepsy is a lifelong sleep disorder characterized by a classic tetrad of excessive daytime sleepiness with irresistible sleep attacks, cataplexy (sudden bilateral loss of muscle tone), hypnagogic hallucination, and sleep paralysis. There are two distinct groups of patients, ie, those having narcolepsy with cataplexy and those having narcolepsy without cataplexy. Narcolepsy affects 0.05% of the population. It has a negative effect on the quality of life of its sufferers and can restrict them from certain careers and activities. There have been advances in the understanding of the pathogenesis of narcolepsy. It is thought that narcolepsy with cataplexy is secondary to loss of hypothalamic hypocretin neurons in those genetically predisposed to the disorder by possession of human leukocyte antigen DQB1*0602. The diagnostic criteria for narcolepsy are based on symptoms, laboratory sleep tests, and serum levels of hypocretin. There is no cure for narcolepsy, and the present mainstay of treatment is pharmacological treatment along with lifestyle changes. Some novel treatments are also being developed and tried. This article critically appraises the evidence for diagnosis and treatment of narcolepsy. PMID:21931493

  2. [NARCOLEPSY WITH CATAPLEXY: TYPE 1 NARCOLEPSY].

    Science.gov (United States)

    Dauvilliers, Yves; Lopez, Régis

    2016-06-01

    Narcolepsy with cataplexy or narcolepsy type 1 in a rare, disabling sleep disorder, with a prevalence of 20 to 30 per 100,000. Its onset peaks in the second decade. The main features are excessive daytime sleepiness and cataplexy or sudden less of muscle tone triggered by emotional situations. Other less consistent symptoms include hypnagogic hallucinations, sleep paralysis, disturbed nighttime sleep, and weight gain. Narcolepsy with cataplexy remains a clinical diagnosis but nighttime and daytime polysomnography (multiple sleep latency tests) are useful to document mean sleep latency below 8 min and at least two sleep-onset REM periods. HLA typing shows an association with HLA DQB1*0602 in more than 92% of cases but was not included in the new diagnostic criteria. In contrast, a low hypocretin-1/orexin-A levels (values below 110 pg/mL) in the cerebrospinal fluid was highly specific for narcolepsy with cataplexy and was included in the recent diagnostic criteria for narcolepsy. The deficiency of the hypocretin system is well-established in human narcoleptics with a reduction of cerebrospinal fluid hypocretin levels in relation with an early loss of hypocretin neurons. The cause of human narcolepsy remains unknown, however an autoimmune process in most probable acting on a highly genetic background with environmental factors such as streptococcal infections, and H1N1 AS03-adjuvanted vaccine named Pandemrix.

  3. Regional cerebral blood flow in schizophrenic patients

    International Nuclear Information System (INIS)

    Sagawa, Katsuo; Sibuya, Isoo; Oiji, Arata; Kawakatsu, Sinobu; Morinobu, Shigeru; Totsuka, Shiro; Kinoshita, Osami; Yazaki, Mitsuyasu.

    1990-01-01

    Seventy-six schizophrenic patients were examined by a Xe-133 inhalation method to determine regional cerebral blood flow. A decreased blood flow was observed in the frontal lobe, especially in the right inferior part. In a study on the relationship between disease subtypes and regional cerebral blood flow, negative symptoms were found more predominantly associated with dissolution type than delusion type. In the group of dissolution type, a decreased blood flow was observed in both the right inferior frontal lobe and the right upper hemisphere, in comparison to the group of delution type. Patients presenting with auditory hallucination had a significantly higher incidence of both negative and positive symptoms, as compared with those not presenting with it. In such patients, a significantly decreased blood flow was also seen in the left upper frontal lobe and the bilateral parietal lobe. Xe-133 inhalation method should assist in evaluating brain function in schizophrenic patients, thus leading to the likelihood of developing a new treatment modality. (N.K.)

  4. Regional cerebral blood flow in diabetic patients

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Ono, Shinnichi; Nishikawa, Takushi

    1993-01-01

    N-isopropyl-p- 123 I-iodoamphetamine (IMP) was used to quantify the regional cerebral blood flow (r-CBF) in 11 diabetic patients (average age; 67.9 years) and 12 non-diabetic subjects (average age; 67.4 years), none of whom had (cerebrovascular disease (CVD) on CT studies. A reference sampling method by continuous arterial blood sampling was used to quantify r-CBF. There were no significant differences in physiological or laboratory data between diabetic and non-diabetic groups except for fasting plasma glucose and HbA 1c levels. The average of r-CBF in each region of cerebrum and cerebellum was significantly lower in diabetic group than that in the control group (p<0.01). These observations show that r-CBF of diabetic patients is reduced, even in the absence of findings of CVD on a CT study. (author)

  5. Type 1 narcolepsy

    DEFF Research Database (Denmark)

    Degn, Matilda; Kornum, Birgitte Rahbek

    2015-01-01

    Type 1 narcolepsy is a sleep disorder characterized by excessive daytime sleepiness with unintentional sleep attacks and cataplexy. The disorder is caused by a loss of hypocretinergic neurons in the brain. The specific loss of these neurons in narcolepsy is thought to result from an autoimmune...

  6. Gender differences in regional cerebral blood flow

    International Nuclear Information System (INIS)

    Gur, R.E.; Gur, R.C.

    1990-01-01

    Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined

  7. Regional cerebral blood flow in schizophrenia

    International Nuclear Information System (INIS)

    Kanoh, Masayuki

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured at rest using the 133 Xe inhalation technique in 40 DSM-III-diagnosed schizophrenics (22 males, 18 females: mean age 35.0 years, range 20-49 years) and 31 age-and sex-matched normal controls (16 males, 15 females: mean age 34.3 years, range 21-49 years). The absolute value (AV) and the percent value (PV) of the rCBF in schizophrenics were compared with those in controls. Correlations between rCBF and the Brief Psychiatric Rating Scale (BPRS) scores or the performance of Wisconsin Card Sorting Test (WCST) were examined in schizophrenics. Schizophrenics showed significantly lower AVs in all brain regions examined and a significantly lower PV in the left superior frontal region than controls. The hyperfrontal rCBF distribution which was found in both hemispheres in controls, was absent in the left hemisphere in schizophrenics. In schizophrenics, superior frontal blood flows were significantly negatively correlated with the negative symptom scores of the BPRS but not with the total scores and the positive symptom scores of the BPRS. In schizophrenics, inferior frontal blood flows were significantly correlated with the number of sorting categories achieved. These results indicate that rCBF in schizophrenia is reduced in the whole brain and especially in the left superior frontal region. These findings suggest a frontal lobe dysfunction in schizophrenia. (author)

  8. What Is Narcolepsy?

    Science.gov (United States)

    ... medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. Narcolepsy in Special Groups School-Aged Children ...

  9. Regional cerebral blood flow in neuropediatrics

    International Nuclear Information System (INIS)

    Junik, R.

    2001-01-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  10. Regional cerebral blood flow in fibromyalgia

    International Nuclear Information System (INIS)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K.

    1998-01-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  11. Regional cerebral blood flow in fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K. [The Queen Elizabeth Hospital , Adelaide, SA (Australia)

    1998-06-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  12. Dynamic exercise enhances regional cerebral artery mean flow velocity

    DEFF Research Database (Denmark)

    Linkis, P; Jørgensen, L G; Olesen, H L

    1995-01-01

    Dynamic exercise enhances regional cerebral artery mean flow velocity. J. Appl. Physiol. 78(1): 12-16, 1995.--Anterior (ACA) and middle (MCA) cerebral artery mean flow velocities (Vmean) and pulsatility indexes were determined using transcranial Doppler in 14 subjects during dynamic exercise afte...

  13. Treatment Options for Narcolepsy.

    Science.gov (United States)

    Barateau, Lucie; Lopez, Régis; Dauvilliers, Yves

    2016-05-01

    Narcolepsy type 1 and narcolepsy type 2 are central disorders of hypersomnolence. Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy and is associated with hypocretin-1 deficiency. On the other hand, in narcolepsy type 2, cerebrospinal fluid hypocretin-1 levels are normal and cataplexy absent. Despite major advances in our understanding of narcolepsy mechanisms, its current management is only symptomatic. Treatment options may vary from a single drug that targets several symptoms, or multiple medications that each treats a specific symptom. In recent years, narcolepsy treatment has changed with the widespread use of modafinil/armodafinil for daytime sleepiness, antidepressants (selective serotonin and dual serotonin and noradrenalin reuptake inhibitors) for cataplexy, and sodium oxybate for both symptoms. Other psychostimulants can also be used, such as methylphenidate, pitolisant and rarely amphetamines, as third-line therapy. Importantly, clinically relevant subjective and objective measures of daytime sleepiness are required to monitor the treatment efficacy and to provide guidance on whether the treatment goals are met. Associated symptoms and comorbid conditions, such as hypnagogic/hypnopompic hallucinations, sleep paralysis, disturbed nighttime sleep, unpleasant dreams, REM- and non REM-related parasomnias, depressive symptoms, overweight/obesity, and obstructive sleep apnea, should also be taken into account and managed, if required. In the near future, the efficacy of new wake-promoting drugs, anticataplectic agents, hypocretin replacement therapy and immunotherapy at the early stages of the disease should also be evaluated.

  14. Regional cerebral blood flow in childhood headache

    International Nuclear Information System (INIS)

    Roach, E.S.; Stump, D.A.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical

  15. Dynamic emission tomography of regional cerebral blood flow

    International Nuclear Information System (INIS)

    Lassen, N.A.

    1984-01-01

    The author reviews three tomographic methods for measuring the regional cerebral blood flow: single photon transmission tomography; dual photon emission tomography; and single photon emission tomography. The latter technique is discussed in detail. (Auth.)

  16. Lucid Dreaming in Narcolepsy

    Science.gov (United States)

    Dodet, Pauline; Chavez, Mario; Leu-Semenescu, Smaranda; Golmard, Jean-Louis; Arnulf, Isabelle

    2015-01-01

    Objective: To evaluate the frequency, determinants and sleep characteristics of lucid dreaming in narcolepsy Settings: University hospital sleep disorder unit Design: Case-control study Participants: Consecutive patients with narcolepsy and healthy controls Methods: Participants were interviewed regarding the frequency and determinants of lucid dreaming. Twelve narcolepsy patients and 5 controls who self-identified as frequent lucid dreamers underwent nighttime and daytime sleep monitoring after being given instructions regarding how to give an eye signal when lucid. Results: Compared to 53 healthy controls, the 53 narcolepsy patients reported more frequent dream recall, nightmares and recurrent dreams. Lucid dreaming was achieved by 77.4% of narcoleptic patients and 49.1% of controls (P dreams/month (P dreaming. Seven of 12 narcoleptic (and 0 non-narcoleptic) lucid dreamers achieved lucid REM sleep across a total of 33 naps, including 14 episodes with eye signal. The delta power in the electrode average, in delta, theta, and alpha powers in C4, and coherences between frontal electrodes were lower in lucid than non-lucid REM sleep in spectral EEG analysis. The duration of REM sleep was longer, the REM sleep onset latency tended to be shorter, and the percentage of atonia tended to be higher in lucid vs. non-lucid REM sleep; the arousal index and REM density and amplitude were unchanged. Conclusion: Narcoleptics have a high propensity for lucid dreaming without differing in REM sleep characteristics from people without narcolepsy. This suggests narcolepsy patients may provide useful information in future studies on the nature of lucid dreaming. Citation: Dodet P, Chavez M, Leu-Semenescu S, Golmard JL, Arnulf I. Lucid dreaming in narcolepsy. SLEEP 2015;38(3):487–497. PMID:25348131

  17. Lucid dreaming in narcolepsy.

    Science.gov (United States)

    Dodet, Pauline; Chavez, Mario; Leu-Semenescu, Smaranda; Golmard, Jean-Louis; Arnulf, Isabelle

    2015-03-01

    To evaluate the frequency, determinants and sleep characteristics of lucid dreaming in narcolepsy. University hospital sleep disorder unit. Case-control study. Consecutive patients with narcolepsy and healthy controls. Participants were interviewed regarding the frequency and determinants of lucid dreaming. Twelve narcolepsy patients and 5 controls who self-identified as frequent lucid dreamers underwent nighttime and daytime sleep monitoring after being given instructions regarding how to give an eye signal when lucid. Compared to 53 healthy controls, the 53 narcolepsy patients reported more frequent dream recall, nightmares and recurrent dreams. Lucid dreaming was achieved by 77.4% of narcoleptic patients and 49.1% of controls (P dreamers achieved lucid REM sleep across a total of 33 naps, including 14 episodes with eye signal. The delta power in the electrode average, in delta, theta, and alpha powers in C4, and coherences between frontal electrodes were lower in lucid than non-lucid REM sleep in spectral EEG analysis. The duration of REM sleep was longer, the REM sleep onset latency tended to be shorter, and the percentage of atonia tended to be higher in lucid vs. non-lucid REM sleep; the arousal index and REM density and amplitude were unchanged. Narcolepsy is a novel, easy model for studying lucid dreaming. © 2015 Associated Professional Sleep Societies, LLC.

  18. Autoimmunity and Immunotherapy in Narcolepsy

    Directory of Open Access Journals (Sweden)

    Min Jae Seong

    2017-06-01

    Full Text Available Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination, and sleep paralysis. Narcolepsy is caused by damage of hypocretin producing neurons in the lateral hypothalamus. The association of narcolepsy with HLA DQB1*0602 and high incidence following H1N1 pandemic in china, vaccination with pandemrix and an adjuvanted H1N1 vaccine suggests that pathophysiology of narcolepsy is involved in the immune system. This review focused on immunological associations and immunotherapy in narcolepsy.

  19. National narcolepsy survey

    LENUS (Irish Health Repository)

    Doherty, L.

    2010-04-01

    Narcolepsy is characterised by excessive daytime sleepiness and cataplexy and has a prevalence of 25 per 100,000. We suspect this is higher than presently seen in the Republic of Ireland. We aimed to calculate the Irish prevalence of Narcolepsy and to examine current management practices. We conducted an online survey of respiratory physicians, neurologists, paediatric neurologists, and psychiatrists with an interest in sleep disorders (73% response rate). Of this group, a total of 16 physicians managed 180 patients prior to January 2009. A clinical diagnosis alone was reached in 67 (41%) patients, the remainder by polysomnography or multiple sleep latency testing. No patients were diagnosed by cerebro-spinal fluid analysis of hypocretin levels. While 70 (42%) patients received modafanil, only 7 (4%) were treated with sodium oxybate. Even allowing for missing data it is apparent that Narcolepsy is hugely under-diagnosed in Ireland, however, current practises adhere with new international guidelines.

  20. A child with narcolepsy

    Directory of Open Access Journals (Sweden)

    Silvério Macedo

    2016-02-01

    Full Text Available Introduction: Narcolepsy is a chronic disease characterized by sleep attacks, excessive daytime sleepiness and nocturnal sleep fragmentation. It can be associated cataplexy and other disturbance of REM sleep (sleep paralysis and hypnagogic hallucinations and hypnopompic. Case report: A 10-year old boy was referred to Pedopsychiatry because of behavioural disturbance, irritability, sleepiness and distraction, being interpreted as an “ill-mannered child.” After clinical evaluation and comprehensive laboratory studies we concluded that he presented narcolepsy with cataplexy. Discussion/conclusion: Patients with narcolepsy face several problems due to the disease which, if left untreated or ineffectively treated, cause embarrassing or distressing symptoms, affecting their quality of life. The purpose of this paper is to draw attention to this problem since it is a rare condition and therefore seldom not recognized by the general public or even by health professionals.

  1. Anesthetic Management of Narcolepsy Patients During Surgery: A Systematic Review.

    Science.gov (United States)

    Hu, Sally; Singh, Mandeep; Wong, Jean; Auckley, Dennis; Hershner, Shelley; Kakkar, Rahul; Thorpy, Michael J; Chung, Frances

    2018-01-01

    Narcolepsy is a rare sleep disorder characterized by excessive daytime sleepiness, sleep paralysis, and/or hypnagogic/hypnopompic hallucinations, and in some cases cataplexy. The response to anesthetic medications and possible interactions in narcolepsy patients is unclear in the perioperative period. In this systematic review, we aim to evaluate the current evidence on the perioperative outcomes and anesthetic considerations in narcolepsy patients. Electronic literature search of Medline, Medline in-process, Embase, Cochrane Database of Systematic Reviews databases, international conference proceedings, and abstracts was conducted in November 2015 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline. A total of 3757 articles were screened using a 2-stage strategy (title-abstract followed by full text). We included case studies/series, cohort studies, and randomized controlled trials of narcolepsy patients undergoing surgical procedures under anesthesia or sedation. Preoperative narcolepsy symptoms and sleep study data, anesthetic technique, and perioperative complications were extracted. Screening of articles, data extraction, and compilation were conducted by 2 independent reviewers and any conflict was resolved by the senior author. A total of 19 studies including 16 case reports and 3 case series were included and evaluated. The majority of these patients received general anesthesia, whereas a small percentage of patients received regional anesthesia. Reported complications of narcolepsy patients undergoing surgeries were mainly related to autonomic dysregulation, or worsening of narcolepsy symptoms intra/postoperatively. Narcolepsy symptoms worsened only in those patient populations where the preoperative medications were either discontinued or reduced (mainly in obstetric patients). In narcolepsy patients, use of depth of anesthesia monitoring and total intravenous technique may have some advantage in terms

  2. Mechanisms regulating regional cerebral activation during dynamic handgrip in humans

    DEFF Research Database (Denmark)

    Williamson, James; Friedman, D B; Mitchell, J H

    1996-01-01

    Dynamic hand movement increases regional cerebral blood flow (rCBF) of the contralateral motor sensory cortex (MS1). This increase is eliminated by regional anesthesia of the working arm, indicating the importance of afferent neural input. The purpose of this study was to determine the specific...

  3. Narcolepsy and the hypocretins.

    Science.gov (United States)

    Wurtman, Richard J

    2006-10-01

    Narcolepsy is a chronic neurologic disease characterized by excessive daytime sleepiness and one or more of three additional symptoms (cataplexy, or sudden loss of muscle tone; vivid hallucinations; and brief periods of total paralysis) related to the occurrence of rapid eye movement (REM) sleep at inappropriate times. The daytime sleepiness typically presents as a sudden overwhelming urge to sleep, followed by periods of sleep that last for seconds or minutes, or even longer. During daytime sleep episodes, patients may exhibit "automatic behavior," performing conventionalized functions (eg, taking notes), but not remembering having done so once they are awake. About 10% of narcoleptics are members of familial clusters; however, genetic factors alone are apparently insufficient to cause the disease, inasmuch as the most common genetic disorder, a mutation in chromosome 6 controlling the HLA antigen immune complex, although seen in 90% to 100% of patients, also occurs in as many as 50% of people without narcolepsy. A dog model of narcolepsy exhibits a mutation on chromosome 12 that disrupts the processing of the peptide neurotransmitter hypocretin. No such mutation characterizes human narcolepsy; however, cerebrospinal fluid (CSF) hypocretin levels are profoundly depressed in narcoleptic patients, and a specific reduction in hypocretin-containing neurons has been described. One hypothesis concerning the pathophysiology of narcolepsy proposes that the HLA subtype resulting from the mutation on chromosome 6 increases the susceptibility of hypocretin-containing brain neurons to immune attack. Because hypocretin may normally participate in the maintenance of wakefulness, the loss of neurons that release this peptide might allow REM sleep to occur at inappropriate times, ie, while the patient is awake, in contrast to its normal cyclic appearance after a period of slow-wave sleep. The cataplexy, hallucinations, and/or paralysis associated with REM episodes normally are

  4. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Kitamura, Shin

    1983-01-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways. (J.P.N.)

  5. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin [Nippon Medical School, Tokyo

    1983-04-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways.

  6. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R

    1993-01-01

    This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized on electroencepha......This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized...... electroencephalography-verified generalized seizures....

  7. Regional effects of craniotomy on cerebral circulation and metabolism

    International Nuclear Information System (INIS)

    Abumiya, Takeo; Sayama, Ichiro; Asakura, Ken; Hadeishi, Hiromu; Mizuno, Makoto; Suzuki, Akifumi; Yasui, Nobuyuki; Shishido, Fumio; Uemura, Kazuo

    1990-01-01

    Regional effects of craniotomy on cerebral circulation and metabolism, such as regional cerebral blood flow (rCBF), regional cerebral oxygen consumption (rCMRO 2 ), regional oxygen extraction fraction (rOEF), and regional cerebral blood volume (rCBV) were examined by a PET (positron emission tomography) study concerning surgery that was performed on un-ruptured aneurysm patients. Eight patients with intracranial un-ruptured aneurysms were studied pre- and post-operatively by the 15 O labelled-gas steady-state method, using HEADTOME-III. All patients underwent aneurysmal surgery performed by the transsylvian approach. There was a significant increase in the mean OEF values taken from the whole-brains of 8 patients, but there was not a significant change in CBF, CMRO 2 or CBV. The increase in OEF was caused by decrease of O 2 content, which was caused by post-operative decrease in the Hb value. So, this OEF increase was not the direct effect of craniotomy. In 2 patients, the rCBF and rCMRO 2 , in the fronto-temporal region (where craniotomy was performed) increased post-operatively. This regional effect suggests transient reactive hyperemia following compressive ischemia during the operative procedure, and metabolic demands for recovery of brain function. In 2 other patients, who had relatively low rCBFs during the pre-operative study, rCBF and rCMRO 2 in the bi-frontal region had decreased more at the post-operative study. This change appears to have been caused by removal of cerebrospinal fluid and depression of the frontal lobe. From this study, it becomes evident that the regional effect of craniotomy on cerebral circulation and metabolism is not so great, when adequate microsurgical techniques are used. (author)

  8. Causes of Hypersomnia – Narcolepsy

    Directory of Open Access Journals (Sweden)

    M V Padma Srivastav

    2014-03-01

    Full Text Available The causes of hypersomnia or excessive daytime sleepiness (EDS besides volitionalsleep deprivation and obstructive sleep apnea are principally due to primary centralnervous system abnormalities. Most common amongst these is Narcolepsy, a primarydisorder of the neural control of wakefulness and sleep. The recent discovery ofhypocretin/orexin deficiency as the main cause of narcolepsy will lead to importanttherapeutic advances for patients with narcolepsy and further to understanding of thecontrol of sleep and wakefulness in general. Importantly, the excessive daytimesleepiness is not due to psychiatric conditions, but rather is always due to sleepdeprivation or an underlying diagnosable and treatable sleep disorder.Key words : EDS, Sleep, Narcolepsy

  9. Fused cerebral organoids model interactions between brain regions.

    Science.gov (United States)

    Bagley, Joshua A; Reumann, Daniel; Bian, Shan; Lévi-Strauss, Julie; Knoblich, Juergen A

    2017-07-01

    Human brain development involves complex interactions between different regions, including long-distance neuronal migration or formation of major axonal tracts. Different brain regions can be cultured in vitro within 3D cerebral organoids, but the random arrangement of regional identities limits the reliable analysis of complex phenotypes. Here, we describe a coculture method combining brain regions of choice within one organoid tissue. By fusing organoids of dorsal and ventral forebrain identities, we generate a dorsal-ventral axis. Using fluorescent reporters, we demonstrate CXCR4-dependent GABAergic interneuron migration from ventral to dorsal forebrain and describe methodology for time-lapse imaging of human interneuron migration. Our results demonstrate that cerebral organoid fusion cultures can model complex interactions between different brain regions. Combined with reprogramming technology, fusions should offer researchers the possibility to analyze complex neurodevelopmental defects using cells from neurological disease patients and to test potential therapeutic compounds.

  10. Regional cerebral blood flow in primary degenerative dementia

    International Nuclear Information System (INIS)

    Kawakatsu, Shinobu; Totsuka, Shiro; Shinohara, Masao; Koyama, Hideki; Sagawa, Katsuo; Morinobu, Shigeru; Oiji, Arata; Komatani, Akio

    1991-01-01

    Regional cerebral blood flow (rCBF) was examined, using SPECT by Xe-133 inhalation, in patients with primary degenerative dementia who were subgrouped according to predominant symptoms with respect to amnesia, apraxia, agnosia, aphasia, and personality changes. Also the effect of sex and age at dementia onset on the rCBF patterns was assessed. (author). 26 refs.; 1 fig.; 7 tabs

  11. Patterns of regional cerebral blood flow in acute stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Skriver, E B

    1981-01-01

    In a consecutive group of 56 stroke patients the regional cerebral blood flow was measured within 84 hours after stroke. A 254 multidetector scintillation camera and the intracarotid Xenon-133 injection method was used to study rCBF. Typical rCBF-patterns are described and compared to the findings...

  12. Activation of different cerebral functional regions following ...

    African Journals Online (AJOL)

    Background: To explore the brain function regions characteristics of the acupoint combination, this study observed activity changes in the brain regions of healthy volunteers after acupuncture at both Taixi (KI3) and Taichong (LR3) (KI3 + LR3) and KI3 alone using resting-state functional magnetic resonance imaging(fMRI).

  13. Regional cerebral blood flow measurement in brain tumors

    International Nuclear Information System (INIS)

    Izunaga, Hiroshi; Hirota, Yoshihisa; Takahashi, Mutsumasa; Fuwa, Isao; Kodama, Takafumi; Matsukado, Yasuhiko

    1986-01-01

    The regional cerebral blood flow (CBF) was determined on seventeen patients with brain tumors. Ring type single photon emission CT (SPECT) was used following intravenous injection of 133 Xe. Case materials included eleven meningiomas and six malignant gliomas. Evaluation was performed with emphasis on the following points; 1. Correlation of the flow data within tumors to the angiographic tumor stains, 2. Influence of tumors on the cerebral blood flow of the normal brain tissue, 3. Correlation between degree of peripheral edema and the flow data of the affected hemispheres. There was significant correlation between flow data within tumors and angiographic tumor stains in meningiomas. Influence of tumors on cerebral blood flow of the normal tissue was greater in meningiomas than in gliomas. There was negative correlation between the degree of peripheral edema and the flow data of the affected hemisphere. It has been concluded that the measurement of CBF in brain tumors is a valuable method in evaluation of brain tumors. (author)

  14. Regional cerebral blood flow measurement in brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Izunaga, Hiroshi; Hirota, Yoshihisa; Takahashi, Mutsumasa; Fuwa, Isao; Kodama, Takafumi; Matsukado, Yasuhiko

    1986-10-01

    The regional cerebral blood flow (CBF) was determined on seventeen patients with brain tumors. Ring type single photon emission CT (SPECT) was used following intravenous injection of /sup 133/Xe. Case materials included eleven meningiomas and six malignant gliomas. Evaluation was performed with emphasis on the following points; 1. Correlation of the flow data within tumors to the angiographic tumor stains, 2. Influence of tumors on the cerebral blood flow of the normal brain tissue, 3. Correlation between degree of peripheral edema and the flow data of the affected hemispheres. There was significant correlation between flow data within tumors and angiographic tumor stains in meningiomas. Influence of tumors on cerebral blood flow of the normal tissue was greater in meningiomas than in gliomas. There was negative correlation between the degree of peripheral edema and the flow data of the affected hemisphere. It has been concluded that the measurement of CBF in brain tumors is a valuable method in evaluation of brain tumors.

  15. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  16. Effect of pregnancy on regional cerebral blood flow

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Ikeda, Tomoaki; Mori, Norimasa

    1993-01-01

    Regional cerebral blood flow (r-CBF) of 10 pregnant women were quantified by 133 Xe SPECT study with inhalation method before and after artificial abortion. During pregnancy, value of r-CBF in each region except occipital lobe was significantly higher than that of the post abortion. Arterial blood gas was analyzed after SPECT procedure. P co2 concentration increased significantly after artificial abortion. Although its mechanism is unknown, our preliminary work demonstrates that r-CBF increased by pregnancy. (author)

  17. Narcolepsy as an autoimmune disease

    DEFF Research Database (Denmark)

    Partinen, Markku; Kornum, Birgitte Rahbek; Plazzi, Giuseppe

    2014-01-01

    in the incidence of narcolepsy after the pandemic AS03 adjuvanted H1N1 vaccination in 2010 from Sweden and Finland supports the immune-mediated pathogenesis. Epidemiological observations from studies in China also suggest a role for H1N1 virus infections as a trigger for narcolepsy. Although the pathological...

  18. Measurement of regional cerebral blood flow by positron emission tomography

    International Nuclear Information System (INIS)

    Herscovitch, P.; Powers, W.J.

    1987-01-01

    The principal advantage of positron emission tomography over other methods for measuring cerebral blood flow stems from the accurate, quantitative three-dimensional measurements of regional brain radioactivity that are possible with this technique. As a result, accurate quantitative measurements of regional cerebral blood flow can be obtained for both superficial and deep cerebral structures. The value of PET for investigating central nervous system physiology and pathology extends far beyond this, however. Through the use of different radiotracers and appropriate mathematical models, PET can be applied to the measurement of a wide variety of physiologic variables. Measurements of rCBF tell only part of the story. Experience with PET and with a variety of other techniques has taught us that rCBF is at times a poor indicator of the metabolic, functional, and biochemical status of cerebral tissue. It is only by understanding the interaction of all of these factors that our understanding of neurologic disease can advance. It is in the investigation of these complex relationships that the real value of PET resides

  19. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    International Nuclear Information System (INIS)

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation

  20. Regional cerebral blood flow in aphasia

    DEFF Research Database (Denmark)

    Soh, K; Larsen, B; Skinhøj, E

    1978-01-01

    . In motor (nonfluent) aphasia, the rCBF method showed areas of cortical dysfunction that always included the lower part of the rolandic area while Broca's area was not consistently affected. In sensory (fluent) aphasia, the superior-posterior temporal cortex was involved in all cases. In global aphasia......, the abnormalities included both regions consistently involved in the other types of aphasia. The 133Xe injection method for mapping abnormalities relevant for localizing the cortical speech areas was superior to the classical neuroradiological methods in that several cases failed to show any relevant lesion...

  1. Regional cerebral blood flow in endogenous depression

    International Nuclear Information System (INIS)

    Sagawa, Katsuo; Morinobu, Shigeru; Kawakatsu, Shinobu

    1990-01-01

    The subjects were twenty-nine depressed patients who met the DSM-III rd criteria for bipolar disorder or major depression. The rCBF was determined by the Xe-133 inhalation method (HEADTOME: ring type SPECT). There were no significant differences in the rCBF values between the patients with bipolar depression and normal controls. The rCBF values of patients with unipolar depression were significantly lower than those of controls, especially in the left temporo-parietal region (p L) were more noticeable (p<0.01) in unipolar depression patients than in bipolar depression patients. (author)

  2. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    International Nuclear Information System (INIS)

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-01-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-[123I]iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion

  3. Epigenome-wide association study of DNA methylation in narcolepsy: an integrated genetic and epigenetic approach.

    Science.gov (United States)

    Shimada, Mihoko; Miyagawa, Taku; Toyoda, Hiromi; Tokunaga, Katsushi; Honda, Makoto

    2018-04-01

    Narcolepsy with cataplexy, which is a hypersomnia characterized by excessive daytime sleepiness and cataplexy, is a multifactorial disease caused by both genetic and environmental factors. Several genetic factors including HLA-DQB1*06:02 have been identified; however, the disease etiology is still unclear. Epigenetic modifications, such as DNA methylation, have been suggested to play an important role in the pathogenesis of complex diseases. Here, we examined DNA methylation profiles of blood samples from narcolepsy and healthy control individuals and performed an epigenome-wide association study (EWAS) to investigate methylation loci associated with narcolepsy. Moreover, data from the EWAS and a previously performed narcolepsy genome-wide association study were integrated to search for methylation loci with causal links to the disease. We found that (1) genes annotated to the top-ranked differentially methylated positions (DMPs) in narcolepsy were associated with pathways of hormone secretion and monocarboxylic acid metabolism. (2) Top-ranked narcolepsy-associated DMPs were significantly more abundant in non-CpG island regions and more than 95 per cent of such sites were hypomethylated in narcolepsy patients. (3) The integrative analysis identified the CCR3 region where both a single methylation site and multiple single-nucleotide polymorphisms were found to be associated with the disease as a candidate region responsible for narcolepsy. The findings of this study suggest the importance of future replication studies, using methylation technologies with wider genome coverage and/or larger number of samples, to confirm and expand on these results.

  4. Regional cerebral blood flow measurement using a scintillation camera

    International Nuclear Information System (INIS)

    Heiss, W.D.

    1979-01-01

    A scintillation camera connected to auxillary equipment with off-line data processing or connected to an on-line dedicated computer system permits measurement of hemispheric and regional cerebral blood flow. Reliable flow values are obtained from regions limited in size by spatial resolution and the count rates achieved. Flow measurements obtained with the camera are able to resolve inhomogeneities of cerebral circulation in normal subjects. In a variety of clinical conditions, the localization, severity and extent of flow alterations are shown. Results of flow measurements in individual cases elucidate the pathogenesis of neurologic deficits, quantify the damage to the brain, indicate therapeutic measures of potential value and permit an estimation of the further clinical course. With restricted spatial resolution, flow measurements after intravenous 133 Xe injection are also feasible

  5. Regional cerebral glucose metabolism in patients with alcoholic Korsakoff's syndrome

    International Nuclear Information System (INIS)

    Kessler, R.M.; Parker, E.S.; Clark, C.M.; Martin, P.R.; George, D.T.; Weingartner, H.; Sokoloff, L.; Ebert, M.H.; Mishkin, M.

    1985-01-01

    Seven alcoholic male subjects diagnosed as having Korsakoff's syndrome and eight age-matched male normal volunteers were studied with /sup 18/F 2-fluoro-2-deoxy-D-glucose (2/sup 18/FDG). All subjects were examined at rest with eyes covered in a quiet, darkened room. Serial plasma samples were obtained following injection of 4 to 5 mCi of 2/sup 18/FDG. Tomographic slices spaced at 10mm axial increments were obtained (in-plane resolution = 1.75 cm, axial resolution = 1.78 cm). Four planes were selected from each subject, and a total of 46 regions of interest were sampled and glucose metabolic rates for each region calculated. The mean glucose metalbolic rate for the 46 regions in the Korsakoff subjects was significantly lower than that in the normal controls (5.17 +- .43 versus 6.6 +- 1.31). A Q-component analysis, which examined each subject's regional rates relative to his mean rate, revealed two distinct patterns in the Korsakoff group. Glucose metabolism was significantly reduced in 37 of the 46 regions sampled. Reduced cerebral glucose metabolism in a nondemented group of subjects has not previously been reported. The reduction in cortical metabolism may be the result of damage to sub-cortical projecting systems. The differing patterns of cerebral metabolism in Korsakoff's syndrome suggests subgroups with differing neuropathology. Regions implicated in memory function, medial temporal, thalamic and medial prefrontal were among the regions reduced in metabolism

  6. Narcolepsy: Pathophysiology and Neuropsychological Changes

    Directory of Open Access Journals (Sweden)

    Angela Naumann

    2003-01-01

    Full Text Available Narcolepsy is now recognized as a distinctive disorder with specific pathophysiology and neurochemical abnormalities. Findings on the role of the neuropeptide hypocretin are opening new avenues of research and new strategies for therapy. Recently, neuropsychological and electrophysiological studies have provided evidence for reduced memory performance on standard memory tests in addition to subjective complaints of forgetfulness which may be related to changes in attentional processing. Further studies are, however, necessary to clarify the neuropsychological profile in narcolepsy. This review focuses on the recent advances in understanding narcolepsy.

  7. Genetic association, seasonal infections and autoimmune basis of narcolepsy

    Science.gov (United States)

    Singh, Abinav Kumar; Mahlios, Josh; Mignot, Emmanuel

    2014-01-01

    In recent years, a growing number of potential autoimmune disorders affecting neurons in the central nervous system have been identified, including narcolepsy. Narcolepsy is a lifelong sleep disorder characterized by excessive daytime sleepiness with irresistible sleep attacks, cataplexy (sudden bilateral loss of muscle tone), hypnagogic hallucinations, and abnormalities of Rapid Eye Movement sleep. Narcolepsy is generally a sporadic disorder and is caused by the loss of hypocretin (orexin)-producing neurons in the hypothalamus region of the brain. Studies have established that more than 90% of patients have a genetic association with HLA DQB1*06:02. Genome-wide association analysis shows a strong association between narcolepsy and polymorphisms in the TCRα locus and weaker associations within TNFSF4 (also called OX40L), Cathepsin H and the P2RY11-DNMT1 (purinergic receptor subtype P2Y11 to DNMT1, a DNA methytransferase) loci, suggesting an autoimmune basis. Mutations in DNMT1 have also been reported to cause narcolepsy in association with a complex neurological syndrome, suggesting the importance of DNA methylation in the pathology. More recently, narcolepsy was identified in association with seasonal streptococcus, H1N1 infections and following AS03-adjuvanted pH1N1 influenza vaccination in Northern Europe. Potential immunological pathways responsible for the loss of hypocretin producing neurons in these cases may be molecular mimicry or bystander activation. Specific autoantibodies or T cells cross-reactive with hypocretin neurons have not yet been identified, however, thus narcolepsy does not meet Witebsky’s criteria for an autoimmune disease. As the brain is not an easily accessible organ, mechanisms of disease initiation and progression remain a challenge to researchers. PMID:23497937

  8. Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

    Directory of Open Access Journals (Sweden)

    Д. А. Долженко

    2015-10-01

    Full Text Available A retrospective analysis of the results of endovascular treatment of patients with the brain aneurysms was carried out at the Neurosurgical Department of Regional Clinical Hospital in Barnaul over a period from 2009 to 2011. 52 patients with 57 cerebral aneurysms were included in the study and 55 endovascular interventions were performed. Total embolization (type A was used in 77% of patients, embolization type B was performed in 19% of cases, incomplete embolization (type C occurred in 4% of cases. 14 (26,9% patients were operated in the acute period of SAH. Conclusions are made relating to the effectiveness and relative safety of intravascular treatment of aneurysms, the need for differentiated approaches to the tactics of surgical treatment of patients in the acute period of hemorrhagic stroke due to the rupture of a cerebral aneurysm.

  9. Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

    International Nuclear Information System (INIS)

    Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

    1987-01-01

    The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

  10. Misleading hallucinations in unrecognized narcolepsy.

    Science.gov (United States)

    Szucs, A; Janszky, J; Holló, A; Migléczi, G; Halász, P

    2003-10-01

    To describe psychosis-like hallucinatory states in unrecognized narcolepsy. Two patients with hypnagogic/hypnapompic hallucinations are presented. Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy. We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.

  11. Update on therapy for narcolepsy.

    Science.gov (United States)

    Thorpy, Michael J

    2015-05-01

    Narcolepsy is a severe, incurable, neurological disorder that is treated by pharmacological management of its symptoms. The main symptoms are excessive daytime sleepiness (EDS) and cataplexy, although addition symptoms that may require treatment include sleep paralysis, hypnagogic hallucinations, and disturbed nocturnal sleep. Sodium oxybate and modafinil/armodafinil are the first-line treatments for EDS, and sodium oxybate for cataplexy. Sodium oxybate treats all the symptoms of narcolepsy, whereas modafinil is effective for EDS only. Alternative medications for EDS include methylphenidate or amphetamines such as dextroamphetamine, lisdexamfetamine, methamphetamine, or combination amphetamine salts. Non-FDA approved medications for cataplexy include norepinephrine reuptake inhibitors such as venlafaxine or atomoxetine. Combination therapy can be more effective for sleepiness such as sodium oxybate and modafinil/armodafinil. Medication for narcolepsy is generally well tolerated and usually required life-long although does not eliminate all symptoms of narcolepsy.

  12. Regional cerebral blood flow in patients with hypertensive intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Kuroda, Kiyoshi

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured in 36 patients with hypertensive intracerebral hemorrhage (putaminal hemorrhage) treated surgically, using the Xenon-133 intracarotid injection method. The correlations between CBF in four regions, (the hemisphere, the frontal region, the sensori-motor area and the focal area) and the duration from the operation, the conscious level, the hematoma volume and motor function were investigated. Mean cerebral blood flow (MCBF), rCBF in sensori-motor area and in the focal area showed a value below 30 ml/100g/min. for any duration after the operation within one year. However, in the frontal region rCBF tends to increase from 4 months after the operation. There was a close correlation between the conscious level and CBF, especially in the frontal region. The higher CBF was noted in the better consciousness group. In hematoma cases the larger the hematoma volume (especially those over 31 ml)the lower the CBF in all three regions. In the focal area rCBF showed the lowest value among these three regions and was dependent on the hematoma volume, while frontal region revealed the highest flow value of them all, even in cases with a hematoma volume over 81 ml. There was a significant difference in rCBF between cases with severe motor disturbance and cases with moderate motor disturbance, except in the focal area. In the frontal region rCBF coincides rather well to the degree of motor disturbance. While, rCBF in the focal area was less than 30 ml/100g/min., and showed no correlation to motor function. (J.P.N.)

  13. Narcolepsy following yellow fever vaccination: A case report

    Directory of Open Access Journals (Sweden)

    Richard Ewald Rosch

    2016-08-01

    Full Text Available Narcolepsy with cataplexy is a rare, but important differential diagnosis for daytime sleepiness and atonic paroxysms in an adolescent. A recent increase in incidence in the paediatric age-group probably linked to the use of the Pandremix influenza vaccine in 2009, has increased awareness that different environmental factors can ‘trigger’ narcolepsy with cataplexy in a genetically susceptible population.Here we describe the case of a 13 year-old boy with narcolepsy following yellow-fever vaccination. He carries the HLA DQB1*0602 haplotype strongly associated with narcolepsy and cataplexy. Polysomnography showed rapid sleep onset with rapid eye movement (REM latency of 47 minutes, significant sleep fragmentation and a mean sleep latency of 1.6 minutes with sleep onset REM in 4 out of 4 nap periods. Together with the clinical history, these findings are diagnostic of narcolepsy type 1. The envelope protein E of the yellow fever vaccine strain 17D has significant amino acid sequence overlap with both hypocretin and the hypocretin receptor 2 receptors in protein regions that are predicted to act as epitopes for antibody production. These findings raise the question whether the yellow fever vaccine strain may, through a potential molecular mimicry mechanism, be another infectious trigger for this neuro-immunological disorder.

  14. Regional cerebral blood flow in focal cortical epilepsy

    DEFF Research Database (Denmark)

    Hougaard, Kristina Dupont; Oikawa, T; Sveinsdottir, E

    1976-01-01

    Regional cerebral blood flow (rCBF) was studied in ten patients with focal cortical epilepsy. The blood flow was measured by the intra-arterial injection of xenon 133 (133Xe), and the isotope clearance was recorded by a multidetector scintillation camera with 254 detectors. Three patients were....... This finding accords with earlier studies. All nine patients studied in the interictal phase showed, either spontaneously or during activation by intermittent light, focal flow increases in areas presumed to comprise the epileptic focus. These interictal hyperemic foci probably reflect subictal neuronal...

  15. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders

    Directory of Open Access Journals (Sweden)

    David Vállez García

    2016-08-01

    Full Text Available There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD. However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1 to validate previous results showing alterations of regional cerebral blood flow (rCBF in cWAD, (2 to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3 to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.

  16. Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hyoung; Chung, Yong An; Seo, Ye Young; Yoo, Ik Dong; Na, Sae Jung; Jung, Hyun Suk; Kim, Ki Jun [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-04-15

    The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4 weeks (male: 7, female: 5, age range: 19approx52 years, average age: 29.3+-9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19approx53 years, average age: 31.4+-9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated

  17. Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder

    International Nuclear Information System (INIS)

    Lee, Won Hyoung; Chung, Yong An; Seo, Ye Young; Yoo, Ik Dong; Na, Sae Jung; Jung, Hyun Suk; Kim, Ki Jun

    2009-01-01

    The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4 weeks (male: 7, female: 5, age range: 19∼52 years, average age: 29.3±9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19∼53 years, average age: 31.4±9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated

  18. Type of aphasia and regional cerebral blood flow

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru

    1982-01-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with 133 Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter. (J.P.N.)

  19. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders.

    Science.gov (United States)

    Vállez García, David; Doorduin, Janine; Willemsen, Antoon T M; Dierckx, Rudi A J O; Otte, Andreas

    2016-08-01

    There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H2(15)O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Sleep spindle density in narcolepsy

    DEFF Research Database (Denmark)

    Christensen, Julie Anja Engelhard; Nikolic, Miki; Hvidtfelt, Mathias

    2017-01-01

    BACKGROUND: Patients with narcolepsy type 1 (NT1) show alterations in sleep stage transitions, rapid-eye-movement (REM) and non-REM sleep due to the loss of hypocretinergic signaling. However, the sleep microstructure has not yet been evaluated in these patients. We aimed to evaluate whether...... the sleep spindle (SS) density is altered in patients with NT1 compared to controls and patients with narcolepsy type 2 (NT2). METHODS: All-night polysomnographic recordings from 28 NT1 patients, 19 NT2 patients, 20 controls (C) with narcolepsy-like symptoms, but with normal cerebrospinal fluid hypocretin...... levels and multiple sleep latency tests, and 18 healthy controls (HC) were included. Unspecified, slow, and fast SS were automatically detected, and SS densities were defined as number per minute and were computed across sleep stages and sleep cycles. The between-cycle trends of SS densities in N2...

  1. Portable real time analysis system for regional cerebral blood flow

    International Nuclear Information System (INIS)

    Tiernan, T.; Entine, G.; Stump, D.A.; Prough, D.S.

    1988-01-01

    A very portable, regional cerebral blood flow (rCBF) analysis instrument system suitable for use in the operating theater during surgery is under development. Cadmium telluride (CdTe) solid state radiation detectors, an 8086 based data acquisition and communications module and a DEC Microvax computer are used so that the instrument is very compact, yet has the computational power to provide real time data analysis in the clinical environment. The instrument is currently being used at Bowman Gray School of Medicine to study rCBF during cardiopulmonary bypass surgery (CPB). Preliminary studies indicate that monitoring rCBF during this surgical procedure may provide insights into the mechanism that causes a significant fraction of these patients to suffer post operative neuropsychological deficit

  2. Aging, regional cerebral blood flow, and neuropsychological functioning

    International Nuclear Information System (INIS)

    MacInnes, W.D.; Golden, C.J.; Gillen, R.W.; Sawicki, R.F.; Quaife, M.; Uhl, H.S.; Greenhouse, A.J.

    1984-01-01

    Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers (56-88 years old), both healthy and demented, underwent the 133 xenon inhalation rCBF procedure and were given the LNNB. The decrements in the gray-matter blood flow paralleled decrements in performance on the LNNB. Using partial correlations, a significant proportion of shared variance was observed between gray-matter blood flow and the LNNB scales. However, there was much less of a relationship between white-matter blood flow and performance on the LNNB. This study suggests that even within a restricted age sample rCBF is related in a global way to neuropsychological functioning

  3. Regional cerebral blood flow and P300 in neurosurgical disorders

    International Nuclear Information System (INIS)

    Funahashi, Kazuyoshi; Hyoutani, Genhachi; Maeshima, Shinichirou; Miyamoto, Kazuki; Kuwata, Toshikazu; Terada, Tomoaki; Komai, Norihiko

    1990-01-01

    Changes in regional cerebral blood flow (rCBF), P300 and higher brain function were studied in neurosurgical patients with localized lesions on computed tomography (CT). Twenty-five patients ranging in age from 30 to 81 were studied. Nineteen of these suffered from cerebrovascular disease and six had tumors. Using the oddball paradigm, P300 components were elicited by rate tones (2 KHz) and recorded at Cz and Pz referred to linked ear-lobe electorodes. The P300 latencies of the patients were statistically compared with those of 27 normal subjects. Higher brain function was evaluated with the following psychological tests: a rating scale for psychological function (Sano and Tanemura), Mini-Mental State (MMS), Hasegawa's Dementia Scale (HDS) and the 'Kanahiroi' test. Regional CBF was measured in the bilateral cerebral cortices (the frontal, temporal and occipital lobes), thalamus and basal ganglia by means of a cold xenon CT method. The laterality indices of rCBF (Rt. rCBF/Lt. rCBF) in the bilateral symmetrical areas of the patients were compared to those of 8 normal subjects. Of the 25 patients, 12 revealed prolongation of P300 latency. Ten (86%) of the 12 with prolonged P300 latency showed reduction of rCBF in the right cerebral hemisphere (rt. frontal lobe, rt. thalamus and rt. basal ganglia). Significant correlations (P<0.025) were recognized between the P300 latencies and the laterality indices of rCBF in the frontal lobe and thalamus. There was a significant correlation (P<0.05) between the scores of MMS and HDS and the laterality indicies of rCBF in the frontal lobe only. In the 13 patients with normal P300 latency, 6 (46%) displayed no reduction in rCBF. The remaining 7 patients with normal P300 showed reduction of rCBF in the left hemisphere. Both right frontal lobe and right thalamus have an important role affecting the prolongation of P300 latency and disturbance of cognitive functions. (author)

  4. Obesity accompanies narcolepsy with cataplexy but not narcolepsy without cataplexy

    Czech Academy of Sciences Publication Activity Database

    Šonka, K.; Kemlink, D.; Bušková, J.; Pretl, M.; Srutková, Z.; Horvát, E. M.; Vodička, Pavel; Poláková, Veronika; Nevšímalová, S.

    2010-01-01

    Roč. 31, č. 5 (2010), s. 631-634 ISSN 0172-780X Grant - others:GA MŠk(CZ) 0021620816; GA MŠk(CZ) 0021620849 Keywords : narcolepsy with cataplexy * Body Mass Index * sleep iness Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.621, year: 2010

  5. Measurement of narcolepsy symptoms: The Narcolepsy Severity Scale.

    Science.gov (United States)

    Dauvilliers, Yves; Beziat, Severine; Pesenti, Carole; Lopez, Regis; Barateau, Lucie; Carlander, Bertrand; Luca, Gianina; Tafti, Mehdi; Morin, Charles M; Billiard, Michel; Jaussent, Isabelle

    2017-04-04

    To validate the Narcolepsy Severity Scale (NSS), a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 (NT1). A 15-item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep was developed and validated by sleep experts with patients' feedback. Seventy untreated and 146 treated adult patients with NT1 were evaluated and completed the NSS in a single reference sleep center. The NSS psychometric properties, score changes with treatment, and convergent validity with other clinical parameters were assessed. The NSS showed good psychometric properties with significant item-total score correlations. The factor analysis indicated a 3-factor solution with good reliability, expressed by satisfactory Cronbach α values. The NSS total score temporal stability was good. Significant NSS score differences were observed between untreated and treated patients (dependent sample, 41 patients before and after sleep therapy; independent sample, 29 drug-free and 105 treated patients). Scores were lower in the treated populations (10-point difference between groups), without ceiling effect. Significant correlations were found among NSS total score and daytime sleepiness (Epworth Sleepiness Scale, Mean Sleep Latency Test), depressive symptoms, and health-related quality of life. The NSS can be considered a reliable and valid clinical tool for the quantification of narcolepsy symptoms to monitor and optimize narcolepsy management. © 2017 American Academy of Neurology.

  6. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Cermik, Tevfik F.; Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N.; Ugur-Altun, Betuel

    2007-01-01

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 ± 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 ± 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms. (orig.)

  7. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Cermik, Tevfik F. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Trakya Universitesi Hastanesi, Nukleer Tip Anabilim Dali, Gullapoglu Yerleskesi, Edirne (Turkey); Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Ugur-Altun, Betuel [Hospital of the University of Trakya, Department of Internal Medicine, Division of Endocrinology, Edirne (Turkey)

    2007-04-15

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 {+-} 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 {+-} 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms. (orig.)

  8. Regional cerebral blood flow in the persistent vegetative state

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Masaharu; Kuroda, Ryotaro; Ioku, Masahiko [Kinki Univ., Osakasayama, Osaka (Japan). Faculty of Medicine; and others

    1989-05-01

    Regional cerebral blood flow (CBF) in eight patients in a persistent vegetative state was measured and compared with that in five healthy volunteers. The patients were classified into three groups: Group 1 (locked-in syndrome) consisted of a single patient, Group 2 (typical vegetative state) of five patients, and Group 3 (prolonged coma) of two patients. CBF was measured early after onset by single photon emission computed tomography with {sup 123}I-N-isopropyl-p-iodo-amphetamine and/or {sup 99m}Tc-hexamethyl-propyleneamine oxime. The regions of interest (ROIs) were the bilateral frontal, temporal, parietal, occipital, and cerebellar areas and basal ganglia. The values obtained in these areas were averaged, and the ratio for each ROI ((the value in the ROI/the mean value) x 100) was calculated. 'Hyper-frontal distribution' of CBF was found to be rare in both the normal condition and the vegetative state. Higher CBF values were noted in the left than in the right frontal area in four of the five volunteers but in only four of the eight patients. CBF distribution in the frontal lobe was characteristic for each group: Group 1 showed high CBF bilaterally, although the elevation was statistically significant only on the right side, and Group 3 exhibited significantly low values. In Group 2, CBF was variable but, for the most part, within normal limits. Awareness was closely correlated with frontal lobe function and alteration of CBF in the frontal region. (author).

  9. Patients with narcolepsy in Slovenia

    Directory of Open Access Journals (Sweden)

    Leja Dolenc Grošelj

    2014-12-01

    Full Text Available Abstract Background: To determine the number of patients with narcolepsy in Slovenia, describe their typical clinical features and the diagnostic criteria they met on polysomnography (PSG, the mean sleep latency test (MSLT and HLA typing.Methods: Retrospective study of all narcolepsy patients referred to the National Sleep Disorder Centre at the Institute of Clinical Neurophysiology, University Medical Centre Ljubljana in the period from May 1994 to September 2013.Results: There are currently only 38 patients with narcolepsy in Slovenia. The average time lapse from onset to diagnosis is 17 years. The time lapse is much longer for older patients. The prevalence of narcolepsy in Slovenia is 1.85 to 100,000 inhabitants. All patients had EDS, 89% cataplexy, 66% hallucinations and 37% sleep paralysis at the time of diagnosis. Characteristic changes on PSG and MSLT were present in 97% of all tested patients. HLA DQB1*0602 is present in 88% of all tested patients. The most common differential diagnoses found were OSAS and hypersomnia.Conclusion: With a prevalence of 1.85/100,000 narcolepsy in Slovenia, it is seriously underdiagnosed and not recognized by general practitioners and neurologists alike. Both should be more aware of the disease and think about the possibility of it in patients with excessive daytime sleepiness and unexplained attacks, with additional symptoms such as hallucinations and paralysis during sleep. Such patients should be sent to the Sleep Disorder Centre, where the diagnosis can be confirmed and treatment started as soon as possible, thereby reducing the patient’s pathological symptoms and improve their quality of life.  

  10. Age differences in intercorrelations between regional cerebral metabolic rates for glucose

    International Nuclear Information System (INIS)

    Horwitz, B.; Duara, R.; Rapoport, S.I.

    1986-01-01

    Patterns of cerebral metabolic intercorrelations were compared in the resting state in 15 healthy young men (ages 20 to 32 years) and 15 healthy elderly men (ages 64 to 83 years). Controlling for whole-brain glucose metabolism, partial correlation coefficients were determined between pairs of regional cerebral metabolic rates for glucose determined by positron emission tomography using [18F]fluorodeoxyglucose and obtained in 59 brain regions. Compared with the young men, the elderly men had fewer statistically significant correlations, with the most notable reductions observed between the parietal lobe regions, and between the parietal and frontal lobe regions. These results suggest that cerebral functional interactions are reduced in healthy elderly men

  11. Reduced deep regional cerebral venous oxygen saturation in hemodialysis patients using quantitative susceptibility mapping.

    Science.gov (United States)

    Chai, Chao; Liu, Saifeng; Fan, Linlin; Liu, Lei; Li, Jinping; Zuo, Chao; Qian, Tianyi; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2018-02-01

    Cerebral venous oxygen saturation (SvO 2 ) is an important indicator of brain function. There was debate about lower cerebral oxygen metabolism in hemodialysis patients and there were no reports about the changes of deep regional cerebral SvO 2 in hemodialysis patients. In this study, we aim to explore the deep regional cerebral SvO 2 from straight sinus using quantitative susceptibility mapping (QSM) and the correlation with clinical risk factors and neuropsychiatric testing . 52 hemodialysis patients and 54 age-and gender-matched healthy controls were enrolled. QSM reconstructed from original phase data of 3.0 T susceptibility-weighted imaging was used to measure the susceptibility of straight sinus. The susceptibility was used to calculate the deep regional cerebral SvO 2 and compare with healthy individuals. Correlation analysis was performed to investigate the correlation between deep regional cerebral SvO 2 , clinical risk factors and neuropsychiatric testing. The deep regional cerebral SvO 2 of hemodialysis patients (72.5 ± 3.7%) was significantly lower than healthy controls (76.0 ± 2.1%) (P deep regional cerebral SvO 2 in patients. The Mini-Mental State Examination (MMSE) scores of hemodialysis patients were significantly lower than healthy controls (P deep regional cerebral SvO 2 did not correlate with MMSE scores (P = 0.630). In summary, the decreased deep regional cerebral SvO 2 occurred in hemodialysis patients and dialysis duration, parathyroid hormone, hematocrit, hemoglobin and red blood cell may be clinical risk factors.

  12. Physiological activation of the human cerebral cortex during auditory perception and speech revealed by regional increases in cerebral blood flow

    DEFF Research Database (Denmark)

    Lassen, N A; Friberg, L

    1988-01-01

    by measuring regional cerebral blood flow CBF after intracarotid Xenon-133 injection are reviewed with emphasis on tests involving auditory perception and speech, and approach allowing to visualize Wernicke and Broca's areas and their contralateral homologues in vivo. The completely atraumatic tomographic CBF...

  13. Attenuated heart rate response is associated with hypocretin deficiency in patients with narcolepsy.

    Science.gov (United States)

    Sorensen, Gertrud Laura; Knudsen, Stine; Petersen, Eva Rosa; Kempfner, Jacob; Gammeltoft, Steen; Sorensen, Helge Bjarup Dissing; Jennum, Poul

    2013-01-01

    Several studies have suggested that hypocretin-1 may influence the cerebral control of the cardiovascular system. We analyzed whether hypocretin-1 deficiency in narcolepsy patients may result in a reduced heart rate response. We analyzed the heart rate response during various sleep stages from a 1-night polysomnography in patients with narcolepsy and healthy controls. The narcolepsy group was subdivided by the presence of +/- cataplexy and +/- hypocretin-1 deficiency. Sleep laboratory studies conducted from 2001-2011. In total 67 narcolepsy patients and 22 control subjects were included in the study. Cataplexy was present in 46 patients and hypocretin-1 deficiency in 38 patients. None. All patients with narcolepsy had a significantly reduced heart rate response associated with arousals and leg movements (P hypocretin-1 deficiency and cataplexy groups compared with patients with normal hypocretin-1 levels (P hypocretin-1 deficiency significantly predicted the heart rate response associated with arousals in both REM and non-REM in a multivariate linear regression. Our results show that autonomic dysfunction is part of the narcoleptic phenotype, and that hypocretin-1 deficiency is the primary predictor of this dysfunction. This finding suggests that the hypocretin system participates in the modulation of cardiovascular function at rest.

  14. Acute effects of thalamotomy and pallidotomy on regional cerebral metabolism, evaluated by PET

    NARCIS (Netherlands)

    Henselmans, JML; de Jong, BM; Pruim, J; Staal, MJ; Rutgers, AWF; Haaxma, R

    The subacute effect of thalamotomy and pallidotomy on regional cerebral metabolism was studied by means of Positron Emission Tomography (PET). In this way we aimed to identify the pattern of functional deafferentiation following a specific lesion in the basal ganglia. The cerebral distribution of

  15. Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia

    NARCIS (Netherlands)

    Gieteling, Esther W.; van Rijn, Monique A.; de Jong, Bauke M.; Hoogduin, Johannes M.; Renken, Remco; van Hilten, Jacobus J.; Leenders, Klaus L.

    The pathogenesis of dystonia in Complex Regional Pain Syndrome type 1 (CRPS-1) is unclear. In primary dystonia, functional magnetic resonance imaging (fMRI) has revealed changes in cerebral networks during execution of movement. The aim of this study was to determine cerebral network function in

  16. Regional cerebral blood flow changes in patients with internet addiction.

    Science.gov (United States)

    Otte, Andreas

    2016-01-01

    Dear Editor, Internet addiction (IA) has become a severe challenge of our modern world today, though little is known about its pathology. In this context, the interesting study by Liu et al. in the May-August 2016 issue of HJNM using 99m Tc-labelled ethylene biyldicysteinate dimer single photon emission tomography (SPET) at rest and after pharmaceutical (adenosine) stress is more than welcomed. As this seems to be the first perfusion SPET study in this indication, the obtained data may be discussed carefully. There are mainly the following questions: a) Regional cerebral blood flow (rCBF): There is no description on how the rCBF was calculated: Was it scaled relatively to the whole brain mean value or to the cerebellar mean value? b) P value threshold and clusters: There is no indication of whether the authors are performing any kind of correction for multiple comparisons in the statistical parametric mapping (SPM) t-test. This, combined with the use of a really "liberal" voxel P value of only 0.01 could be subject to providing many false positive results. Generally a P value threshold of 0.001 should be used. In addition, there is no information related to the clusters. For the question of the validity of parametric statistical methods used for the analysis of functional neuroimaging data, we would like to mention the important recent paper by Eklund et al. 2016. c) Data analysis: The authors state (p. 97): "As some abnormal rCBF in adenosine-stressed state might relate with normal responses to adenosine compared to resting state, we excluded those regions that showed abnormal rCBF in stressed state in healthy controls (Table 4) from those in IA group (Table 5). The rest abnormal regions were compared between the IA group and the control group". For this, with SPM a flexible factorial design with all the data rather than only t-tests would have been interesting to find out whether the difference between the groups at stress is the same difference observed between

  17. Regional cerebral blood flow in the patient with brain tumor

    International Nuclear Information System (INIS)

    Tsuchida, Shohei

    1993-01-01

    Regional cerebral blood flow (rCBF) was measured with xenon-enhanced CT (Xe-CT) in 21 cases of intracranial tumors (13 meningiomas, 5 gliomas, 3 metastatic brain tumors). Peritumoral edema was graded as mild, moderate or severe based on the extent of edema on CT and MRI. According to intratumoral blood flow distribution patterns, three patterns were classified as central type with relatively high blood flow at the center of the tumor, homogeneous type with an almost homogeneous blood flow distribution, and marginal type with relatively high blood flow at the periphery of the tumor. High grade astrocytoma and metastatic brain tumor showed marginal type blood flow and moderate or severe edema except in one case. Five meningiomas with severe peritumoral edema revealed marginal type blood flow and four with mild peritumoral edema showed central type blood flow, except for one case. No correlation was found between the extent of peritumoral edema and histological subtype, tumor size, location, duration of clinical history, vascularization on angiogram, and mean blood flow in the tumor. These results suggest that blood flow distribution patterns within the tumor may affect the extension of peritumoral edema. Pre- and postoperative rCBFs were evaluated with Xe-CT and IMP-SPECT in 7 cases, mean rCBF of peritumoral edema was 6.2 ml/100 g/min preoperatively, and discrepancy between rCBF on Xe-CT and that on IMP-SPECT was shown in the remote cortical region ipsilateral to the tumor. Postoperative rCBF revealed an improved blood flow in both adjacent and remote areas, suggesting that the decreased blood flow associated with brain tumors might be relieved after surgery. (author) 53 refs

  18. Regional cerebral blood flow and periventricular hyperintensity in silent cerebral infarction. Comparison with multi-infarct dementia

    International Nuclear Information System (INIS)

    Koshi, Yasuhiko; Kitamura, Shin; Nagazumi, Atushi; Tsuganesawa, Toshikazu; Terashi, Akiro

    1996-01-01

    In order to investigate relationship between regional cerebral blood flow (rCBF) and the white matter lesions on MRI in silent cerebral infarction, we quantitatively measured rCBF by 123 I-IMP autoradiography method (IMP ARG method) and single photon emission tomography (SPECT) in 36 patients with silent cerebral infarction (SCI group), 22 patients with multi-infarct dementia (MID group), and 16 control subjects without periventricular hyperintensity (PVH) and lacunar infarction on MRI (CL group). Regions of interest (ROIs) on rCBF images were set in the frontal (F), temporal (T), parietal (P), occipital (O) cortex, and the cerebral white matter (W). The severity of PVH on MRI T 2 -weighted image was divided into four grades (grade 0-3). Though the frequency of hypertension was significantly higher in SCI group and MID group compared with CL group, no significant difference was seen in the mean age among these three groups. rCBF in the white matter and cerebral cortices except the occipital cortex in SCI group was significantly low compared with CL group (rCBF SCI /rCBF CL : W 0.87, F 0.87, T 0.87, P 0.88, O 0.92). rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex, in MID group was significantly low compared with SCI group (rCBF MID /rCBF CL : W 0.69, F 0.71, T 0.74, P 0.75, O 0.81). The mean grade of PVH in MID group was significantly higher than that in SCI group (SCI 1.1 vs MID 2.5). The severity of PVH was significantly correlated with each rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex. Our findings suggest that the quantitative measurement of rCBF by IMP ARG method is useful for the follow-up study in the patients with silent cerebral infarction as well as the evaluation of the severity of PVH on MRI. (author)

  19. Changes in regional cerebral blood flow during auditory cognitive tasks

    International Nuclear Information System (INIS)

    Ohyama, Masashi; Kitamura, Shin; Terashi, Akiro; Senda, Michio.

    1993-01-01

    In order to investigate the relation between auditory cognitive function and regional brain activation, we measured the changes in the regional cerebral blood flow (CBF) using positron emission tomography (PET) during the 'odd-ball' paradigm in ten normal healthy volunteers. The subjects underwent 3 tasks, twice for each, while the evoked potential was recorded. In these tasks, the auditory stimulus was a series of pure tones delivered every 1.5 sec binaurally at 75 dB from the earphones. Task A: the stimulus was a series of tones with 1000 Hz only, and the subject was instructed to only hear. Task B: the stimulus was a series of tones with 1000 Hz only, and the subject was instructed to push the button on detecting a tone. Task C: the stimulus was a series of pure tones delivered every 1.5 sec binaurally at 75 dB with a frequency of 1000 Hz (non-target) in 80% and 2000 Hz (target) in 20% at random, and the subject was instructed to push the button on detecting a target tone. The event related potential (P300) was observed in task C (Pz: 334.3±19.6 msec). At each task, the CBF was measured using PET with i.v. injection of 1.5 GBq of O-15 water. The changes in CBF associated with auditory cognition was evaluated by the difference between the CBF images in task C and B. Localized increase was observed in the anterior cingulate cortex (in all subjects), the bilateral associate auditory cortex, the prefrontal cortex and the parietal cortex. The latter three areas had a large individual variation in the location of foci. These results suggested the role of those cortical areas in auditory cognition. The anterior cingulate was most activated (15.0±2.24% of global CBF). This region was not activated in the condition of task B minus task A. The anterior cingulate is a part of Papez's circuit that is related to memory and other higher cortical function. These results suggested that this area may play an important role in cognition as well as in attention. (author)

  20. Regional cerebral blood flow changes in chronic polidrug abusers

    International Nuclear Information System (INIS)

    Quintana, J.C.; Olea, E.; Seijas, D.; Haydn, V.

    2002-01-01

    Chronic exposure to cocaine and other drugs are in clear association with a variety of medical complications, involving many organ systems. The Central Nervous System (CNS) is particularly sensitive to such exposures: permanent behavioral, psychiatric and neurological complications are common in this group of patients. Regional cerebral blood perfusion (rCBF) analysis has been used to study these conditions with PET and SPECT for a long time. According to the literature, it is clear that drug exposure (particularly cocaine) does produce significant changes over rCBF, nevertheless the vast majority of SPECT and some PET studies are difficult to reproduce because they were analyzed using subjective (visual) and/or ROI's to address the changes. Aim: To study the pattern of rCBF change of chronic cocaine and other drugs (polidrug) users/abusers population using brain SPECT and SPM (Statistical Parametric Mapping). Material and Methods: From a population of 163 addicted patients, 55 chronic cocaine and other drugs users/abuser were selected. A pre-treatment brain SPECT under basal conditions was performed in all of them. 99mTc-ECD was used as rCBF tracer and SPM (Statistical Parametric Mapping) as a framework to address statistically significant rCBF variations of change. The whole group was compared with a population of normal patients (both sexes, aged between 20 and 40 y.o., no history of trauma, drug exposure, neurological or psychiatric disorders). Results: Significant areas of reduced (hypoperfusion) and increased (hyperperfusion) rCBF were identified in the patients group. The hypoperfusion areas involve mainly the left insula region and the surrounding frontal and temporal lobe and a smaller area in the anterior and inferior portion of the right frontal lobe. The increased perfusion areas were identified at the left thalamus and the right fronto-parietal cortical region. Conclusion: Our results suggest that chronic cocaine exposure produce activation/damage to

  1. Establishment of modified reversible regional cerebral ischemic models

    International Nuclear Information System (INIS)

    Ji Xunming; Ling Feng; Zhao Xiqing; Xuan Yun; Wang Yueqin; Ling Xiaolan; Chang Hongjun; Zhang Zhiping

    2005-01-01

    Objective: Modifying the method of establishing reversible middle cerebral ischemic models in rats for improvement of the stability and rate of success, so as to raise the reliability of cerebral ischemic study. Methods: Sixty male Wistar rats were randomly divided into two groups, modified and control groups, 30 rats in each group. The method of silicone- tipping on one end of the nylon suture was used to modify the establishment of embolus, and tip-heating method was used to establish the traditional embolus with all the other steps of the procedure just the same. The Zea Longa 5 scoring scale was used to estimate the neurological deficiency while TTC staining method was used to measure and calculate the volume of cerebral infarction. The percentage of successful models with 3-4 grade scorings and the coefficient of the variations of cerebral infarct volume were used to estimate the stability of the models. Results: The rate of success of establishment models in the modification group was significantly higher in comparing with the traditional group (93% vs 60%, χ 2 =9.32, P=0.002). The percentage of model establishment with 3-4 grade neurological scores in modification group was higher than that in the traditional group 96.4% vs 61.2%, χ 2 =9.51, P=0.002). The cerebral infarct volume in modification group and traditional group were (4.1450±0.5019) cm 3 and (3.8435 ± 0.8164) cm 3 , and the coefficients of variation were 12.01% and 21.24% respectively, which indicated that the stability of models was significantly higher in modification group than in the traditional one. Conclusions: The rates of success and stability of the models for reversible focal cerebral ischemia made by the modification method were significantly improved, with decreasing the cost of model creation and increasing the accuracy of study of ischemic cerebral vascular disease. (authors)

  2. Measurement of regional cerebral glucose utilization in man by positron emission tomography

    International Nuclear Information System (INIS)

    Baron, J.C.

    1986-05-01

    The various methods available for the study of regional cerebral glucose consumption in man by positron emission tomography are described and their applications, limitations and principal physiopathological results are presented [fr

  3. Regional cerebral blood flow and oxygen metabolism in normal pressure hydrocephalus after subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Masatsune; Kikuchi, Haruhiko; Taki, Waro; Kobayashi, Akira; Nishizawa, Sadahiko; Yonekura, Yoshiharu; Konishi, Junji [Kyoto Univ. (Japan). Faculty of Medicine

    1989-05-01

    To clarify the pathophysiology of normal pressure hydrocephalus (NPH) after subarachnoid hemorrhage, the authors measured cerebral blood flow (CBF), cerebral oxygen metabolic rates (CMRO{sub 2}), the cerebral oxygen extraction fraction (OEF), and cerebral blood volume (CBV) in eight normal volunteers, six SAH patients with NPH, and seven patients without NPH by {sup 15}O-labeled gas and positron emission tomography (PET). In the NPH group, PET revealed a decrease in CBF in the lower regions of the cerebral cortex and a diffuse decrease in CMRO{sub 2}. The decrease in CBF in the lower frontal, temporal, and occipital cortices was significantly greater in the NPH than in the non-NPH group. Reduction of CMRO{sub 2} was also more extensive in the NPH group, and both CBF and CMRO{sub 2} were more markedly decreased in the lower frontal region. OEF was increased in all areas in both of the patient groups, but the increase was not significant in most areas. CBF, CMRO{sub 2} and OEF did not significantly differ between the non-NPH group and the normal volunteers. There was no significant difference in CBV among the three groups. These results indicate that NPH involves impairment of cerebral oxygen metabolism in the lower regions of the cerebral cortex, particularly in the lower frontal region. (author).

  4. Health, social, and economic consequences of narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke Falkner; Petersen, Eva Rosa

    2012-01-01

    Despite the fact that narcolepsy is a chronic disorder affecting younger people, there is insufficient information about its societal burden, time course, and familiar effect. We aimed to estimate the factual direct and indirect costs of narcolepsy patients and their families in a national sample...

  5. Increased lucid dreaming frequency in narcolepsy

    NARCIS (Netherlands)

    Rak, M.; Beitinger, P.; Steiger, A.; Schredl, M.; Dresler, M.

    2015-01-01

    STUDY OBJECTIVE: Nightmares are a frequent symptom in narcolepsy. Lucid dreaming, i.e., the phenomenon of becoming aware of the dreaming state during dreaming, has been demonstrated to be of therapeutic value for recurrent nightmares. Data on lucid dreaming in narcolepsy patients, however, is

  6. Clinical and Neurobiological Aspects of Narcolepsy

    Science.gov (United States)

    Nishino, Seiji

    2007-01-01

    Narcolepsy is characterized by excessive daytime sleepiness (EDS), cataplexy and/or other dissociated manifestations of rapid eye movement (REM) sleep (hypnagogic hallucinations and sleep paralysis). Narcolepsy is currently treated with amphetamine-like central nervous system (CNS) stimulants (for EDS) and antidepressants (for cataplexy). Some other classes of compounds such as modafinil (a non-amphetamine wake-promoting compound for EDS) and gamma-hydroxybutyrate (GHB, a short-acting sedative for EDS/fragmented nighttime sleep and cataplexy) given at night are also employed. The major pathophysiology of human narcolepsy has been recently elucidated based on the discovery of narcolepsy genes in animals. Using forward (i.e., positional cloning in canine narcolepsy) and reverse (i.e., mouse gene knockout) genetics, the genes involved in the pathogenesis of narcolepsy (hypocretin/orexin ligand and its receptor) in animals have been identified. Hypocretins/orexins are novel hypothalamic neuropeptides also involved in various hypothalamic functions such as energy homeostasis and neuroendocrine functions. Mutations in hypocretin-related genes are rare in humans, but hypocretin-ligand deficiency is found in many narcolepsy-cataplexy cases. In this review, the clinical, pathophysiological and pharmacological aspects of narcolepsy are discussed. PMID:17470414

  7. The incidence of narcolepsy in Europe

    DEFF Research Database (Denmark)

    Wijnans, Leonoor; Lecomte, Coralie; de Vries, Corinne

    2013-01-01

    In August 2010 reports of a possible association between exposure to AS03 adjuvanted pandemic A(H1N1)pdm09 vaccine and occurrence of narcolepsy in children and adolescents emerged in Sweden and Finland. In response to this signal, the background rates of narcolepsy in Europe were assessed to rapi...

  8. Semiquantifying regional cerebral blood flow by dynamic CT scanning

    International Nuclear Information System (INIS)

    Takeuchi, Totaro; Kasahara, Eishi; Takahashi, Eriko; Kojima, Seiichi; Ogawa, Haruhiko; Suzuki, Keiko; Miyamae, Tatsuya; Yamazaki, Setsuo.

    1990-01-01

    The study was undertaken to evaluate the semi-quantitative significance of the absolute value obtained by calculating the regional cerebral blood flow index (rCBFI) from dynamic CT in comparison with SPECT. rCBFI was calculated from mean transit time (MTT) and blood capacity index (BCI) obtained by rapidly infusing 50 ml of Omnipurk into the elbow vein by the use of Hitachi's W-600. [rCBFI=BCI/MTT unit/sec (U/S)] measurment of the rCBF by SPECT was made according to the semi-quantitative method by Matsuda et al. by the use of SHIMADZU's improved type HEADTOME SET-050 with rapid infusion of 123 I-IMP in 3.5 m Ci from the elbow vein. Patients in whom no abnormality was observed in the cardiopulmonary function were enrolled as subjects. The rCBFI in each intracranial site was calculated from dynamic CT in 10 normal adults (aged 35-60, averaging 46.7) as subjects and compared with the rCBF obtained from SPECT in the same cases and same site. Comparative investigation was made similarly between rCBFI and rCBF regarding 10 patients with tracranial diseases (age 29-65, averaging 51.2). The mean rCBFIs in the normal adults obtained from dynamic CT were 1.15±0.18 U/S in the frontal lobar cortex, 1.28±0.19 U/S in the temporal lobar cortex, 1.43±0.1 U/S in the occipital lobar cortex, 1.27±0.2 U/S in the basal ganglia region and 0.43±0.1 U/S in the white matter. On the other hand, the mean rCBFs by SPECT were 47.36±3.93 ml/100 g/min, 55.19±2.22 ml/100 g/min, 61.92±5.42 ml/100 g/min, 54.38±3.51 ml/100 g/min and 38.68±6.18 ml/100 g/min, respectively. Positive correlation was observed between rCBFIs and rCBFs of 10 normal adults and 10 patients with intracranial disease, totalling 20 cases (r=0.79, P<0.005). The rCBFI by dynamic CT has a correlation with the rCBF by SPECT, suggesting the possibility of its evaluation as an absolute value, though semi-quantitatively. (author)

  9. Cases of pediatric narcolepsy after misdiagnoses.

    Science.gov (United States)

    Kauta, Shilpa R; Marcus, Carole L

    2012-11-01

    Narcolepsy is characterized by recurrent brief attacks of irresistible sleepiness. Signs can begin during childhood. However, diagnoses are frequently delayed by 10-15 years because of unfamiliarity with pediatric narcolepsy and variable presentations of its associated features (cataplexy, hypnagogic/hypnopompic hallucinations, and sleep paralysis). Therefore, patients may remain untreated during their formative years. Three children with narcolepsy who were initially misdiagnosed are described. Each child's signs were initially related to depression, hypothyroidism, jaw dysfunction, or conversion disorder. However, after a multiple sleep latency test, the diagnosis of narcolepsy was established. All three patients were treated appropriately with stimulant medications, selective serotonin reuptake inhibitors, or sodium oxybate, and demonstrated positive responses. Although no definitive cure exists for narcolepsy, early recognition and appropriate symptomatic treatment with medications can allow affected children to improve quality of life and achieve normality, both academically and socially. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Clanet, M

    1987-06-18

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO/sub 2/), oxygen extraction (EO/sub 2/) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO/sub 2/ and often a decrease in CMRO/sub 2/, whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO/sub 2/, EO/sub 2/ and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis.

  11. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    International Nuclear Information System (INIS)

    Clanet, M.

    1987-01-01

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO 2 ), oxygen extraction (EO 2 ) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO 2 and often a decrease in CMRO 2 , whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO 2 , EO 2 and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis [fr

  12. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders

    NARCIS (Netherlands)

    Vállez García, David; Doorduin, Janine; Willemsen, Antoon T.M.; Dierckx, Rudi A.j.o.; Otte, Andreas

    There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing

  13. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    Kudo, Ryozo

    1985-01-01

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133 Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  14. Preliminary studies of regional cerebral blood flow changes in patients with leukoaraiosis

    International Nuclear Information System (INIS)

    Li Yaming; Ren Yan; He Qiu

    1997-01-01

    PURPOSE: To investigate changes of regional cerebral blood flow (rCBF) in leukoaraiosis (LA) lesion and cortical regions and analyse the relation between rCBF changes and dementia. METHODS: Regional cerebral blood flow perfusion imaging with SPECT was performed in 49 patients with subcortical multiple cerebral infarction, including 24 cases company LA [LA(+)], 25 cases not company LA[LA(-)] and 10 normal subjects. The relative analysis was made between rCBF changes and cognitive scores. RESULTS: Compared the LA(+) with control, the rCBFs in frontal, parietal, temporal cortexes and LA lesion significantly decreased (P<0.05). The rCBF of frontal, parietal cortexes and LA lesions was also significantly decreased (P<0.05) compared with LA(-) groups. The cognitive scores were significantly related with rCBF changes in frontal cortex and LA lesion (r = 0.765, P<0.01 and r = 0.439, P<0.05). CONCLUSION: In patients with subcortical multiple cerebral infarction company LA lesion, there were extensive ischemic hypoperfusion changes in the cortical regions and LA lesion, which may response to decreased cerebral function and had certain relationship with dementia. The examination with SPECT cerebral blood flow perfusion imaging had unique advantage and value

  15. Potentials of positron emission tomography for regional cerebral blood flow evaluation

    International Nuclear Information System (INIS)

    Depresseux, J.C.

    1982-01-01

    A general overview of the potentials of positron emission tomography and of positron-emitting radiopharmaceuticals for the evaluation of regional cerebral blood flow is proposed and discussed. Specific characteristics of this technique are described, with special stress on conceptual and methodological implications. Four different approaches to the problem of the determination of cerebral blood flow are distinguished: trapping equilibrium methods, steady state equilibrium methods, clearance methods and convoluted kinetic methods [fr

  16. Determination of regional cerebral blood flow curves and parameters by computed γ camera

    International Nuclear Information System (INIS)

    Zhu Guohong

    1988-01-01

    Regional CBF curves and parameters were determined in 236 subjects by Sigma 438/MCS 560 computed γ camera. Each subject was given 99m TcO 4 -370 MBq intravenously. Four CBF curves and three parameters were derived by the computer.The results from 39 normal subjects, 22 patients with cerebral embolism, 53 patients with cerebrovascular sclerosis, 56 patients with diseases of cervical vertebrae, 10 patients with concussion and 5 patients with cerebral arteritis were analyzed

  17. Regional Cerebral Oximetry During Cardiopulmonary Resuscitation: Useful or Useless?

    Science.gov (United States)

    Genbrugge, Cornelia; Dens, Jo; Meex, Ingrid; Boer, Willem; Eertmans, Ward; Sabbe, Marc; Jans, Frank; De Deyne, Cathy

    2016-01-01

    Approximately 375,000 people annually experience sudden cardiac arrest (CA) in Europe. Most patients who survive the initial hours and days after CA die of postanoxic brain damage. Current monitors, such as electrocardiography and end-tidal capnography, provide only indirect information about the condition of the brain during cardiopulmonary resuscitation (CPR). In contrast, cerebral near-infrared spectroscopy provides continuous, noninvasive, real-time information about brain oxygenation without the need for a pulsatile blood flow. It measures transcutaneous cerebral tissue oxygen saturation (rSO2). This information could supplement currently used monitors. Moreover, an evolution in rSO2 monitoring technology has made it easier to assess rSO2 in CA conditions. We give an overview of the literature regarding rSO2 measurements during CPR and the current commercially available devices. We highlight the feasibility of cerebral saturation measurement during CPR, its role as a quality parameter of CPR, predictor of return of spontaneous circulation (ROSC) and neurologic outcome, and its monitoring function during transport. rSO2 is feasible in the setting of CA and has the potential to measure the quality of CPR, predict ROSC and neurologic outcome, and monitor post-CA patients during transport. The literature shows that rSO2 has the potential to serve multiple roles as a neuromonitoring tool during CPR and also to guide neuroprotective therapeutic strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women

    NARCIS (Netherlands)

    Georgiadis, Janniko R.; Kortekaas, Rudie; Kuipers, Rutger; Nieuwenburg, Arie; Pruim, Jan; Reinders, A. A. T. Simone; Holstege, Gert

    2006-01-01

    There is a severe lack of knowledge regarding the brain regions involved in human sexual performance in general, and female orgasm in particular. We used [(15)O]-H(2)O positron emission tomography to measure regional cerebral blood flow (rCBF) in 12 healthy women during a nonsexual resting state,

  19. New possibilities for quantitative measurements of regional cerebral blood flow with gold-195m

    International Nuclear Information System (INIS)

    Lindner, P.; Nickel, O.

    1985-01-01

    A previously reported theory for quantitative cerebral blood flow measurement for nondiffusible radiotracers has been applied to patients after stroke and to volunteers undergoing a mental stimulation exercise. The energy spectrum of gold-195m shows two strong photon peaks, one at an energy level of 68 keV and a second at an energy-level of 262 keV. The low energy peak is suitable for perfusion studies in lateral views of the hemispheres; no look-through effect is seen. The high energy level is good for studies in posterior-anterior positions. Parametric images for quantitative regional cerebral blood flow can be generated. The area of occluded vessels in the case of stroke can be detected. Quantitative activation patterns of cerebral blood flow during mental stimulation can be generated. The results prove that, not only with freely diffusible indicators like xenon but also with nondiffusible indicators, it is possible to measure quantitatively cerebral blood flow patterns

  20. Glycopyrrolate does not influence the visual or motor-induced increase in regional cerebral perfusion

    DEFF Research Database (Denmark)

    Rokamp, Kim Z; Olesen, Niels D; Larsson, Henrik B W

    2014-01-01

    Acetylcholine may contribute to the increase in regional cerebral blood flow (rCBF) during cerebral activation since glycopyrrolate, a potent inhibitor of acetylcholine, abolishes the exercise-induced increase in middle cerebral artery mean flow velocity. We tested the hypothesis that cholinergic...... vasodilatation is important for the increase in rCBF during cerebral activation. The subjects were 11 young healthy males at an age of 24 ± 3 years (mean ± SD). We used arterial spin labeling and blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) to evaluate rCBF with and without...... intravenous glycopyrrolate during a handgrip motor task and visual stimulation. Glycopyrrolate increased heart rate from 56 ± 9 to 114 ± 14 beats/min (mean ± SD; p

  1. Assessing regional cerebral blood flow in depression using 320-slice computed tomography.

    Directory of Open Access Journals (Sweden)

    Yiming Wang

    Full Text Available While there is evidence that the development and course of major depressive disorder (MDD symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT, to assess regional cerebral blood flow (rCBF in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24 score > 20, and Self-Rating Depression Scale (SDS score > 53 and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI. 16 subjects (8 =  MDD; 8 =  healthy also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\\middle\\low shear rateand hematocrit (HCT were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

  2. Regional cerebral glucose metabolism in patients with Parkinson's disease with or without dementia

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Masayuki; Ichiya, Yuichi; Hosokawa, Shinichi; Otsuka, Makoto; Kuwabara, Yasuo; Fukumura, Toshimitsu; Kato, Motohiro; Goto, Ikuo; Masuda, Kouji [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1992-11-01

    By means of positron emission tomography, the cerebral glucose metabolism in 5 patients with Parkinson's disease with dementia was compared with that in 9 patients without dementia, and that in 5 normal volunteers. The metabolic rates for glucose were measured by placing one hundred regions of interest. In the demented patients, cerebral glucose metabolism was diffusely decreased compared with that of the non-demented patients and the normal controls. The most significant decrease in glucose metabolism was observed in the angular gyrus (49.7% of the normal controls). The glucose metabolism in the cingulate, pre- and postcentral, occipital and subcortical regions was relatively spared (62.1 to 85.5% of the normal controls). In the patients without dementia, the glucose metabolism in each region was not significantly different from that in the normal controls. These results suggest that diffuse glucose hypometabolism in the cerebral cortex may correlate with that of patients with Parkinson's disease with dementia. (author).

  3. Higher cerebral oxygen saturation may provide higher urinary output during continuous regional cerebral perfusion

    Directory of Open Access Journals (Sweden)

    Tomoyasu Takahiro

    2008-10-01

    Full Text Available Abstract Objective We examined the hypothesis that higher cerebral oxygen saturation (rSO2 during RCP is correlated with urinary output. Methods Between December 2002 and August 2006, 12 patients aged 3 to 61 days and weighing 2.6 to 3.4 kg underwent aortic arch repair with RCP. Urinary output and rSO2 were analyzed retrospectively. Data were assigned to either of 2 groups according to their corresponding rSO2: Group A (rSO2 ≦ 75% and Group B (rSO2 Results Seven and 5 patients were assigned to Group A and Group B, respectively. Group A was characterized by mean radial arterial pressure (37.9 ± 9.6 vs 45.8 ± 7.8 mmHg; P = 0.14 and femoral arterial pressure (6.7 ± 6.1 vs 20.8 ± 14.6 mmHg; P = 0.09 compared to Group B. However, higher urinary output during CPB (1.03 ± 1.18 vs 0.10 ± 0.15 ml·kg-1·h-1; P = 0.03. Furthermore our results indicate that a higher dose of Chlorpromazine was used in Group A (2.9 ± 1.4 vs 1.7 ± 1.0 mg/kg; P = 0.03. Conclusion Higher cerebral oxygenation may provide higher urinary output due to higher renal blood flow through collateral circulation.

  4. Narcolepsy/Cataplexy and Occult Neuroblastoma

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-11-01

    Full Text Available Investigators at the University of Chicago and Northwestern University, Chicago, IL; University Hospital Southampton, UK; and Kiev Paediatric Hospital, Ukraine, report three children with narcolepsy and cataplexy subsequently diagnosed with neuroblastoma.

  5. Double tracer autoradiographic method for sequential evaluation of regional cerebral perfusion

    International Nuclear Information System (INIS)

    Matsuda, H.; Tsuji, S.; Oba, H.; Kinuya, K.; Terada, H.; Sumiya, H.; Shiba, K.; Mori, H.; Hisada, K.; Maeda, T.

    1989-01-01

    A new double tracer autoradiographic method for the sequential evaluation of altered regional cerebral perfusion in the same animal is presented. This method is based on the sequential injection of two tracers, 99m Tc-hexamethylpropyleneamine oxime and N-isopropyl-( 125 I)p-iodoamphetamine. This method is validated in the assessment of brovincamine effects on regional cerebral perfusion in an experimental model of chronic brain ischemia in the rat. The drug enhanced perfusion recovery in low-flow areas, selectively in surrounding areas of infarction. The results suggest that this technique is of potential use in the study of neuropharmacological effects applied during the experiment

  6. [Narcolepsy with cataplexy: an autoimmune disease?].

    Science.gov (United States)

    Jacob, Louis; Dauvilliers, Yves

    2014-12-01

    Narcolepsy type 1 (also named narcolepsy-cataplexy or hypocretin deficiency syndrome) is a rare sleep disorder characterized by excessive daytime sleepiness and cataplexy, plus frequently hypnagogic hallucinations, sleep paralysis and nocturnal sleep disturbances. Narcolepsy type 1 is an immune system-associated disease linked with the destruction of 70.000-90.000 hypocretin neurons notably involved in wakefulness. Among narcoleptic patients, 98% are positive for HLA-DQB1*06:02, a HLA class II allele, against 20-25% in general population. Individuals carrying HLA-DQB1*06:02 have an extraordinary risk to develop narcolepsy (odd ratio: 251). Other genes involved in CD4+ T cells and immune system activation as T-cell receptor α are also associated with narcolepsy. The development of the disease is linked with environmental factors such as influenza and streptococcal infections. Narcolepsy type 1 incidence also increased in Europe following the use of Pandemrix, a 2009 H1N1 AS03-adjuvanted vaccine manufactured by GlaxoSmithKline. Interestingly, such increase was not observed with Arepanrix, another vaccine developed by GSK very similar to Pandemrix. © 2014 médecine/sciences – Inserm.

  7. ApoE polymorphisms in narcolepsy

    Science.gov (United States)

    Gencik, Martin; Dahmen, Norbert; Wieczorek, Stefan; Kasten, Meike; Gencikova, Alexandra; Epplen, Jorg T

    2001-01-01

    Background Narcolepsy is a common neuropsychiatric disorder characterized by increased daytime sleepiness, cataplexy and hypnagogic hallucinations. Deficiency of the hypocretin neurotransmitter system was shown to be involved in the pathogenesis of narcolepsy in animals and men. There are several hints that neurodegeneration of hypocretin producing neurons in the hypothalamus is the pathological correlate of narcolepsy. The ApoE4 allele is a major contributing factor to early-onset neuronal degeneration in Alzheimer disease and other neurodegenerative diseases as well. Methods To clarify whether the ApoE4 phenotype predisposes to narcolepsy or associates with an earlier disease onset, we have genotyped the ApoE gene in 103 patients with narcolepsy and 101 healthy controls. Results The frequency of the E4 allele of the ApoE gene was 11% in the patient and 15% in the control groups. Furthermore, the mean age of onset did not differ between the ApoE4+ and ApoE4- patient groups. Conclusion Our results exclude the ApoE4 allele as a major risk factor for narcolepsy. PMID:11560764

  8. ApoE polymorphisms in narcolepsy

    Directory of Open Access Journals (Sweden)

    Kasten Meike

    2001-08-01

    Full Text Available Summary Background Narcolepsy is a common neuropsychiatric disorder characterized by increased daytime sleepiness, cataplexy and hypnagogic hallucinations. Deficiency of the hypocretin neurotransmitter system was shown to be involved in the pathogenesis of narcolepsy in animals and men. There are several hints that neurodegeneration of hypocretin producing neurons in the hypothalamus is the pathological correlate of narcolepsy. The ApoE4 allele is a major contributing factor to early-onset neuronal degeneration in Alzheimer disease and other neurodegenerative diseases as well. Methods To clarify whether the ApoE4 phenotype predisposes to narcolepsy or associates with an earlier disease onset, we have genotyped the ApoE gene in 103 patients with narcolepsy and 101 healthy controls. Results The frequency of the E4 allele of the ApoE gene was 11% in the patient and 15% in the control groups. Furthermore, the mean age of onset did not differ between the ApoE4+ and ApoE4- patient groups. Conclusion Our results exclude the ApoE4 allele as a major risk factor for narcolepsy.

  9. Decreased regional cerebral glucose metabolism in the prefrontal regions in adults' with internet game addiction

    International Nuclear Information System (INIS)

    Park, Hyun Soo; Bang, Soong Ae; Yoon, Eun Jin; Cho, Sang Soo; Kim, Sang Hee; Kim, Yu Kyeong; Kim, Sang Eun

    2007-01-01

    Internet Game Addiction (IGA) is known to be associated with poor decision-making and diminished impulse control; however, the underlying neural substrates of IGA have not been identified. To investigate the neural substrates of IGA, we compared regional cerebral glucose metabolism between adults with and without IGA, primarily in the prefrontal brain regions, which have been implicated in inhibitory control. We studied 10 right-handed participants (5 controls: male, 23.8±0.75 y, 5 IGAs: male, 22.6±2.42 y) with FDG PET. A standardized questionnaire was used to assess the severity of IGA. Before scanning, all subjects carried out a computerized version of the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART), as measures of behavioral inhibitory control. Statistical Parametric Mapping 2 (SPM2) was used to analyze differences in regional brain glucose metabolism between adults with and without IGA. Consistent with our predictions, compared to controls, significant reductions in FDG uptake in individuals with IGA were found in the bilateral orbitofrontal gyrus (BA 11, 47), bilateral inferior frontal gyrus (BA 44, 48), cingulate cortex (BA 24), and bilateral supplementary motor area (SMA) (BA 6); whereas increases were found in the bilateral hippocampus. Correlation analyses within the IGA group further showed that the level of glucose metabolism in the right orbitofrontal gyrus was marginally positively correlated with task scores in BART. Our results showed that IGA is associated with reduced glucose metabolism in the prefrontal regions involved in inhibitory control. This finding highlights dysfunctional inhibitory brain systems in individuals with IGA and offers implications for the development for therapeutic paradigms for IGA

  10. A study on measurement of the regional cerebral blood flow using autoradiographic method in moyamoya disease

    International Nuclear Information System (INIS)

    Sasaki, Tomohiro; Kiya, Katsuzo; Yuki, Kiyoshi; Kawamoto, Hitoshi; Mizoue, Tatsuya; Kiura, Yoshihiro; Uozumi, Tohru; Ikawa, Fusao

    1997-01-01

    Development of Autoradiographic method (ARG) has provided measurement of cerebral blood flow in moyamoya disease. We evaluate a cerebral vasodilatory capacity (CVC) for moyamoya disease using ARG method. We used 5 patients with moyamoya disease as a candidate for measurement of the cerebral blood flow (CBF) who admitted to Hiroshima Prefectural Hospital during the past one year. There were 3 patients in an adult age and 2 patients in a young age. We tried to measure the regional CBF (rCBF) using ARG method which was a easy way to estimate the rCBF on SPECT. The CVC was calculated from the difference of the rCBF between resting SPECT and Diamox-loading SPECT. Results were as follows; Reactivity of cerebral vessels to CO 2 loading and CVC weakened in moyamoya disease. The rCBF and CVC in the territories of anterior and middle cerebral arteries reduced in comparison with those in the area supplied by the posterior cerebral artery. The CVC at the treated side with surgical reconstruction recovered somewhat in an adult type. From these results, measurement of CBF using ARG method seems to be useful for evaluation of the CVC in moyamoya disease. (author)

  11. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  12. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    NARCIS (Netherlands)

    Droogleever Fortuyn, H.A.; Lappenschaar, G.A.; Nienhuis, F.J.; Furer, J.W.; Hodiamont, P.P.G.; Rijnders, C.A.T.; Lammers, G.J.; Renier, W.O.; Buitelaar, J.K.; Overeem, S.

    2009-01-01

    OBJECTIVE: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  13. Psychotic symptoms in narcolepsy : phenomenology and a comparison with schizophrenia

    NARCIS (Netherlands)

    Fortuyn, Hal A. Droogleever; Lappenschaar, G. A.; Nienhuis, Fokko J.; Furer, Joop W.; Hodiamont, Paul P.; Rijnders, Cees A.; Lammers, Gert Jan; Renier, Willy O.; Buitelaar, Jan K.; Overeem, Sebastlaan

    2009-01-01

    Objective: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  14. ImmunoChip study implicates antigen presentation to T cells in narcolepsy.

    Directory of Open Access Journals (Sweden)

    Juliette Faraco

    Full Text Available Recent advances in the identification of susceptibility genes and environmental exposures provide broad support for a post-infectious autoimmune basis for narcolepsy/hypocretin (orexin deficiency. We genotyped loci associated with other autoimmune and inflammatory diseases in 1,886 individuals with hypocretin-deficient narcolepsy and 10,421 controls, all of European ancestry, using a custom genotyping array (ImmunoChip. Three loci located outside the Human Leukocyte Antigen (HLA region on chromosome 6 were significantly associated with disease risk. In addition to a strong signal in the T cell receptor alpha (TRA@, variants in two additional narcolepsy loci, Cathepsin H (CTSH and Tumor necrosis factor (ligand superfamily member 4 (TNFSF4, also called OX40L, attained genome-wide significance. These findings underline the importance of antigen presentation by HLA Class II to T cells in the pathophysiology of this autoimmune disease.

  15. Regional cerebral blood flow and the effects of nicardipine, a new cerebral vasodilator, in patients with neuropsychiatric symptoms

    International Nuclear Information System (INIS)

    Toyoda, Katsuhiro; Motomura, Naoyasu; Murata, Koen; Sakai, Toshiaki; Yoshioka, Michio; Tsutsumi, Shigetoshi.

    1984-01-01

    Regional cerebral blood flow (rCBF) was determined by 133 Xe inhalation method in 22 neuropsychiatric patients with an average age of 65.8 years -- 14 patients having cerebrovascular disturbance (Group 1) and 8 patients having endogenous or organic psychosis or neurological lesions (Group 2). Furthermore, nicardipine was orally administered to the patients and its effects on rCBF and on neuropsychiatric symptoms were examined. Regarding the mean and abnormal decrease of rCBF in the bilateral hemispheres and the frequency of ischemic foci, there was no significant difference between the groups. However, regional ischemic focus was more frequently observed in Group 1 than in Group 2. Long-term serial administration of nicardipine increased the rCBF and improved psychiatric symptoms in some of the patients in Group 1. (Namekawa, K.)

  16. Regional cerebral glucose metabolism in systemic lupus erythematosus patients with major depressive disorder.

    Science.gov (United States)

    Saito, Tomoyuki; Tamura, Maasa; Chiba, Yuhei; Katsuse, Omi; Suda, Akira; Kamada, Ayuko; Ikura, Takahiro; Abe, Kie; Ogawa, Matsuyoshi; Minegishi, Kaoru; Yoshimi, Ryusuke; Kirino, Yohei; Ihata, Atsushi; Hirayasu, Yoshio

    2017-08-15

    Depression is frequently observed in patients with systemic lupus erythematosus (SLE). Neuropsychiatric SLE (NPSLE) patients often exhibit cerebral hypometabolism, but the association between cerebral metabolism and depression remains unclear. To elucidate the features of cerebral metabolism in SLE patients with depression, we performed brain 18F-fluoro-d-glucose positron emission tomography (FDG-PET) on SLE patients with and without major depressive disorder. We performed brain FDG-PET on 20 SLE subjects (5 male, 15 female). The subjects were divided into two groups: subjects with major depressive disorder (DSLE) and subjects without major depressive disorder (non-DSLE). Cerebral glucose metabolism was analyzed using the three-dimensional stereotactic surface projection (3D-SSP) program. Regional metabolism was evaluated by stereotactic extraction estimation (SEE), in which the whole brain was divided into segments. Every SLE subject exhibited cerebral hypometabolism, in contrast to the normal healthy subjects. Regional analysis revealed a significantly lower ER in the left medial frontal gyrus (p=0.0055) and the right medial frontal gyrus (p=0.0022) in the DSLE group than in the non-DSLE group. Hypometabolism in the medial frontal gyrus may be related to major depressive disorder in SLE. Larger studies are needed to clarify this relationship. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Left-right cortical asymmetries of regional cerebral blood flow during listening to words

    DEFF Research Database (Denmark)

    Nishizawa, Y; Olsen, T S; Larsen, B

    1982-01-01

    1. Regional cerebral blood flow (rCBF) was measured during rest and during listening to simple words. The xenon-133 intracarotid technique was used and results were obtained from 254 regions of seven right hemispheres and seven left hemispheres. The measurements were performed just after carotid...... of the entire hemisphere. The focal rCBF increases were localized to the superior part of the temporal regions, the prefrontal regions, the frontal eye fields, and the orbitofrontal regions. Significant asymmetries were found in particular in the superior temporal region with the left side showing a more...

  18. Regional cerebral blood flow distribution in newly diagnosed schizophrenia and schizophreniform disorder

    DEFF Research Database (Denmark)

    Rubin, P; Holm, S; Madsen, P L

    1994-01-01

    Regional cerebral blood flow distribution (rCBF) in 24 first admissions with schizophrenia or schizophreniform disorder and in 17 healthy volunteers was examined. Single photon emission computed tomography with a brain-retained tracer, technetium-99m-d,l-hexamethyl-propylene amine oxime, was used...... interrelationship in schizophrenia and schizophreniform disorder....

  19. Cognitive profiles and regional cerebral blood flow patterns in dementia of the Alzheimer type

    DEFF Research Database (Denmark)

    Waldemar, G; Bruhn, P; Schmidt, E

    1994-01-01

    Individual cognitive profiles and correlations between cognitive functions and regional cerebral blood flow (rCBF) were analyzed in 20 consecutive patients with a clinical diagnosis of probable Alzheimer's disease (AD). CBF was measured with high resolution single photon emission computed...

  20. Regional cerebral blood flow changes related to affective speech presentation in persistent vegetative state

    NARCIS (Netherlands)

    deJong, BM; Willemsen, ATM; Paans, AMJ

    A story told by his mother was presented on tape to a trauma patient in persistent vegetative state (PVS). During auditory presentation, measurements of regional cerebral blood flow (rCBF) were performed by means of positron emission tomography (PET). Changes in rCBF related to this stimulus

  1. Detection of cerebral arterial gas embolism using regional cerebral oxygen saturation, quantitative electroencephalography, and brain oxygen tension in the swine

    NARCIS (Netherlands)

    Weenink, R. P.; Hollmann, M. W.; Stevens, M. F.; Kager, J.; van Gulik, T. M.; van Hulst, R. A.

    2014-01-01

    Cerebral air emboli occur as a complication of invasive medical procedures. The sensitivity of cerebral monitoring methods for the detection of air emboli is not known. This study investigates the utility of electroencephalography and non-invasively measured cerebral oxygen saturation in the

  2. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

    2016-12-01

    Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (Psurgery (Pshoulder surgery had no major impact on cerebral blood flow and cerebral oxygenation. However, some impact on neurobehavioral outcome 24 hours after surgery was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. New possibilities for quantitative measurements of regional cerebral blood flow with Au-195 m

    International Nuclear Information System (INIS)

    Lindner, P.; Nickel, O.

    1984-01-01

    A previously reported theory for quantitative cerebral blood flow measurement for nondiffusible radiotracers has been applied on patients after stroke and an volunteers undergoing a mental stimulation exercise. Quantitative measurements of cerebral blood flow patterns not only in p-a. but also in lateral views of the brain are possible by the use of the recently developed generator for the short lived (30 sec) isotope Au-195 m. The energy spectrum of the eluate of the generator shows two strong photon peaks, one at an energy level of 68 KeV and a second at an energy-level of 262 KeV. The low energy peak is suitable for perfusion studies in lateral views of the hemispheres, no ''look through'' effect is seen. The high energy level is good for studies in p-a-positions. The studies last less than 1 minute and can be repeated after 3 minutes. Parametric images for quantitative regional cerebral blood flow can be generated. The area of occluded vessels in the case of stroke can be detected. Quantitative activation patterns of cerebral blood flow during mental stimulation can be generated. The results prove that not only with freely diffusible indicators like Xenon but also with nondiffusible indicators it is possible to measure quantitatively cerebral blood flow patterns. (orig.)

  4. Study of regional cerebral blood flow in obsessive compulsive disorder patients with SPM and ROI method

    International Nuclear Information System (INIS)

    Li Peiyong; Jiang Xufeng; Zhang Liying; Guo Wanhua; Zhu Chengmo

    2002-01-01

    Objective: To investigate the alternations in regional cerebral blood flow (rCBF) in obsessive compulsive disorder (OCD) patients using statistical parametric mapping (SPM). Methods: rCBF measurements using 99 Tc m -ethyl cysteinate dimer (ECD) SPECT was performed on 14 OCD patients and 23 age-matched healthy volunteers. The rCBF distribution was compared between these two groups with SPM under the conditions of increased and decreased perfusion, and with regions of interest (ROIs) using cerebral template. P value was set at 0.01 level. Results: SPM analysis showed that rCBF decreased in cerebral areas including bilateral putamen, superior temporal gyrus and precuneus, and right orbital gyrus, superior and middle frontal gyrus, and left temporo-occipital lobule and superior parietal gyrus, and vermis. rCBF was also increased in left inferior frontal gyrus and posterior cingulate gyrus. With ROIs method, rCBF was decreased in right anterior frontal, temporo-parietal lobule and left temporo-occipital lobule. Conclusions: The study supports the viewpoint that rCBF abnormality of fronto-striatal circuits is involved in OCD patients. SPM method is a forceful tool in analyzing cerebral regional characters

  5. Regional cerebral glucose metabolism during sevoflurane anaesthesia in healthy subjects studied with positron emission tomography

    DEFF Research Database (Denmark)

    Schlünzen, L; Juul, N; Hansen, K V

    2010-01-01

    BACKGROUND: The precise mechanism by which sevoflurane exerts its effects in the human brain remains unknown. In the present study, we quantified the effects of sevoflurane on regional cerebral glucose metabolism (rGMR) in the human brain measured with positron emission tomography. METHODS: Eight...... areas by 48-71% of the baseline (Pbrain metabolic reduction of GMR in all regions...... of the human brain, with the most marked metabolic suppression in the lingual gyrus, thalamus and occipital lobe....

  6. Regional quantitative noninvasive assessment of cerebral perfusion and function with N-Isopropyl-[123I]p-iodoamphetamine

    International Nuclear Information System (INIS)

    von Schulthess, G.K.; Ketz, E.; Schubiger, P.A.; Bekier, A.

    1985-01-01

    Although several reports on the clinical usefulness of N-isopropyl-[ 123 I]p-iodoamphetamine (IMP) in the diagnosis of cerebral disease have appeared in the literature, quantitative, noninvasive measurements of regional cerebral blood flow with this method pose difficulties because cerebral IMP uptake not only depends on cerebral perfusion but also on cerebral function. Rather than trying to develop a method to measure cerebral perfusion with IMP, the authors have chosen to test a method to quantitatively evaluate planar and emission computed tomographic (ECT) studies by comparing the data obtained in patients with established pathology with the data obtained in a group of normal individuals. Using this method, absolute cerebral IMP uptake (counts/pixel/mCi/min) and planar anterior right-left ratios were obtained. Also measured were right-left ratios obtained from 12 paired regions in three ECT slices. The evaluation of the patients cerebral IMP uptake asymmetries relative to the normal standard values is a useful adjunct to qualitative image analysis in assessing the presence ans severity of disease, as qualitative analysis is prone to false-positive and negative results. Cerebral IMP uptake as measured in cts/pixel/mCi/min is abnormal only in severe cerebral disease and therefore generally a less helpful parameter

  7. Quantitative Analysis of Regional Cerebral Blood Flow using 99mTc-HMPAO SPECT in Parkinson's Disease

    International Nuclear Information System (INIS)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin; Lee, Myung Hae

    1992-01-01

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using 99m Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 ± 0.033 and 0.108 ± 0.062, respectively and PIA were -0.4 ± 0.7% and -0.7 ± 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  8. Quantitative Analysis of Regional Cerebral Blood Flow using {sup 99m}Tc-HMPAO SPECT in Parkinson's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Myung Hae [Asan Medical Center, Seoul (Korea, Republic of)

    1992-07-15

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using {sup 99m}Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 +- 0.033 and 0.108 +- 0.062, respectively and PIA were -0.4 +- 0.7% and -0.7 +- 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  9. The Humanistic and Economic Burden of Narcolepsy.

    Science.gov (United States)

    Flores, Natalia M; Villa, Kathleen F; Black, Jed; Chervin, Ronald D; Witt, Edward A

    2016-03-01

    To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls. This analysis was conducted on data from the 2011, 2012, and 2013 US National Health and Wellness Survey (NHWS; 2011 NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013 NHWS n = 75,000). Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization. Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p productivity through effective assessment and treatment of narcolepsy. © 2016 American Academy of Sleep Medicine.

  10. Narcolepsy: current treatment options and future approaches

    Science.gov (United States)

    Billiard, Michel

    2008-01-01

    The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1) Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS) and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2) The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3) A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy. PMID:18830438

  11. Narcolepsy: etiology, clinical features, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Jolanta B. Zawilska

    2012-10-01

    Full Text Available [u][/u] Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations. Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil. Cataplexy is treated with sodium oxybate (GHB, tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

  12. Investigational therapies for the treatment of narcolepsy.

    Science.gov (United States)

    de Biase, Stefano; Nilo, Annacarmen; Gigli, Gian Luigi; Valente, Mariarosaria

    2017-08-01

    Narcolepsy is a chronic sleep disorder characterized by a pentad of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep. While non-pharmacological treatments are sometimes helpful, more than 90% of narcoleptic patients require a pharmacological treatment. Areas covered: The present review is based on an extensive Internet and PubMed search from 1994 to 2017. It is focused on drugs currently in development for the treatment of narcolepsy. Expert opinion: Currently there is no cure for narcolepsy, with treatment focusing on symptoms control. However, these symptomatic treatments are often unsatisfactory. The research is leading to a better understanding of narcolepsy and its symptoms. New classes of compounds with possible applications in the development of novel stimulant/anticataplectic medications are described. H3 receptor antagonists represent a new therapeutic option for EDS in narcolepsy. JZP-110, with its distinct mechanism of action, would be a new therapeutic option for the treatment of EDS in the coming years. In the future, hypocretin-based therapies and immune-based therapies, could modify the clinical course of the disease. However, more information would be necessary to completely understand the autoimmune process and also how this process can be altered for therapeutic benefits.

  13. Dynamic alteration of regional cerebral blood flow during carotid compression and proof of reversibility

    International Nuclear Information System (INIS)

    Asahi, Kouichi; Hori, M; Hamasaki, N; Sato, S; Nakanishi, H; Kuwatsuru, R; Sasai, K; Aoki, S

    2012-01-01

    It is difficult to non-invasively visualize changes in regional cerebral blood flow caused by manual compression of the carotid artery. To visualize dynamic changes in regional cerebral blood flow during and after manual compression of the carotid artery. Two healthy volunteers were recruited. Anatomic features and flow directions in the circle of Willis were evaluated with time-of-flight magnetic resonance angiography (MRA) and two-dimensional phase-contrast (2DPC) MRA, respectively. Regional cerebral blood flow was visualized with territorial arterial spin-labeling magnetic resonance imaging (TASL-MRI). TASL-MRI and 2DPC-MRA were performed in three states: at rest, during manual compression of the right carotid artery, and after decompression. In one volunteer, time-space labeling inversion pulse (Time-SLIP) MRA was performed to confirm collateral flow. During manual carotid compression, in one volunteer, the right thalamus changed to be fed only by the vertebrobasilar system, and the right basal ganglia changed to be fed by the left internal carotid artery. In the other volunteer, the right basal ganglia changed to be fed by the vertebrobasilar system. 2DPC-MRA showed that the flow direction changed in the right A1 segment of the anterior cerebral artery and the right posterior communicating artery. Perfusion patterns and flow directions recovered after decompression. Time-SLIP MRA showed pial vessels and dural collateral circulation when the right carotid artery was manually compressed. Use of TASL-MRI and 2DPC-MRA was successful for non-invasive visualization of the dynamic changes in regional cerebral blood flow during and after manual carotid compression

  14. Narcolepsy in Adolescence-A Missed Diagnosis: A Case Report.

    Science.gov (United States)

    Gupta, Anoop K; Sahoo, Swapnajeet; Grover, Sandeep

    2017-01-01

    Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents.

  15. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R

    1993-01-01

    on electroencephalography, the regional neuronal activity expressed as rCBF unexpectedly was markedly asymmetrical in one of the cases. These findings demonstrated that the 99mTc-HMPAO technique makes it possible to discriminate intraictal variation in cortical and subcortical activation between the hemispheres during...

  16. Regional cerebral blood flow in psychiatry: The resting and activated brains of schizophrenic patients

    International Nuclear Information System (INIS)

    Gur, R.E.

    1984-01-01

    The investigation of regional brain functioning in schizophrenia has been based on behavioral techniques. Although results are sometimes inconsistent, the behavioral observations suggest left hemispheric dysfunction and left hemispheric overreaction. Recent developments in neuroimaging technology make possible major refinements in assessing regional brain function. Both anatomical and physiological information now be used to study regional brain development in psychiatric disorders. This chapter describes the application of one method - the xenon-133 technique for measuring regional cerebral blood flow (rCBF) - in studying the resting and activated brains of schizoprenic patients

  17. Regional cerebral blood flow during mechanical hyperventilation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Høgh, Peter; Larsen, Fin Stolze

    2000-01-01

    Mechanical hyperventilation is often instituted in patients with acute bacterial meningitis when increased intracranial pressure is suspected. However, the effect on regional cerebral blood flow (CBF) is unknown. In this study, we measured regional CBF (rCBF) in patients with acute bacterial...... meningitis before and during short-term hyperventilation. In 17 patients with acute bacterial meningitis, absolute rCBF (in ml/100 g min-1) was measured during baseline ventilation and hyperventilation by single-photon emission computed tomography (SPECT) using intravenous 133Xe bolus injection. Intravenous...... in the frontal and parietal cortex as well as in the basal ganglia. Focal perfusion abnormalities were present in 10 of 12 patients. Regional cerebral blood flow abnormalities are frequent in patients with acute bacterial meningitis. Short-term hyperventilation does not enhance these abnormalities....

  18. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, J. J.; Im, K. C.; Moon, D. H. [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)

    2003-07-01

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p<0.0001, extent threshold>100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF.

  19. Pathophysiology, Clinical, and Therapeutic Aspects of Narcolepsy

    Directory of Open Access Journals (Sweden)

    Pinar Guzel Ozdemir

    2014-09-01

    Full Text Available Narcolepsy is a lifelong sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination, and sleep paralysis. The exact cause remains unknown, but there is significant evidence that hypocretin deficiency plays an integral role. There have been advances in the understanding of the pathogenesis of narcolepsy. It has a negative effect on the quality of life and can restrict the patients from certain careers and activities. Diagnosis relies on patient history and objective data gathered from polysomnography and multiple sleep latency testing. Treatment focuses on symptom relief through medication, education, and behavioral modification. Both classic pharmacological treatments as well as newer options have significant problems, especially because of side effects and abuse potential. Some novel modalities are being examined to expand options for treatment. In this review, the pathophysiological, clinical, and pharmacotherapeutic aspects of narcolepsy are discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 271-283

  20. Narcolepsy and cataplexy: a pediatric case report.

    Science.gov (United States)

    Savaş, Tülin; Erol, Ilknur; Saygı, Semra; Habeşoğlu, Mehmet Ali

    2016-12-01

    Narcolepsy is characterized by excessive sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis during the rapid eye movement period of sleep. Herein, we present a boy aged eight years who was diagnosed as having narcolepsy and cataplexy about thirteen months after his first presentation. He was admitted with symptoms of daytime sleepiness. In the follow-up, cataplexy in the form of head dropping attacks developed seven months after the first admission. The patient was investigated for different prediagnoses and was eventually diagnosed as having narcolepsy and cataplexy through polysomnography and multiple sleep latency tests thirteen months after the first presentation. He is being followed up and is under drug therapy; his symptoms have improved substantially.

  1. Narcolepsy: current treatment options and future approaches

    Directory of Open Access Journals (Sweden)

    Michel Billiard

    2008-06-01

    Full Text Available Michel BilliardDepartment of Neurology, Gui de Chauliac Hospital, Montpellier, FranceAbstract: The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1 Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2 The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3 A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy.Keywords: narcolepsy, treatment, conventional drugs, modafinil, sodium oxybate, future treatments

  2. [Workplace accomodations for two workers with narcolepsy].

    Science.gov (United States)

    Vico Garcerán, Belén; Monzó Salas, Monserrat; Cuenca Esteve, Francisco; Luis Domingo, José

    2013-01-01

    We describe the case of two workers evaluated in our occupational health unit. The first worker was a kitchen aide; the second was a primary care physician. Both had been diagnosed with narcolepsy and had obvious disability.We assessed occupational hazards related to their jobs, analysed their tasks, and performed medical examinations. Afterwards, we offered recommendations to the patients, consisting of avoidance of situations involving a risk of work accidents and improving their sleep habits. Narcolepsy is a rare disorder, but it has important social and occupational consequences. A better understanding of the disease and some work accommodations can help improve the quality of life of affected workers.

  3. Regional cerebral metabolic correlates of WASO during NREM sleep in insomnia.

    Science.gov (United States)

    Nofzinger, Eric A; Nissen, Christoph; Germain, Anne; Moul, Douglas; Hall, Martica; Price, Julie C; Miewald, Jean M; Buysse, Daniel J

    2006-07-15

    To investigate the non-rapid eye movement (NREM) sleep-related regional cerebral metabolic correlates of wakefulness after sleep onset (WASO) in patients with primary insomnia. Fifteen patients who met DSM-IV criteria for primary insomnia completed 1-week sleep diary (subjective) and polysomnographic (objective) assessments of WASO and regional cerebral glucose metabolic assessments during NREM sleep using [18F] fluoro-2-deoxy-D-glucose positron emission tomography. Whole-brain voxel-by-voxel correlations, as well as region of interest analyses, were performed between subjective and objective WASO and relative regional cerebral metabolism using the statistical software SPM2. Subjective WASO was significantly greater than objective WASO, but the 2 measures were positively correlated. Objective WASO correlated positively with the percentage of stage 2 sleep and negatively with the percentage of stages 3 and 4 sleep. Both subjective and objective WASO positively correlated with NREM sleep-related cerebral glucose metabolism in the pontine tegmentum and in thalamocortical networks in a frontal, anterior temporal, and anterior cingulate distribution. Increased relative metabolism in these brain regions during NREM sleep in patients with insomnia is associated with increased WASO measured either subjectively or objectively. These effects are related to the lighter sleep stages of patients with more WASO and may result from increased activity in arousal systems during sleep and or to activity in higher-order cognitive processes related to goal-directed behavior, conflict monitoring, emotional awareness, anxiety, and fear. Such changes may decrease arousal thresholds and/or increase perceptions of wakefulness in insomnia.

  4. Development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids

    International Nuclear Information System (INIS)

    Wang Peng; Ji Xunming

    2007-01-01

    The neuroprotection of induced hypothermia has been investigated intensively and confirmed in animal models and it has been used clinically in many fields since the finding of sub-hypothermia can also reduce cerebral injury. However the use of hypothermia in clinics is limited by the simultaneously induced systemic complications. Recently the sub-hypothermia induced by hypothermic regional arterial perfusion is proved to be the most effective method to reach the goal, including hypothermic normal saline with no influences on whole body temperature, cardiac rhythm and blood coagulation. According to the well development, fruitful achievement in the present status of this field, the authors are surely to have the inspiration for the further investigation and development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids. (authors)

  5. 99mTc-HMPAO Regional Cerebral Blood Flow SPECT in Transient Ischemic Attacks

    International Nuclear Information System (INIS)

    Ahn, Myeong Im; Park, Young Ha; Lee, Sung Yong; Chung, Soo Kyo; Kim, Jong Woo; Bahk, Yong Whee

    1989-01-01

    Transient ischemic attacks (TJAs) is a syndrome resulting from brain ischemia lasting less than 24 hours. The mechanisms of TIAs may be similar to those of cerebral embolism and thrombosis, and thus TIAs may be followed by cerebral infarction. Despite the availability of CT scanning, the diagnosis and management of TIAs continue to be difficult. Recently SPECT has been advocated as a diagnostic imaging modality. We performed 99m Tc-HMPAO regional cerebral blood flow (rCRF) SPECT in 24 patients with the clinical diagnosis of TIAs to assess its ability to detect early changes of rCBF, and determine the diagnostic value. Ten men and fourteen women with an average of 51 years (range; 27-74 years) were included. All but 8 patients had normal brain CT prior to SPECT. The two patients had moderate degree of brain atrophy and the 6 patients nonspecific calcifications. Eighteen of the 24 patients had abnormal 99m Tc-HMPAO rCBF SPECT. Fifteen had unilateral involvement and the other three had bilateral involvements. Seventy-five percents of the defects were found in the left cerebral hemisphere. According to the distribution of the lesions (total number: 34 lesions), fourteen were in the parietal, eight in the temporal, and the remainders were elsewhere. 99m Tc-HMPAO rCHF SPECT is sensitive in detecting rCRF abnormalities in patients with TIAs, and represent the most accurate diagnostic tool available in the diagnosis of TIAs

  6. Nicardipine reduces calcium accumulation and electrolyte derangements in regional cerebral ischemia in rats

    International Nuclear Information System (INIS)

    Hadani, M.; Young, W.; Flamm, E.S.

    1988-01-01

    We studied the effects of the calcium channel blocker nicardipine on regional tissue Ca 2+ , Na + , K + , and water shifts in the brains of seven Sprague-Dawley rats after permanent occlusions of the middle cerebral artery. We also assessed the entry of [ 14 C]nicardipine into the brains of five rats; the highest concentrations of [ 14 C]nicardipine were in the infarcted area. Nicardipine treatment significantly reduced Ca 2+ accumulation in the middle cerebral artery territory by 60% compared with six untreated rats 6 hours after arterial occlusion. Eight 125-micrograms/kg boluses of nicardipine given every 30 minutes starting 5 minutes after arterial occlusion also significantly reduced the Na + and K + shifts in the middle cerebral artery territory by 40% and 50%, respectively, 6 hours after arterial occlusion. Nicardipine appears to reduce Ca 2+ accumulation more than it reduces Na + and water accumulation and K + loss. Our results suggest that a calcium channel blocker can protect brain tissues in a model of focal cerebral infarction by directly reducing Ca 2+ entry into ischemic cells

  7. Low regional cerebral blood flow in burning mouth syndrome patients with depression.

    Science.gov (United States)

    Liu, B-L; Yao, H; Zheng, X-J; Du, G-H; Shen, X-M; Zhou, Y-M; Tang, G-Y

    2015-07-01

    The main aims of this study were to (i) investigate the emotional disorder status of patients with burning mouth syndrome (BMS) and (ii) detect regional cerebral blood flow in BMS patients with the application of combined single-photon emission computed tomography and computed tomography (SPECT/CT). The degree of pain was measured using the visual analysis scale, and emotional disorder with the self-rating anxiety scale, self-rating depression scale, and Hamilton depression rating scale in 29 patients with BMS and 10 healthy controls. SPECT/CT was performed in 29 patients with BMS and 10 healthy controls, and statistical parametric mapping method was used for between-group analyses. The incidence rate of depression in patients with BMS was 31.0%. Compared to the control group, patients with BMS displayed significantly different depression and anxiety scales (P < 0.05). Significantly lower regional cerebral blood flow in the left parietal and left temporal lobes was recorded for BMS patients with depression (P < 0.05). Patients with BMS experience more depression and anxious emotion. Moreover, depression in patients with BMS may be associated with lower regional cerebral blood flow in the left temporal and left parietal lobes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Regional cerebral blood flow characteristics of the Sturge-Weber syndrome

    International Nuclear Information System (INIS)

    Riela, A.R.; Stump, D.A.; Roach, E.S.; McLean, W.T. Jr.; Garcia, J.C.

    1985-01-01

    Four patients with the Sturge-Weber syndrome were studied using the non-invasive Xenon-133 inhalation technique. All four patients had decreased regional cerebral blood flow in the area of their lesion, and in two patients who were subsequently tested with 5% carbon dioxide inhalation, impaired vasomotor reactivity was documented. Diminished regional cerebral blood flow is consistent with previously described nuclide flow studies which demonstrated a delay in the initial perfusion blush in the region of the abnormal vasculature. The focal decrease in blood flow was greatest in the most severely affected patient, but was also prominent in the two younger patients, both of whom have excellent neurologic function. These studies suggest that localized decrease in blood flow and vasomotor dysfunction in Sturge-Weber syndrome can precede the occurrence of severe neurologic impairment and extensive cerebral atrophy and possibly be a major contributing factor in progressive dysfunction. A secondary observation was that the blood flow in the unaffected hemisphere was significantly greater in two children compared to the two adults and was similar to the age-related differences reported for normal children and adults

  9. Regional Cerebral Glucose Metabolism in Novelty Seeking and Antisocial Personality: A Positron Emission Tomography Study.

    Science.gov (United States)

    Park, So Hyeon; Park, Hyun Soo; Kim, Sang Eun

    2016-08-01

    Novelty seeking (NS) and antisocial personality (ASP) are commonly exhibited by those who suffer from addictions, such as substance abuse. NS has been suggested to be a fundamental aspect of ASP. To investigate the neurobiological substrate of NS and ASP, we tested the relationship between regional cerebral glucose metabolism and the level of NS, determining the differences between individuals with and without ASP. Seventy-two healthy adults (43 males, mean age±SD=38.8±16.6 years, range=20~70 years; 29 females, 44.2±20.1 years, range=19~72 years) underwent resting-state brain positron emission tomography (PET) 40 minutes after (18)F-fluorodeoxyglucose (FDG) injection. Within 10 days of the FDG PET study, participants completed Cloninger's 240-item Temperament and Character Inventory (TCI) to determine NS scores. Participants with and without ASP were grouped according to their TCI profiles. Statistical parametric mapping analysis was performed using the FDG PET and TCI profile data. NS scores positively correlated with metabolism in the left anterior cingulate gyrus and the insula on both sides of the brain and negatively correlated with metabolism in the right pallidum and putamen. Participants with ASP showed differences in cerebral glucose metabolism across various cortical and subcortical regions, mainly in the frontal and prefrontal areas. These data demonstrate altered regional cerebral glucose metabolism in individuals with NS and ASP and inform our understanding of the neurobiological substrates of problematic behaviors and personality disorders.

  10. Evaluation of regional cerebral circulation and metabolism in moyamoya disease using positron emission computed tomography

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo

    1986-01-01

    Regional cerebral blood flow, oxygen extraction fraction, metabolic rate of oxygen, blood volume and transit time were evaluated in 11 patients with moyamoya disease and 3 with suspected moyamoya disease using positron emission computed tomography. Eight of them were examined before and after EC-IC bypass surgery. Moyamoya patients were classified into four groups, namely, pediatric bilateral chronic type (over 5 years from onset), pediatric bilateral early type (within 5 years from onset), pediatric unilateral early type and adult type, according to age, duration of disease from onset and angiographic findings. These four groups showed different patterns on PET images; diffusely decreased CBF and CMRO2 in pediatric bilateral chronic type, decreased CBF and increased OEF in the frontal or temporoparietal region in pediatric bilateral early type, diffusely decreased CBF and increased OEF in the unilateral cerebral hemisphere in pediatric unilateral cerebral hemisphere in pediatric unilateral early type, and decreased CBF and CMRO2 in adult type. An increase of rCBV was demonstrated in frontal regions or basal ganglia in all groups, more prominently in pediatric patients. This was thought to be a common finding in moyamoya disease, corresponding to moyamoya vessels. Staging of moyamoya disease by PET was presented and compared to the angiographic staging. They were significantly correlated, and the stage 3 on PET image with decreased CMRO2 corresponded to the stage 3 or 4 on angiography, the most active stage of moyamoya disease. PET revealed increased CBF in the cortical area around EC-IC bypass but no remarkable changes in mean values of rCBF, OEF, CMRO2 and CBV in cerebral hemisphere. Some patients showed decreased rCBV in the basal ganglia. (J.P.N.)

  11. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    International Nuclear Information System (INIS)

    Ichiseki, Hajime; Terashi, Akiro; Hamamoto, Makoto; Miyazaki, Tokuzo.

    1995-01-01

    We have performed single photon emission computed tomography (SPECT) with 99m Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author)

  12. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Ichiseki, Hajime; Terashi, Akiro [Nippon Medical School, Tokyo (Japan); Hamamoto, Makoto; Miyazaki, Tokuzo

    1995-12-01

    We have performed single photon emission computed tomography (SPECT) with {sup 99m}Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author).

  13. Moebius syndrome and narcolepsy: A case dissertation

    Directory of Open Access Journals (Sweden)

    Lídia Sabaneeff

    2014-03-01

    Full Text Available Moebius syndrome (MS is a congenital syndrome characterized by unilateral or bilateral aplasia of the VI and VII cranial nerves, with consequent convergent strabismus and bilateral peripheral facial paralysis. This syndrome might be associated with diurnal excessive sleepiness and muscular hypotony, mimetizing in this manner, narcolepsy. The diagnostic criteria for narcolepsy depend on the presence of REM sleep during the day. As with patients with MS we do not have ocular movements due to the VI nerve paralysis, the absence of horizontal ocular movements might make it difficult to confirm narcolepsy in these patients. The common clinical characteristics of these patients are due to a possible impairment of the same structures that are affected in the central nervous system. However, the mechanism by which it occurs remains to be fully understood. Further electrophysiological researches are necessary to better clarify the association of these two diseases. The objective of this dissertation is to describe and discuss a case of Moebius syndrome with diurnal excessive sleepiness as a differential diagnosis for narcolepsy.

  14. Narcolepsy as an Immune-Mediated Disease

    Directory of Open Access Journals (Sweden)

    Alberto K. De la Herrán-Arita

    2014-01-01

    Full Text Available Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, cataplexy, hypnagonic hallucinations, sleep paralysis, and disturbed nocturnal sleep patterns. This disease is secondary to the specific loss of hypothalamic hypocretin (orexin-producing neurons in the lateral hypothalamus. An autoimmune basis for the disease has long been suspected based on its strong association with the genetic marker DQB1*06:02, and current studies greatly support this hypothesis. Narcolepsy with hypocretin deficiency is associated with human leukocyte antigen (HLA and T cell receptor (TCR polymorphisms, suggesting that an autoimmune process targets a peptide unique to hypocretin-producing neurons via specific HLA-peptide-TCR interactions. This concept has gained a lot of notoriety after the increase of childhood narcolepsy in 2010 following the 2009 H1N1 pandemic (pH1N1 in China and vaccination with Pandemrix, an adjuvanted H1N1 vaccine that was used in Scandinavia. The surge of narcolepsy cases subsequent to influenza A H1N1 infection and H1N1 vaccination suggests that processes such as molecular mimicry or bystander activation might be crucial for disease development.

  15. Regional cerebral blood flow changes in patients with internet addiction: Authors' reply.

    Science.gov (United States)

    Liu, Guobing; Shi, Hongcheng

    2016-01-01

    To the comments of Prof. Andreas Otte to our work we reply as follows: As was mentioned by Prof. Andreas Otte, our study was the first study of regional cerebral blood flow changes in patients with internet addiction. Therefore, there was not much previous, established experience to refer to. As an exploration study, it was inevitable that there were some insufficiencies. We feel great appreciation to Prof. Andreas Otte for his comments on our work, which will improve our studying quality in this field in the future. Prof. Andreas Otte inquired in his letter how the regional cerebral blood flow (rCBF) was calculated, and was scaled, relatively to the whole brain mean value or to the cerebellar mean value. All rCBF data were scaled relatively to the whole brain, in our study. As for the question in relation to the test level, the P-value of 0.05 was only used when comparing intergroup differences of baseline or clinical information of patients using SPSS, while the P-value of 0.01 was used for the statistical parametric mapping (SPM) t-test. We had tried using the test level of Pfalse-positive results. However, in order to control false-positive errors, we performed intragroup comparisons from rest to adenosine-stressed status firstly by paired t test to identify cerebral regions with obvious rCBF changes because of administration of adenosine. On the basis of these cerebral regions, we subsequently performed a two-sample t test to compare intergroup differences to identify cerebral regions with rCBF that could have attributed to internet addiction. We believed that this "twostep" statistical mode might reduce the probability of falsepositive results to some extent. As for the cluster question in relation to SPM analysis, it seems more problematic and more prone for clusterwise inference to produce false-positive results than voxelwise inference, as mentioned in the paper by Eklund et al (2016). We did not take the two-way ANOVA analysis, instead, we performed the

  16. Analysis of Regional Cerebral Blood Flow Using 99mTc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    International Nuclear Information System (INIS)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In

    1988-01-01

    99m Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, 99m Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  17. Evaluation of regional cerebral blood flow and volume of rapidly exchangeable water in man by positron emission tomography

    International Nuclear Information System (INIS)

    Depresseux, J.C.; Cheslet, J.P.; Hodiaumont, J.

    1982-01-01

    The present investigation uses bolus inhalation of C 15 O 2 and sequential positron emission tomography of the brain in view to simultaneously evaluate regional cerebral blood flow and regional cerebral volume of rapidly exchangeable water in normal human subjects. Arguments allow to infer that the cerebral distribution volume of radiowater does vary with time during the initial period of invasion of tissue by the indicator. Implications of this variation on the validity of classical data procedures is discussed and an alternative original method is proposed [fr

  18. Region-specific maturation of cerebral cortex in human fetal brain: diffusion tensor imaging and histology

    International Nuclear Information System (INIS)

    Trivedi, Richa; Gupta, Rakesh K.; Saksena, Sona; Husain, Nuzhat; Srivastava, Savita; Rathore, Ram K.S.; Sarma, Manoj K.; Malik, Gyanendra K.; Das, Vinita; Pradhan, Mandakini; Pandey, Chandra M.; Narayana, Ponnada A.

    2009-01-01

    In this study, diffusion tensor imaging (DTI) and glial fibrillary acidic protein (GFAP) immunohistochemical analysis in different cortical regions in fetal brains at different gestational age (GA) were performed. DTI was performed on 50 freshly aborted fetal brains with GA ranging from 12 to 42 weeks to compare age-related fractional anisotropy (FA) changes in different cerebral cortical regions that include frontal, parietal, occipital, and temporal lobes at the level of thalami. GFAP immunostaining was performed and the percentage of GFAP-positive areas was quantified. The cortical FA values in the frontal lobe peaked at around 26 weeks of GA, occipital and temporal lobes at around 20 weeks, and parietal lobe at around 23 weeks. A significant, but modest, positive correlation (r=0.31, p=0.02) was observed between cortical FA values and percentage area of GFAP expression in cortical region around the time period during which the migrational events are at its peak, i.e., GA ≤ 28 weeks for frontal cortical region and GA≤22 weeks for rest of the lobes. The DTI-derived FA quantification with its GFAP immunohistologic correlation in cortical regions of the various lobes of the cerebral hemispheres supports region-specific migrational and maturational events in human fetal brain. (orig.)

  19. Region-specific maturation of cerebral cortex in human fetal brain: diffusion tensor imaging and histology

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Richa; Gupta, Rakesh K.; Saksena, Sona [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, UP (India); Husain, Nuzhat; Srivastava, Savita [CSM Medical University, Department of Pathology, Lucknow (India); Rathore, Ram K.S.; Sarma, Manoj K. [Indian Institute of Technology, Department of Mathematics and Statistics, Kanpur (India); Malik, Gyanendra K. [CSM Medical University, Department of Pediatrics, Lucknow (India); Das, Vinita [CSM Medical University, Department of Obstetrics and Gynecology, Lucknow (India); Pradhan, Mandakini [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Medical Genetics, Lucknow (India); Pandey, Chandra M. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Biostatistics, Lucknow (India); Narayana, Ponnada A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Houston, TX (United States)

    2009-09-15

    In this study, diffusion tensor imaging (DTI) and glial fibrillary acidic protein (GFAP) immunohistochemical analysis in different cortical regions in fetal brains at different gestational age (GA) were performed. DTI was performed on 50 freshly aborted fetal brains with GA ranging from 12 to 42 weeks to compare age-related fractional anisotropy (FA) changes in different cerebral cortical regions that include frontal, parietal, occipital, and temporal lobes at the level of thalami. GFAP immunostaining was performed and the percentage of GFAP-positive areas was quantified. The cortical FA values in the frontal lobe peaked at around 26 weeks of GA, occipital and temporal lobes at around 20 weeks, and parietal lobe at around 23 weeks. A significant, but modest, positive correlation (r=0.31, p=0.02) was observed between cortical FA values and percentage area of GFAP expression in cortical region around the time period during which the migrational events are at its peak, i.e., GA {<=} 28 weeks for frontal cortical region and GA{<=}22 weeks for rest of the lobes. The DTI-derived FA quantification with its GFAP immunohistologic correlation in cortical regions of the various lobes of the cerebral hemispheres supports region-specific migrational and maturational events in human fetal brain. (orig.)

  20. The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery

    OpenAIRE

    Song, Inkyung; Kim, Dong Yeon; Kim, Youn Jin

    2012-01-01

    Background Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing tot...

  1. Regional cerebral metabolic changes after acupuncture by FDG PET: effects and methodology

    International Nuclear Information System (INIS)

    Guan Yihui; Li Ji; Zuo Chuantao; Dong Jincheng; Zhao Jun; Lin Xiangtong

    2002-01-01

    In order to investigate the therapeutic mechanisms of acupuncture pints in cerebrovascular ischemic patients and normal volunteers, FDG PET was adopted. Changes in cerebral glucose metabolism and cerebral functional activity before and after electro-acupuncture treatment were studied in 12 normal volunteers and 11 cerebrovascular ischemic patients. The PET imaging was read by visual interpretation and calculated by semi-quantitative analysis. After acupuncture, cerebral glucose metabolism of the normal group is higher in the frontal lobe, temporal lobe, thalamus bilaterally and cerebellum contralaterally. The cerebrovascular ischemic patients had manifested greater response in their lesions than in their normal regions of the two tested groups, as well as than in their normal regions of the whole brain, after acupuncture treatment. The study shows that the regulatory effects of acupuncture on the central nervous system influence the brain at multiple-sections, multiple-directions and multiple-levels of brain function. It conforms to the holistic and bi-directions regulatory laws of acupuncture

  2. Regional cerebral metabolic changes after acupuncture by FDG PET: Effects and methodology

    International Nuclear Information System (INIS)

    Guan, Y.H.; Zuo, C.T.; Zhao, J.; Lin, X.T.; Li, J.; Dong, J.C.

    2002-01-01

    Abstract Objectives: To observe the regional cerebral metabolism changes in cerebrovascular ischemic patients and normal volunteers while acupuncture by using FDG PET. To definite the locations of the influence of these acupoints on brain function in certain regions of the cerebrum, as well as to explore the laws of therapeutic effects of acupuncture on subjects and established the One-day method for brain FDG PET scan. Methods and Materials Using FDG PET, cerebral glucose metabolism and cerebral functional changes before and after electro-acupuncture treatment were investigated in 12 normal volunteers and 8 cerebrovascular ischemic patients. These subjects were treated with acupuncture in the following points: Hegu (LI4) and Quchi (LI11) of Hand Yang-Ming meridian, Zusanli (ST36) and Shangjuxu (ST37) of Foot Yang-Ming meridian and added Motor Area and Fengchi (B20). Limbs points were contralateral to the brain points. In the normal group, the side of the body treated by acupuncture was randomly selected and in the patients groups, the sides treated were on the side of paralysis. PET imaging was read by visual interpretation and calculated in multiple ROI semi-quantitative analysis method. Therefore, the image subject method was used to demonstrate the variety of glucose metabolism after acupuncture. Results One-day method was established in these studies. PET imaging was read by visual interpretation in blind method and calculated by semi-quantitative analysis. This results shows that cerebral glucose metabolism and cerebral functional activity of the normal is higher in the frontal lobe, temporal lobe, thalamus, Sensorimotor, Parietal bilaterally and cerebellum contralaterally. After acupuncture, the increase ratio of ipslateral glucose metabolism was between 23% and 38%; while the contralateral increase ratio between 22% and 40%. Above all, the variation in cerebral glucose metabolism was predominantly contralateral cerebral regions. The cerebrovascular ischemic

  3. Effect of axillary blockade on regional cerebral blood flow during static handgrip

    DEFF Research Database (Denmark)

    Friedman, D B; Friberg, L; Mitchell, J H

    1991-01-01

    Regional cerebral blood flow (rCBF) was determined at rest and during static handgrip before and after regional blockade with lidocaine. A fast rotating single photon emission computer tomograph system with 133Xe inhalation was used at orbitomeatal plane (OM) +2.5 and +6.5 cm in eight subjects. M...... static handgrip, there was no increase in rCBF after partial sensory and motor blockade. Thus bilateral activation occurs in the premotor and motor sensory cortex during static handgrip, and this activation requires neural feedback from the contracting muscles....

  4. Sleep transitions in hypocretin-deficient narcolepsy.

    Science.gov (United States)

    Sorensen, Gertrud Laura; Knudsen, Stine; Jennum, Poul

    2013-08-01

    Narcolepsy is characterized by instability of sleep-wake, tonus, and rapid eye movement (REM) sleep regulation. It is associated with severe hypothalamic hypocretin deficiency, especially in patients with cataplexy (loss of tonus). As the hypocretin neurons coordinate and stabilize the brain's sleep-wake pattern, tonus, and REM flip-flop neuronal centers in animal models, we set out to determine whether hypocretin deficiency and/or cataplexy predicts the unstable sleep-wake and REM sleep pattern of the human phenotype. We measured the frequency of transitions in patients with narcolepsy between sleep-wake states and to/from REM and NREM sleep stages. Patients were subdivided by the presence of +/- cataplexy and +/- hypocretin-1 deficiency. Sleep laboratory studies conducted from 2001-2011. In total 63 narcolepsy patients were included in the study. Cataplexy was present in 43 of 63 patients and hypocretin-1 deficiency was present in 37 of 57 patients. Hypocretin-deficient patients with narcolepsy had a significantly higher frequency of sleep-wake transitions (P = 0.014) and of transitions to/from REM sleep (P = 0.044) than patients with normal levels of hypocretin-1. Patients with cataplexy had a significantly higher frequency of sleep-wake transitions (P = 0.002) than those without cataplexy. A multivariate analysis showed that transitions to/from REM sleep were predicted mainly by hypocretin-1 deficiency (P = 0.011), whereas sleep-wake transitions were predicted mainly by cataplexy (P = 0.001). In human narcolepsy, hypocretin deficiency and cataplexy are both associated with signs of destabilized sleep-wake and REM sleep control, indicating that the disorder may serve as a human model for the sleep-wake and REM sleep flip-flop switches.

  5. Parkinson's disease and narcolepsy-like symptoms.

    Science.gov (United States)

    Ylikoski, Ari; Martikainen, Kirsti; Sarkanen, Tomi; Partinen, Markku

    2015-04-01

    Various sleep-related problems, for example, insomnia and symptoms of rapid eye movement behavior disorder (RBD), are common in patients with Parkinson's disease (PD). We studied the prevalence of symptoms of narcolepsy (NARC), hallucinations, and RBD and their association with other symptoms. Altogether, 1447 randomly selected patients with PD, aged 43-89 years, participated in a questionnaire study. A structured questionnaire with 207 items was based on the Basic Nordic Sleep Questionnaire. Questions on demographics, PD, RBD, and other issues were included. The response rate was 59.0%; of these patients, 73% had answered to all questions that were used in the analyses (N = 623). The occurrence of suspected narcolepsy (Ullanlinna Narcolepsy Scale ≥ 14 and Epworth Sleepiness Scale ≥ 11) was observed in 9.3% of the subjects (PD with NARC), RBD (REM Sleep Behavior Disorder Screening Questionnaire ≥ 6) in 39.2% of all patients with PD, and in 62.1% of those with PD and NARC. In patients with PD, hallucinations before going to bed in the evening occurred in 5.8%, hypnagogic hallucinations in 4.0%, hallucinations during night 8.3%, and hypnopompic hallucinations in 3.2%. Cataplexy symptoms occurred in 43.1% of subjects with PD and NARC. In a logistic regression analysis, PD with NARC was associated with RBD, all types of hallucinations, daytime sleepiness, fatigue, insomnia, and intense dreaming also when adjusted for age, sex, disease duration, and levodopa. Narcolepsy-like symptoms may be present in patients with PD. Symptoms of RBD were associated with symptoms of narcolepsy including symptoms of cataplexy. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    International Nuclear Information System (INIS)

    Perani, D.; Di Piero, V.; Vallar, G.

    1988-01-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([/sup 99m/Tc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data

  7. Quantitative determination of the regional cerebral blood flow with 133Xe

    International Nuclear Information System (INIS)

    Otto, H.J.; Abraham, K.; Freitag, J.; Koch, R.D.; Freitag, G.; Hoefs, R.

    1982-01-01

    After injection of 133 Xe into the A. carotis interna, the regional blood flow in the brain was determined with a 10-channel measuring unit. From the first clinical evaluation of the findings in 35 patients, the following conclusions can be drawn: 1. In epileptics, a localized hyperemia indicates very probably a latent increased convulsive activity. 2. The measurement of the cerebral blood flow does not yield a contribution to the diagnosis of the type of cerebral tumors. 3. As consequence of mass shifting of space occupying processes particularly endangered brain sections, also remote from the focus proper, show a localized pathological hyeperemia (morbid 'luxus perfusion'). 4. Of greatest importance is the method with regard to the elucidation of pathophysiological relations, as well as of questions in connection with the blood/brain barrier function, and concerning the indication for and the estimation of the results of vascular interventions. (author)

  8. Regional cerebral glucose consumption measured by positron emission tomography in patients with Wilson's disease

    International Nuclear Information System (INIS)

    Kuwert, T.; Scholz, D.; Milz, M.; Herzog, H.; Feinendegen, L.E.; Hefter, H.; Weiss, P.; Arendt, G.; Loken, M.; Minnesota Univ., Minneapolis, MN; Hennerici, M.

    1992-01-01

    Using positron emission tomography (PET), the regional cerebral metabolic rate of glucose consumption (rCMRGlc) was measured in 14 patients with Wilson's disease (WD) and 23 normal subjects. In WD patients, cerebellar, striatal and - to a lesser extent - cortical and thalamic rCMRGlc were significantly decreased compared with controls. Striatal rCMRGlc was significantly reduced in those 4 patients who had recently started decoppering therapy as compared with striatal rCMRGlc measured in those 10 patients with longer duration of medication. Caudate rCMRGlc correlated significantly with various signs of extrapyramidal dysfunction. Cerebellar, thalamic and cortical rCMRGlc correlated significantly with the severity of pyramidal signs. These data indicate that the PET measurement of rCMRGlc may be a useful tool to evaluate cerebral involvement in WD and to monitor the response to treatment. (orig.)

  9. Regional cerebral blood flow during mechanical hyperventilation in patients with fulminant hepatic failure

    DEFF Research Database (Denmark)

    Strauss, Gitte Irene; Høgh, Peter; Møller, Kirsten

    1999-01-01

    Hyperventilation is frequently used to prevent or postpone the development of cerebral edema and intracranial hypertension in patients with fulminant hepatic failure (FHF). The influence of such therapy on regional cerebral blood flow (rCBF) remains, however, unknown. In this study the CBF......-distribution pattern was determined within the first 12 hours after development of hepatic encephalopathy (HE) stage 4 before and during hyperventilation. Ten consecutive patients (median age 48 [range 33-57] years) with FHF and 9 healthy controls (median age 54 [24-58] years) had rCBF determined by single photon...... emission computed tomography (SPECT) using intravenous injection of 133Xenon. For determination of high resolution CBF pattern, the patients were also studied with 99mTc-hexa-methylpropyleneamine oxime (HMPAO) in the hyperventilation condition. There was no significant difference in the rCBF distribution...

  10. The evaluation of cerebral hemodynamics in patients with intracranial tumors by stable xenon CT; The effect of glycerol administration on regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Shimoda, Masami; Kawamata, Fumio; Yamamoto, Masahiro; Ohsuga, Hitoshi; Hidaka, Mitsuru; Oda, Shinri; Shibuya, Naoki; Yamamoto, Isao; Sato, Osamu (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1989-04-01

    In evaluating cerebral regional blood flow (rCBF), stable xenon-enhanced tomography (XeCT) study associated with simultaneous blood sampling was applied in 15 cases of intracranial neoplasms. The effect of intravenous glycerol infusion on rCBF was also investigated. The results indicated that intratumoral rCBF values were not only variable and unrelated to their histological types and grades, but also were not correlated with the vascularity of the lesion as demonstrated by angiography. When a tumor mass was enhanced after the injection of iodinated contrast media, it proved to be useful in distinguishing tumor mass and its associated edema that the rCBF of the peritumoral edematous region was predominantly low (10{plus minus}5 ml/100 g/min). The regional cerebral blood flow in remote areas, both ipsilateral and contralateral to the lesion, was low in value, and there was no statistical significance between affected and sound sides. Following glycerol administration, rCBF was increased in the whole intracranial region, but not inside of the neoplasm, particularly when the intracranial pressure (ICP) was increased. It was assumed that the elevated rCBF after glycerol administration was due to the increase in the cerebral perfusion pressure resulting from the ICP reduction, the hemodilution effect, cerebral vessel dilatation after metabolic acidosis, and/or mechanically rectified microcirculation after edema reduction. (author).

  11. Narcolepsy in children: a diagnostic and management approach.

    Science.gov (United States)

    Babiker, Mohamed O E; Prasad, Manish

    2015-06-01

    To provide a diagnostic and management approach for narcolepsy in children. Narcolepsy is a chronic disabling disorder characterized by excessive daytime sleepiness, cataplexy, hypnogogic and/or hypnopompic hallucinations, and sleep paralysis. All four features are present in only half of the cases. Excessive daytime sleepiness is the essential feature of narcolepsy at any age and is usually the first symptom to manifest. A combination of excessive daytime sleepiness and definite cataplexy is considered pathognomonic of narcolepsy syndrome. New treatment options have become available over the past few years. Early diagnosis and management can significantly improve the quality of life of patients with narcolepsy with cataplexy. This review summarizes the pathophysiology, clinical features, and management options for children with narcolepsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Regional cerebral blood flow in pure dysarthria. A 3D-SSP study

    International Nuclear Information System (INIS)

    Okamoto, Kensho; Kamogawa, Kenji; Okuda, Bungo; Kawabata, Keita; Tachibana, Hisao

    2007-01-01

    Pure dysarthria from brain infarction is a rare condition, and its pathophysiology remains unclear. To clarify the underlying mechanism of pure dysarthria, we investigated the lesion sites and regional cerebral blood flow in patients with pure dysarthria. We examined 18 consecutive patients with pure dysarthria (9 men and 9 women; mean age, 71 years) who underwent MRI and cerebral blood flow studies. To visualize the regional cerebral blood flow, we generated Z score images using the three-dimensional stereotactic surface projection (3D-SSP) method with single-photon emission computed tomography (SPECT) and N-isopropyl-p [ 123 I]iodoamphetamine. Data on the brain surface perfusion extracted by the 3D-SSP analysis were compared between the pure dysarthria (PD) patients and 9 control subjects. MRI revealed multiple lacunar infarctions involving the internal capsule and/or corona radiata in 11 patients, left internal capsule-corona radiata infarction in 4 patients, and pontine infarction in 3 patients. SPECT with 3D-SSP demonstrated bilateral frontal cortical hypoperfusion in all patients, particularly in the anterior opercular region. Based on intergroup comparisons, the PD group exhibited pronounced cortical hypoperfusion in the opercular and medial frontal regions, left more than right. In conclusion, pure dysarthria is considered to originate from frontal cortical hypoperfusion, mainly in the anterior opercular and medial frontal regions, which is probably due to interruption of the corticosubcortical neural networks relevant to speech expression and articulation. In addition, it is suggested that left hemispheric lesions may make a greater contribution to the development of pure dysarthria than do right ones. (author)

  13. The effect of glycerol on regional cerebral blood flow, blood volume and oxygen metabolism

    International Nuclear Information System (INIS)

    Ishikawa, Masatsune; Kikuchi, Haruhiko; Nagata, Izumi; Yamagata, Sen; Taki, Waro; Kobayashi, Akira; Yonekura, Yoshiharu; Nishizawa, Sadahiko.

    1989-01-01

    Using positron emission tomography with 15 O-labelled CO 2 , O 2 and CO gases, the effects of glycerol on regional cerebral blood flow (CBF), blood volume (CBV) and oxygen metabolism (CMRO 2 ) were investigated in 6 patients with meningioma accompanying peritumoral brain edema. The same study was done in 5 normal volunteers. The changes of blood gases, hematocrit and hemoglobin were also examined. After a drip infusion of glycerol, the regional CBF increased not only in the peritumoral cortex and white matter but also in the intact cortex and white matter on the contralateral side. The increase of CBF was extensive and substantially there were no regional differences. In contrast, the changes of CMRO 2 were not significant. This was derived from the increase in oxygen extraction fraction throughout extensive areas including the peritumoral area. There were no changes in CBV. Hematocrit and hemoglobin decreased to a small degree. In the normal volunteers, the same findings were noted. Thus, glycerol increases the functional reserve for cerebral oxygen metabolism, not only in the peritumoral regions but also in the intact regions. The effects of glycerol on hemodynamics and metabolism were discussed with reference to some differences from mannitol. (author)

  14. HYPOCRETIN/OREXIN AND NARCOLEPSY NEW BASIC AND CLINICAL INSIGHTS

    Science.gov (United States)

    NISHINO, Seiji; OKURO, Masashi; KOTORII, Nozomu; ANEGAWA, Emiko; ISHIMARU, Yuji; MATSUMURA, Mari; KANBAYASHI, Takashi

    2009-01-01

    Narcolepsy is a chronic sleep disorder, characterized by excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, and sleep paralysis. Both sporadic (95%) and familial (5%) forms of narcolepsy exist in humans. The major pathophysiology of human narcolepsy has been recently discovered based on the discovery of narcolepsy genes in animals; the genes involved in the pathology of the hypocretin/orexin ligand and its receptor. Mutations in hypocretin-related genes are rare in humans, but hypocretin-ligand deficiency is found in a large majority of narcolepsy with cataplexy. Hypocretin ligand deficiency in human narcolepsy is likely due to the postnatal cell death of hypocretin neurons. Although tight association between human leukocyte antigen (HLA) association and human narcolepsy with cataplexy suggests an involvement of autoimmune mechanisms, this has not yet been proven. Hypocretin deficiency is also found in symptomatic cases of narcolepsy and EDS with various neurological conditions, including immune-mediated neurological disorders, such as Guillain-Barre syndrome, MA2-positive paraneoplastic syndrome and neuromyelitis optica (NMO) related disorder. These findings likely have significant clinical relevance and for understanding the mechanisms of hypocretin cell death and choice of treatment option. These series of discoveries in humans lead to the establishment of the new diagnostic test of narcolepsy (i.e. low cerebrospinal fluid [CSF] hypocretin-1 levels for narcolepsy with cataplexy and narcolepsy due to medical condition). Since a large majority of human narcolepsy patients are ligand deficient, hypocretin replacement therapy may be a promising new therapeutic option, and animal experiments using gene therapy and cell transplantations are in progress. PMID:19555382

  15. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement

    International Nuclear Information System (INIS)

    Volpe, J.J.; Herscovitch, P.; Perlman, J.M.; Raichle, M.E.

    1983-01-01

    Positron emission tomography (PET) now provides the capability of measuring regional cerebral blood flow with high resolution and little risk. In this study, we utilized PET in six premature infants (920 to 1,200 g) with major intraventricular hemorrhage and hemorrhagic intracerebral involvement to measure regional cerebral blood flow during the acute period (5 to 17 days of age). Cerebral blood flow was determined after intravenous injection of H 2 O, labeled with the positron-emitting isotope, 15 O. Findings were similar and dramatic in all six infants. In the area of hemorrhagic intracerebral involvement, little or no cerebral blood flow was detected. However, in addition, surprisingly, a marked two- to fourfold reduction in cerebral blood flow was observed throughout the affected hemisphere, well posterior and lateral to the intracerebral hematoma, including cerebral white matter and, to a lesser extent, frontal, temporal, and parietal cortex. In the one infant studied a second time, ie, at 3 months of age, the extent and severity of the decreased cerebral blood flows in the affected hemisphere were similar to those observed on the study during the neonatal period. At the three autopsies, the affected left hemisphere showed extensive infarction, corroborating the PET scans. These observations, the first demonstration of the use of PET in the determination of regional cerebral blood flow in the newborn, show marked impairments in regional cerebral blood flow in the hemisphere containing an apparently restricted intracerebral hematoma, indicating that the hemorrhagic intracerebral involvement is only a component of a much larger lesion, ischemic in basic nature, ie, an infarction. This large ischemic lesion explains the poor neurologic outcome in infants with intraventricular hemorrhage and hemorrhagic intracerebral involvement

  16. Regional cerebral blood flow and CSF pressures during Cushing response induced by a supratentorial expanding mass

    International Nuclear Information System (INIS)

    Schrader, H.; Zwetnow, N.N.; Moerkrid, L.

    1985-01-01

    In order to delineate the critical blood flow pattern during the Cushing response in intracranial hypertension, regional cerebral blood flow was measured with radioactive microspheres in 12 anesthetized dogs at respiratory arrest caused either by expansion of an epidural supratentorial balloon or by cisternal infusion. Regional cerebrospinal fluid pressures were recorded and the local cerebral perfusion pressure calculated in various cerebrospinal compartments. In the 8 dogs of the balloon expansion group, the systemic arterial pressure was unmanipulated in 4, while it was kept at a constant low level (48 and 70 mm Hg) in 2 dogs and, in another 2 dogs, at a constant high level (150 and 160 mm Hg) induced by infusion of Aramine. At respiratory arrest, regional cerebral blood flow had a stereotyped pattern and was largely independent of the blood pressure level. In contrast, concomitant pressure gradients between the various cerebrospinal compartments varied markedly in the 3 animal groups increasing with higher arterial pressure. Flow decreased by 85-100% supratentorially and by 70-100% in the upper brain stem down to the level of the upper pons, while changes in the lower brain stem were minor, on the average 25%. When intracranial pressure was raised by cisternal infusion in 4 dogs, the supratentorial blood flow pattern at respiratory arrest was appriximately similar to the flow pattern in the balloon inflation group. However, blood flow decreased markedly (74-85%) also in the lower brain stem. The results constitute another argument in favour of the Cushing response in supratentorial expansion being caused by ischemia in the brain stem. The critical ischemic region seems to be located rostrally to the oblongate medulla, probably in the pons. (author)

  17. Regional cerebral blood flow measurement with intravenous [15O]water bolus and [18F]fluoromethane inhalation

    International Nuclear Information System (INIS)

    Herholz, K.; Pietrzyk, U.; Wienhard, K.; Hebold, I.; Pawlik, G.; Wagner, R.; Holthoff, V.; Klinkhammer, P.; Heiss, W.D.

    1989-01-01

    In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both [ 15 O]water and [ 18 F]fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of [ 15 O]water. There were reasonable overall correlations between dynamic [ 15 O]water and [ 18 F]fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic [ 15 O]water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic [ 15 O]water cerebral blood flow was 6% lower than that measured with [ 18 F]fluoromethane. There also was a general trend toward a greater underestimation with [ 15 O]water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of [ 15 O]water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error

  18. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    Science.gov (United States)

    Fortuyn, Hal A Droogleever; Lappenschaar, G A; Nienhuis, Fokko J; Furer, Joop W; Hodiamont, Paul P; Rijnders, Cees A; Lammers, Gert Jan; Renier, Willy O; Buitelaar, Jan K; Overeem, Sebastiaan

    2009-01-01

    Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal psychotic disorders between narcolepsy patients and controls. We used SCAN 2.1 interviews to compare psychotic symptoms between 60 patients with narcolepsy, 102 with schizophrenia and 120 matched population controls. In addition, qualitative data was collected to enable a detailed description of hypnagogic hallucinations in narcolepsy. There were clear differences in the pattern of hallucinatory experiences in narcolepsy vs. schizophrenia patients. Narcoleptics reported multisensory "holistic" hallucinations rather than the predominantly verbal-auditory sensory mode of schizophrenia patients. Psychotic symptoms such as delusions were not more frequent in narcolepsy compared to population controls. In addition, the prevalence of formal psychotic disorders was not increased in patients with narcolepsy. Almost half of narcoleptics reported moderate interference with functioning due to hypnagogic hallucinations, mostly due to related anxiety. Hypnagogic hallucinations in narcolepsy can be differentiated on a phenomenological basis from hallucinations in schizophrenia which is useful in differential diagnostic dilemmas.

  19. Neuroimaging of Narcolepsy and Kleine-Levin Syndrome.

    Science.gov (United States)

    Hong, Seung Bong

    2017-09-01

    Narcolepsy is a chronic neurologic disorder with the abnormal regulation of the sleep-wake cycle, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and manifestations related to rapid eye movement sleep, such as cataplexy, sleep paralysis, and hypnagogic hallucination. Over the past decade, numerous neuroimaging studies have been performed to characterize the pathophysiology and various clinical features of narcolepsy. This article reviews structural and functional brain imaging findings in narcolepsy and Kleine-Levin syndrome. Based on the current state of research, brain imaging is a useful tool to investigate and understand the neuroanatomic correlates and brain abnormalities of narcolepsy and other hypersomnia. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Cocaine abstinence following chronic treatment alters cerebral metabolism in dopaminergic reward regions. Bromocriptine enhances recovery

    International Nuclear Information System (INIS)

    Clow, D.W.; Hammer, R.P. Jr.

    1991-01-01

    2-[14C]deoxyglucose autoradiography was used to determine local cerebral glucose utilization (lCGU) in rats following chronic cocaine treatment and subsequent abstinence. lCGU was examined in 43 discrete brain regions in animals which had received daily injections of cocaine for 14 days (10 mg/kg) followed by 3 days of saline or bromocriptine (10 mg/kg) treatment. Cocaine abstinence following chronic treatment significantly reduced lCGU in several regions including mesocorticolimbic structures such as ventral tegmental area, medial prefrontal cortex, and nucleus accumbens (NAc). Within the NAc, however, only the rostral pole showed significant reduction. In contrast, when bromocriptine treatment accompanied abstinence, lCGU was no longer reduced in mesocorticolimbic and most other regions, implying that metabolic recovery was enhanced by bromocriptine treatment during early abstinence following chronic cocaine treatment. These data suggest that cerebral metabolism is decreased during cocaine abstinence following chronic treatment in critical brain regions, and that this alteration can be prevented by treatment with direct-acting dopamine agonists such as bromocriptine

  1. Cocaine abstinence following chronic treatment alters cerebral metabolism in dopaminergic reward regions. Bromocriptine enhances recovery

    Energy Technology Data Exchange (ETDEWEB)

    Clow, D.W.; Hammer, R.P. Jr. (Univ. of Hawaii School of Medicine, Honolulu (USA))

    1991-01-01

    2-(14C)deoxyglucose autoradiography was used to determine local cerebral glucose utilization (lCGU) in rats following chronic cocaine treatment and subsequent abstinence. lCGU was examined in 43 discrete brain regions in animals which had received daily injections of cocaine for 14 days (10 mg/kg) followed by 3 days of saline or bromocriptine (10 mg/kg) treatment. Cocaine abstinence following chronic treatment significantly reduced lCGU in several regions including mesocorticolimbic structures such as ventral tegmental area, medial prefrontal cortex, and nucleus accumbens (NAc). Within the NAc, however, only the rostral pole showed significant reduction. In contrast, when bromocriptine treatment accompanied abstinence, lCGU was no longer reduced in mesocorticolimbic and most other regions, implying that metabolic recovery was enhanced by bromocriptine treatment during early abstinence following chronic cocaine treatment. These data suggest that cerebral metabolism is decreased during cocaine abstinence following chronic treatment in critical brain regions, and that this alteration can be prevented by treatment with direct-acting dopamine agonists such as bromocriptine.

  2. Regional gray matter growth, sexual dimorphism, and cerebral asymmetry in the neonatal brain.

    Science.gov (United States)

    Gilmore, John H; Lin, Weili; Prastawa, Marcel W; Looney, Christopher B; Vetsa, Y Sampath K; Knickmeyer, Rebecca C; Evans, Dianne D; Smith, J Keith; Hamer, Robert M; Lieberman, Jeffrey A; Gerig, Guido

    2007-02-07

    Although there has been recent interest in the study of childhood and adolescent brain development, very little is known about normal brain development in the first few months of life. In older children, there are regional differences in cortical gray matter development, whereas cortical gray and white matter growth after birth has not been studied to a great extent. The adult human brain is also characterized by cerebral asymmetries and sexual dimorphisms, although very little is known about how these asymmetries and dimorphisms develop. We used magnetic resonance imaging and an automatic segmentation methodology to study brain structure in 74 neonates in the first few weeks after birth. We found robust cortical gray matter growth compared with white matter growth, with occipital regions growing much faster than prefrontal regions. Sexual dimorphism is present at birth, with males having larger total brain cortical gray and white matter volumes than females. In contrast to adults and older children, the left hemisphere is larger than the right hemisphere, and the normal pattern of fronto-occipital asymmetry described in older children and adults is not present. Regional differences in cortical gray matter growth are likely related to differential maturation of sensory and motor systems compared with prefrontal executive function after birth. These findings also indicate that whereas some adult patterns of sexual dimorphism and cerebral asymmetries are present at birth, others develop after birth.

  3. Regional cerebral blood flow in Parkinson's disease by [sup 123]I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Yoshihiro [Okayama Univ. (Japan). School of Medicine

    1994-06-01

    Regional cerebral blood flow (rCBF) was evaluated in 63 patients with Parkinson's disease (PD) by single-photon emission computed tomography (SPECT) using N-isopropyl-p-[sup 123]I-iodoamphetamine ([sup 123]I-IMP) as a tracer. Evaluation of the SPECT images was performed in accordance with the rCBF quantification method using a microsphere model. Patients in stage IV demonstrated significantly lower rCBF than those in stage II at the frontal, temporal, parietal, occipital regions and in the thalamus and cerebellum. Subjects with mental symptoms demonstrated decreased rCBF in every region in the brain. The present study indicates that clinical exacerbation and manifestation of dementia and other psychiatric symptoms in Parkinson's disease are associated with decreased blood flow in various brain regions. (author).

  4. The effects of activation procedures on regional cerebral blood flow in humans

    International Nuclear Information System (INIS)

    Rozenfeld, D.; Wolfson, L.I.

    1981-01-01

    Regional cerebral blood flow (r-CBF) can be measured using 133XE and collimated detectors. The radionuclide can be administered either by inhalation or intracarotid injection. Comparison of blood flow determinations at rest and during performance of an activity identifies those brain regions that become active during the performance of the activity. Relatively specific patterns of r-CBF are observed during hand movements, sensory stimulation, eye movements, speech, listening, and reading. Regional CBF changes during reasoning and memorization are less specific and less well characterized. It is clear that brain lesions affect r-CBF responses to various activities, but this effect has not been well correlated with functional deficits or recovery of function. Regional CBF measurement gives information about brain activity and the functional response to experimental manipulation. This approach may well add to our understanding of normal, as well as pathologic, brain functioning

  5. CT perfusion imaging on the disturbance of regional cerebral microcirculation in a pre-infarction period: an experimental study

    International Nuclear Information System (INIS)

    Gao Peiyi; Liang Chenyang; Lin Yan; Yuan Fang; Hu Ling

    2003-01-01

    Objective: To investigate the CT perfusion imaging and the pathological features on the disturbance of regional cerebral microcirculation in a pre-infarction period, and to evaluate the relationship between the astrocytes and regional cerebral microcirculation. Methods: Dynamic CT perfusion imaging of the models with regional cerebral hypoperfusion and astrocytic swelling in rats was performed to assess the presence or absence of the disturbance of regional cerebral microcirculation. Then, the histopathologic examination was made for both models, respectively. The ratios of side-to-side were measured at hypoperfusion areas in the models of regional cerebral ischemia. Results: Regional hypoperfusion was revealed by regional cerebral blood flow (rCBF) and mean transit time (MTT) maps in the group of hypoperfusion for 6 hours. Regional cerebral blood volume (rCBV) and time-to-peak (TTP) maps were normal in that group. The ratios of rCBF, rCBV, MTT and TTP were 0.39-0.55, 0.92-1.00, 1.20-1.50 and 1.00-1.00 respectively. Astrocytic swelling pressing the capillary wall was obvious and subtle neuronal reversible degeneration was occasionally found. TTC stain was normal. In the tACPD group of astrocytic swelling, the abnormal hemodynamic regions on rCBF and MTT maps were found. The rCBV maps of 3 rats in the tACPD group showed the area of reduced rCBV. In 2 rats of tACPD group, the areas of delayed TTP were also found. The ratios of rCBF, rCBV, MTT and TTP were 0.25-0.44, 0.70-1.01, 1.20-2.00 and 1.02-1.45 respectively. TTC stain was negative. Electron microscope study revealed remarkable swelling of astrocytes, especially endfoot processes of astrocytes around capillaries. The abnormal hemodynamic region on rCBF and MTT maps matched with abnormal extent on histopathologic examination. The rCBV and TTP maps appeared normal. Conclusion: The astrocytes can react in a way faster than the neurons in the pre-infarction period, viz. astrocytic swelling. The swelling of

  6. Cerebral perfusion computerized tomography: influence of reference vessels, regions of interest and interobserver variability

    International Nuclear Information System (INIS)

    Soustiel, Jean F.; Mor, Nadav; Zaaroor, Menashe; Goldsher, Dorith

    2006-01-01

    There are still no standardized guidelines for perfusion computerized tomography (PCT) analysis. A total of 61 PCT studies were analyzed using either the anterior cerebral artery (ACA) or the middle cerebral artery (MCA) as the arterial reference, and the superior sagittal sinus (SSS) or the vein of Galen (VG) as the venous reference. The sizes of regions of interest (ROI) were investigated comparing PCT results obtained using a hemispheric ROI combined with vascular pixel elimination with those obtained using five smaller ROIs located over the cortex and basal ganglia. In addition, interobserver variations were explored using a standardized protocol. MCA-based measurements of cerebral blood flow (CBF) and blood volume (CBV) were in accordance with those obtained with the ACA except in 16 patients with ischemic stroke, in whom CBF was overestimated by the ipsilateral MCA. Venous maximal intensity was significantly lower with the VG when compared with the SSS, resulting in overestimation of CBF and CBV. However, in 13.3% of patients the VG ROI yielded higher maximal intensities than the SSS ROI. There was no difference in PCT results between hemispheric ROI and averaged separate ROI when vascular pixel elimination was used. Finally, interobserver variations were as high as 11% for CBF and 12% for CBV. The present results suggest that pathological rather than anatomical considerations should dictate the choice of the arterial ROI. For venous ROI, although SSS seems to be adequate in most instances, deep cerebral veins may occasionally generate higher maximal intensities and should therefore be selected. Importantly, significant user-dependency should be taken into account. (orig.)

  7. Changes of regional cerebral glucose metabolism in normal aging process : A study with FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; Kim, Sang Eun; Lee, Kyung Han; Choi, Yong; Choe, Yearn Seong; Kim, Byung Tae [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)

    2001-08-01

    Normal aging results in detectable changes in the brain structure and function. We evaluated the changes of regional cerebral glucose metabolism in the normal aging process with FDG PET. Brain PET images were obtained in 44 healthy volunteers (age range 20-69'y'; M:F = 29:15) who had no history of neuropsychiatric disorders. On 6 representative transaxial images, ROls were drawn in the cortical and subcortical areas. Regional FDG uptake was normalized using whole brain uptake to adjust for the injection dose and correct for nonspecific declines of glucose metabolism affecting all brain areas equally. In the prefrontal, temporoparietal and primary sensorimotor cortex, the normalized FDG uptake (NFU) reached a peak In subjects in their 30s. The NFU in the prefrontal and primary sensorimotor cortex declined with age after 30s at a rate of 3.15%/decade and 1.93%/decade, respectively. However, the NFU in the lernporoparietal cortex did not change significantly with age after 30s. The anterior (prefrontal) posterior (temporoparietal) gradient peaked in subjects in their 30s and declined with age the reafter at a rate of 35%/decade. The NFU in the caudate nucleus was decreased with age after 20s at a rate of 2.39%/decade. In the primary visual cortex, putamen, and thalamus, the NFU values did not change significantly throughout the ages covered. These patterns were not significantly different between right and left cerebral hemispheres. Of interest was that the NFU in the left cerebellar cortex was increased with age after 20s at a rate of 2.86%/decade. These data demonstrate regional variation of the age-related changes in the cerebral glucose metabolism, with the most prominent age-related decline of metabolism in the prefrontal cortex. The increase in the cerebellar metabolism with age might reflect a process of neuronal plasticity associated with aging.

  8. Quantitative measurement of regional cerebral blood flow using {sup 99m}Tc-HM-PAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hisashi; Nakamura, Yusaku; Yagi, Yuji; Miura, Kosuke; Takahashi, Mitsuo [Kinki Univ., Osaka-Sayama, Osaka (Japan)

    1994-10-01

    This study examined a simple method for measuring the regional cerebral blood flow (rCBF) using {sup 99m}Tc-HM-PAO SPECT. The mean CBF (mCBF) was determined by the Patlack plot method and rCBF was calculated with Lassen`s correction algorithm, as reported by Matsuda et al. The cerebral hemisphere was employed as the reference region for Lassen`s correction. The reference RI count rate was calculated from the left cerebral hemisphere at the basal ganglia level and the correction factor {alpha} was fixed at 2.0. As a result, rCBF could be measured more easily than by Matsuda`s method. The contribution of age, laterality and gender to the CBF of normal subjects were studied. The mCBF value of 26 normal subjects was 53.8{+-}6.4 ml/100 g/min and showed a significant correlation with advancing age (R=0.644, p=0.0004, n=26). The mean values for rCBF of the cerebellum, frontal area, temporal area, occipital area and parietal area were 77.3{+-}6.6 ml/100 g/min, 70.2{+-}9.1 ml/100 g/min, 72.3{+-}7.5 ml/100 g/min, 71.8{+-}6.2 ml/100 g/min and 73.8{+-}8.6 ml/100 g/min, respectively. There were no gender or laterality differences in the mCBF or respective rCBF values. Each of the above listed regions, except for the occipital area, demonstrated a significant correlation with advancing age. The most remarkable decrease in rCBF with age was noted in the frontal area (R=0.757, p=0.001, n=26). (author).

  9. Quantitative measurement of regional cerebral blood flow using 99mTc-HM-PAO SPECT

    International Nuclear Information System (INIS)

    Tanaka, Hisashi; Nakamura, Yusaku; Yagi, Yuji; Miura, Kosuke; Takahashi, Mitsuo

    1994-01-01

    This study examined a simple method for measuring the regional cerebral blood flow (rCBF) using 99m Tc-HM-PAO SPECT. The mean CBF (mCBF) was determined by the Patlack plot method and rCBF was calculated with Lassen's correction algorithm, as reported by Matsuda et al. The cerebral hemisphere was employed as the reference region for Lassen's correction. The reference RI count rate was calculated from the left cerebral hemisphere at the basal ganglia level and the correction factor α was fixed at 2.0. As a result, rCBF could be measured more easily than by Matsuda's method. The contribution of age, laterality and gender to the CBF of normal subjects were studied. The mCBF value of 26 normal subjects was 53.8±6.4 ml/100 g/min and showed a significant correlation with advancing age (R=0.644, p=0.0004, n=26). The mean values for rCBF of the cerebellum, frontal area, temporal area, occipital area and parietal area were 77.3±6.6 ml/100 g/min, 70.2±9.1 ml/100 g/min, 72.3±7.5 ml/100 g/min, 71.8±6.2 ml/100 g/min and 73.8±8.6 ml/100 g/min, respectively. There were no gender or laterality differences in the mCBF or respective rCBF values. Each of the above listed regions, except for the occipital area, demonstrated a significant correlation with advancing age. The most remarkable decrease in rCBF with age was noted in the frontal area (R=0.757, p=0.001, n=26). (author)

  10. Changes of regional cerebral glucose metabolism in normal aging process : A study with FDG PET

    International Nuclear Information System (INIS)

    Yoon, Joon Kee; Kim, Sang Eun; Lee, Kyung Han; Choi, Yong; Choe, Yearn Seong; Kim, Byung Tae

    2001-01-01

    Normal aging results in detectable changes in the brain structure and function. We evaluated the changes of regional cerebral glucose metabolism in the normal aging process with FDG PET. Brain PET images were obtained in 44 healthy volunteers (age range 20-69'y'; M:F = 29:15) who had no history of neuropsychiatric disorders. On 6 representative transaxial images, ROls were drawn in the cortical and subcortical areas. Regional FDG uptake was normalized using whole brain uptake to adjust for the injection dose and correct for nonspecific declines of glucose metabolism affecting all brain areas equally. In the prefrontal, temporoparietal and primary sensorimotor cortex, the normalized FDG uptake (NFU) reached a peak In subjects in their 30s. The NFU in the prefrontal and primary sensorimotor cortex declined with age after 30s at a rate of 3.15%/decade and 1.93%/decade, respectively. However, the NFU in the lernporoparietal cortex did not change significantly with age after 30s. The anterior (prefrontal) posterior (temporoparietal) gradient peaked in subjects in their 30s and declined with age the reafter at a rate of 35%/decade. The NFU in the caudate nucleus was decreased with age after 20s at a rate of 2.39%/decade. In the primary visual cortex, putamen, and thalamus, the NFU values did not change significantly throughout the ages covered. These patterns were not significantly different between right and left cerebral hemispheres. Of interest was that the NFU in the left cerebellar cortex was increased with age after 20s at a rate of 2.86%/decade. These data demonstrate regional variation of the age-related changes in the cerebral glucose metabolism, with the most prominent age-related decline of metabolism in the prefrontal cortex. The increase in the cerebellar metabolism with age might reflect a process of neuronal plasticity associated with aging

  11. Determinants of inclusive education of 8-12 year-old children with cerebral palsy in 9 European regions.

    Science.gov (United States)

    Sentenac, Mariane; Ehlinger, Virginie; Michelsen, Susan Ishoy; Marcelli, Marco; Dickinson, Heather Olivia; Arnaud, Catherine

    2013-01-01

    The principle of inclusive education has been increasingly recognised over recent decades and most countries officially support schooling of children with disabilities in mainstream settings. The SPARCLE study offers the opportunity to report on the schooling practices for children with cerebral palsy according to the nature and severity of their impairments and the schooling policy in European regions. The aim of this paper is to describe the type of schooling of children with cerebral palsy in various European regions after controlling for relevant individual factors. Children aged 8-12 years with cerebral palsy from 9 European regions and their families were interviewed. Our findings support the hypothesis that between-region variations in the type of schooling are still significant after adjustment for individual factors; and that motor function and intellectual ability have different effects on inclusion in mainstream school, depending on the region. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. [Indicators of general, cerebral, and regional hemodynamics in myopic schoolchildren aged 13-15 years].

    Science.gov (United States)

    Iastrebtseva, T A; Chuprov, A D; Plotnikova, Iu A

    2002-01-01

    110 schoolchildren aged 13-15 years were examined. 24 of them had pseudomyopia and 6 patients myopia of various forms. A control group consisted of 38 children. Central hemodynamics was estimated by average dynamic pressure, cerebral hemodynamics--by rheoencephalography, regional hemodynamics--by dopplerography of the internal carotid and suprapubic arteries. It was found that with myopia progression, the average dynamic pressure positively comes down with reduction of reographic waves amplitude in rheogram. The blood flow rate in internal carotid and suprapubic arteries has no substantial impact on myopia course. Predisposition to arterial hypotension is a risk factor for myopia development and progression.

  13. Regional cerebral blood flow for singers and nonsingers while speaking, singing, and humming a rote passage

    International Nuclear Information System (INIS)

    Formby, C.; Thomas, R.G.; Halsey, J.H. Jr.

    1989-01-01

    Two groups of singers (n = 12,13) and a group of nonsingers (n = 12) each produced the national anthem by (1) speaking and (2) singing the words and by (3) humming the melody. Regional cerebral blood flow (rCBF) was measured at rest and during each phonation task from seven areas in each hemisphere by the 133 Xe-inhalation method. Intrahemisphere, interhemisphere, and global rCBF were generally similar across phonation tasks and did not yield appreciable differences among the nonsingers and the singers

  14. The effect of the benzodiazepine antagonist flumazenil on regional cerebral blood flow in human volunteers

    DEFF Research Database (Denmark)

    Wolf, J; Friberg, L; Jensen, J

    1990-01-01

    computerized tomography, SPECT, immediately before, and 5 and 35 min after intravenous injection of flumazenil 1.0 mg or placebo. In addition, mean arterial blood pressures or PaCO2, rCBF were analysed for changes in various regions of interest (RoI). No alterations were found either in the global CBF or in r......CBF in RoI after flumazenil injection. The results showed that a clinically active dose of flumazenil did not directly affect the cerebral circulation in the normal brain and indicated absence of significant intrinsic activity of the drug....

  15. An analysis of regional cerebral blood flow in impulsive murderers using single photon emission computed tomography.

    Science.gov (United States)

    Amen, Daniel G; Hanks, Chris; Prunella, Jill R; Green, Aisa

    2007-01-01

    The authors explored differences in regional cerebral blood flow in 11 impulsive murderers and 11 healthy comparison subjects using single photon emission computed tomography. The authors assessed subjects at rest and during a computerized go/no-go concentration task. Using statistical parametric mapping software, the authors performed voxel-by-voxel t tests to assess significant differences, making family-wide error corrections for multiple comparisons. Murderers were found to have significantly lower relative rCBF during concentration, particularly in areas associated with concentration and impulse control. These results indicate that nonemotionally laden stimuli may result in frontotemporal dysregulation in people predisposed to impulsive violence.

  16. Single-photon tomographic determination of regional cerebral blood flow in epilepsy

    International Nuclear Information System (INIS)

    Bonte, F.J.; Devous, M.D. Sr.; Stokely, E.M.; Homan, R.W.

    1983-01-01

    Using a single-photon emission computed tomographic scanner (SPECT) the authors determined regional cerebral blood flow (rCBF) with inhaled xenon-133, a noninvasive procedure. Studies were performed in 40 normal individuals, and these were compared with rCBF determinations in 51 patients with seizure disorders. Although positive results were obtained in 15 of 16 patients with mass lesions, the group of principal interest comprised 25 patients suffering from ''temporal lobe'' epilepsy. Only one of these had a positive x-ray computed tomogram, but 16 had positive findings on rCBF study. These findings included increased local blood flow in the ictal state and reduced flow interictally

  17. Regional cerebral glucose metabolism in patients with alcoholic Korsakoff's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kessler, R.M.; Parker, E.S.; Clark, C.M.; Martin, P.R.; George, D.T.; Weingartner, H.; Sokoloff, L.; Ebert, M.H.; Mishkin, M.

    1985-05-01

    Seven alcoholic male subjects diagnosed as having Korsakoff's syndrome and eight age-matched male normal volunteers were studied with /sup 18/F 2-fluoro-2-deoxy-D-glucose (2/sup 18/FDG). All subjects were examined at rest with eyes covered in a quiet, darkened room. Serial plasma samples were obtained following injection of 4 to 5 mCi of 2/sup 18/FDG. Tomographic slices spaced at 10mm axial increments were obtained (in-plane resolution = 1.75 cm, axial resolution = 1.78 cm). Four planes were selected from each subject, and a total of 46 regions of interest were sampled and glucose metabolic rates for each region calculated. The mean glucose metalbolic rate for the 46 regions in the Korsakoff subjects was significantly lower than that in the normal controls (5.17 +- .43 versus 6.6 +- 1.31). A Q-component analysis, which examined each subject's regional rates relative to his mean rate, revealed two distinct patterns in the Korsakoff group. Glucose metabolism was significantly reduced in 37 of the 46 regions sampled. Reduced cerebral glucose metabolism in a nondemented group of subjects has not previously been reported. The reduction in cortical metabolism may be the result of damage to sub-cortical projecting systems. The differing patterns of cerebral metabolism in Korsakoff's syndrome suggests subgroups with differing neuropathology. Regions implicated in memory function, medial temporal, thalamic and medial prefrontal were among the regions reduced in metabolism.

  18. Regional cerebral blood flow (rCBF) in psychiatry: Methodological issues

    International Nuclear Information System (INIS)

    Prohovnik, I.

    1984-01-01

    Traditionally, measurements of regional cerebral blood flow (rCBF) have been confined to neurology and nuclear medicine. Only one laboratory had concentrated on using this technique in psychiatric studies. Recently, however, rCBF has been increasingly used in psychiatry, and it seems appropriate at this time to examine the value and limitations of this method. The present article reviews selected methodological issues that may complicate the performance and interpretation of rCBF studies, with the aim of providing some means to evaluate published work and to plan further psychiatric research. In this paper, the term rCBF refers only to the two-dimensional, noninvasive methods that rely on inhalation or intravenous injection of xenon-133. The growing interest of rCBF to psychiatry stems mostly from the fact that this technique can indirectly map cerebral metabolism and, by interface, neural activity or information processing. Regional metabolism and blood flow are closely coupled to the human brain in the absence of gross pathology, and since psychiatric patients rarely present acute neurological abnormalities that might disrupt this coupling, one may infer regional metabolism from flow

  19. Age and regional cerebral blood flow at rest and during cognitive activity

    International Nuclear Information System (INIS)

    Gur, R.C.; Gur, R.E.; Obrist, W.D.; Skolnick, B.E.; Reivich, M.

    1987-01-01

    The relationship between age and regional cerebral blood flow (rCBF) activation for cognitive tasks was investigated with the xenon (Xe 133) inhalation technique. The sample consisted of 55 healthy subjects, ranging in age from 18 to 72 years, who were studied during rest and during the performance of verbal analogy and spatial orientation tasks. The dependent measures were indexes of gray-matter rCBF and average rCBF (gray and white matter) as well as the percentage of gray-matter tissue. Advanced age was associated with reduced flow, particularly pronounced in anterior regions. However, the extent and pattern of rCBF changes during cognition was unaffected by age. For the percentage of gray matter, there was a specific reduction in anterior regions of the left hemisphere. The findings suggest the utility of this research paradigm for investigating neural underpinnings of the effects of dementia on cognitive functioning, relative to the effects of normal aging

  20. Regional cerebral blood flow in schizophrenics. Tests using the xenon Xe 133 inhalation method

    International Nuclear Information System (INIS)

    Ariel, R.N.; Golden, C.J.; Berg, R.A.; Quaife, M.A.; Dirksen, J.W.; Forsell, T.; Wilson, J.; Graber, B.

    1983-01-01

    Measurements of intrahemispheric and bilateral regional cerebral blood flow (CBF) for gray and white matter were compared in 29 schizophrenic patients and 22 normal controls, using the xenon Xe 133 inhalation method. Results showed significantly lower CBF values for all brain regions in the schizophrenic group, and post hoc comparisons showed relatively greater reduced gray-matter CBF values in the anterior areas of the brain. There was also a left-hemisphere frontal loss similar to that reported previously, although it was in the context of a generalized loss in anterior functioning. Interhemispheric comparison within both groups showed no differences between homologous regions for gray matter, and greater white-matter CBF values in the right hemisphere than in the left hemisphere. The findings support a hypothesis of a bilateral anterior deficit in schizophrenia

  1. Attacks of common migraine or hortons headache may not be accompanied by changes in regional cerebral blood flow

    International Nuclear Information System (INIS)

    Henriksen, L.; Aebelholt Krabbe, A.; Tfelt-Hansen, P.; Olesen, J.

    1982-01-01

    Vasospasm and cerebral ischemia, followed by cerebral and extracerebral vasodilation and hyperemia, are generally believed to form the common pathophysiology of the various subtypes of migraine. Mild forms of reactions are thought to result in common migraine (no neurological prodromes or accompaniments), and more severe reactions are thought to induce classical migraine. 8 induced common migraine attacks in 6 patients do not support this unitarian view, as no regional cerebral blood flow changes was found, but suggests a different pathophysiology in common migraine compaired to classical migraine. There are few features in Hortons headache to incriminate the cerebral vessels, and generally patients do not have symptoms attributable to cerebral involvement. In 6 out of 14 patients with known Hortons headache we succesfully induced an attack after alcohol alone or in combination with sublingual nitroglycerine. A slight hyperventilation occurred during the attack, correcting cerebral blood flow for these changes left mean CBF totally unchanged. No regional abnormalities occurred in any of the about 700 regions measured from during each investigation in neither the group with common migraine, nor in the patients with Hortons headache. (Author)

  2. Type of aphasia and regional cerebral blood flow. A study with /sup 133/Xe inhalation method

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru (National Cardiovascular Center, Suita, Osaka (Japan))

    1982-11-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with /sup 133/Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter.

  3. A study on regional cerebral blood flow measurement by N-isopropyl-p-[I-123]iodoamphetamine

    International Nuclear Information System (INIS)

    Seki, Hiroyasu

    1986-01-01

    In vivo characteristics of N-isopropyl-p-[I-123]iodoamphetamine (I-123 IMP) as a potential agent for imaging regional cerebral blood flow (rCBF) were fundamentally studied, and the clinical value of gamma camera rotating SPECT with I-123 IMP was assessed. Brain autoradiography in rats revealed that brain uptake of I-123 IMP is comparable to that described for C-14 iodoantipyrin. In a healthy volunteer, brain uptake was 8.5 % of injected dose at 1.5 hr. Significant uptake of I-123 IMP was observed in the lungs and liver, but not observed in the eyeball or pancreas. Radiation absorbed doses per mCi of I-123 IMP were 0.142 in the brain, 0.178 in the lungs, 0.130 in the liver, 0.038 in the ovaries, 0.027 in the testes, and 0.042 in the total body. A rotating gamma camera for SPECT gave the same linear response to radioactivity as a ring detector, although the latter had better sensitivity and resolution than the former. An increased rCBF was observed with physiological stimulation including left hand movement, reading, and listening, providing three-dimensional mapping of regional cerebral function for kinesthesia. Fifty-three measurements of rCBF were clinically acquired in 42 patients with cerebrovascular disorder. Mean rCBF ranged from 11 to 40 ml/100 g/min. SPECT with I-123 IMP had a significantly high ability to detect ischemic lesions compared with X-ray CT (83 % vs. 41 %). These results indicate the potential benefits of this modality in evaluating cerebral pathophysiology, treatment efficacy, and surgical indications. (Namekawa, K.)

  4. The diagnosis and treatment of pediatric narcolepsy.

    Science.gov (United States)

    Nevsimalova, Sona

    2014-08-01

    Narcolepsy in children is a serious disorder marked by a chronic course and lifelong handicap in school performance and choice of employment, by free time activity limitation, and by behavior and personality changes, all of which constitute a major influence on the quality of life. Increased daytime sleepiness may be the only sign at the disease onset, with attacks of sleep becoming longer and lasting up to hours. Also present may be confusional arousals with features of sleep drunkenness. Paradoxically, preschool and young children may show inattentiveness, emotional lability, and hyperactive behavior. Cataplexy may develop after onset of sleepiness and affect mainly muscles of the face. Hypnagogic hallucinations and sleep paralysis are seldom present. Multiple Sleep Latency Test criteria are not available for children younger than 6 years. The haplotype (HLA-DQB1:0602) can be associated with the disorder; however, the best predictor of narcolepsy-cataplexy is hypocretin deficiency. The treatment generally used in adults is regarded as off-label in childhood, which is why the management of pediatric narcolepsy is difficult.

  5. Transient cerebral ischemia induces albumin expression in microglia only in the CA1 region of the gerbil hippocampus.

    Science.gov (United States)

    Park, Joon Ha; Park, Jin-A; Ahn, Ji Hyeon; Kim, Yang Hee; Kang, Il Jun; Won, Moo-Ho; Lee, Choong-Hyun

    2017-07-01

    Albumin, the most abundant plasma protein, is known to exhibit a neuroprotective effect in animal models of focal and global cerebral ischemia. In the present study, the expression and immunoreactivity of albumin was examined in the hippocampus following 5 min of transient cerebral ischemia in gerbils. Albumin immunoreactivity was observed in microglia of the CA1 hippocampal region 2 days post‑ischemic insult, and it was significantly increased at 4 days following ischemia-reperfusion. In addition, at 4 days post‑ischemic insult, albumin‑immunoreactive microglia were abundant in the stratum pyramidale of the CA1 region. The present results demonstrated that albumin was newly expressed post‑injury in microglia in the CA1 region, suggesting ischemia‑induced neuronal loss. Albumin expression may therefore be associated with ischemia‑induced delayed neuronal death in the CA1 region following transient cerebral ischemia.

  6. The phosphodiesterase 3 inhibitor cilostazol dilates large cerebral arteries in humans without affecting regional cerebral blood flow

    DEFF Research Database (Denmark)

    Birk, Steffen; Kruuse, Christina Rostrup; Petersen, Kenneth A

    2004-01-01

    in the middle cerebral arteries (VMCA) was measured with transcranial Doppler, and the superficial temporal and radial arteries diameters were measured with ultrasonography. During the 4-hour observation period, there was no effect on systolic blood pressure (P = 0.28), but diastolic blood pressure decreased...

  7. Interactive handling of regional cerebral blood flow data using a macrolanguage

    International Nuclear Information System (INIS)

    Sveinsdottir, E.; Schomacker, T.; Lassen, N.A.

    1976-01-01

    A general image handling software system has been developed for on-line collection, processing and display of gamma camera images (IMAGE system). The most distinguishable feature of the system is the ability for the user to interactively specify sequences, called macros, of basic functions to be performed. Information about a specified sequence is retained in the system, thus enabling new sequences or macros to be defined using already specified sequences. Facilities for parameter setting and parameter transfer between functions, as well as facilities for repetition of a function, are included. Finally, functions, be it basic or macro, can be specified to be iteratively activated using a physiological trigger signal as f.ex. the ECG. In addition, a special program system was developed for handling the dynamic data, from Xenon-133 studies of regional cerebral blood flow (CBF system). Parametric or functional images derived from the CBF system and depicting estimates of regional cerebral blood flow, relative weights of grey matter or other parameters can after computation be handled in the IMAGE system

  8. Regional cerebral blood flow in Alzheimer's disease. Comparison between short and long-term donepezil therapy

    International Nuclear Information System (INIS)

    Ushijima, Yo; Okuyama, Chio; Kubota, Takao; Nakai, Takako; Nishimura, Tsunehiko; Mori, Satoru

    2006-01-01

    Treatment with donepezil improves cognitive function of patients with Alzheimer's disease (AD) when compared to a placebo-controlled group. The purpose of this study was to investigate changes in regional cerebral blood flow (rCBF) of AD patients in short-term and long-term treatment with donepezil. rCBF was measured by N-isopropyl-p- 123 I-iodoamphetamine (IMP) autoradiography method. CBF measurements were performed in 17 AD patients before treatment and after 3 months (short-term therapy) and 1 year (long-term therapy). Regions of interest were set at cerebral cortex and cerebellar hemisphere. We used absolute CBF and relative CBF expressed as ratio to cerebellar CBF. Significant increases in relative rCBF were noted in the frontal, parietal and temporal lobes at the end of short-term therapy. rCBF was decreased after the long-term therapy, whereas rCBF was still increased to a slight extent, as compared with the pre-treatment levels. Absolute rCBF showed minimal change and a tendency to decline. Relative rCBF significantly increased in the short-term donepezil therapy, while following the long-term therapy, rCBF decreased to the pre-treatment level. (author)

  9. Regional cerebral blood flow abnormalities in late-life depression. Relation to refractoriness and chronification

    International Nuclear Information System (INIS)

    Awata, Shuichi; Konno, Michiko; Sato, Mitsumoto; Ito, Hiroshi; Ono, Shuichi; Kawashima, Ryuta; Fukuda, Hiroshi

    1998-01-01

    We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and 99m Tc-hexamethyl-propylenamine oxime ( 99m Tc-HMPAO). Compared with 13 age-matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non-refractory subgroup. In the non-reflactory subgroup, rCBF decreased significantly in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late-life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression. (author). 60 refs

  10. Regional cerebral blood flow and brain atrophy in senile dementia of Alzheimer type (SDAT)

    International Nuclear Information System (INIS)

    Okada, Kazunori; Kobayashi, Shoutai; Yamaguchi, Shuhei; Kitani, Mituhiro; Tsunematsu, Tokugoro

    1987-01-01

    To investigate the relationship between the reduction of cerebal blood flow and brain atrophy in SDAT, these were measured in 13 cases of senile dementia of Alzheimer type, and compared to 15 cases of multi-infarct Dementia, 39 cases of lacunar infarction without dementia (non-demented CVD group) and 69 cases of aged normal control. Brain atrophy was evaluated by two-dimensional method on CT film by digitizer and regional cerebral blood flow (rCBF) was measured by 133 Xe inhalation method. The degree of brain atrophy in SDAT was almost similar of that of MID. But it was more severe than that of non-demented group. MID showed the lowest rCBF among these groups. SDAT showed significantly lower rCBF than that of aged control, but rCBF in SDAT was equal to that of lacunar stroke without dementia. Focal reduction of cerebral blood flow in bilateral fronto-parietal and left occipital regions were observed in SDAT. Verbal intelligence score (Hasegawa's score) correlated with rCBF and brain atrophy index in MID, and a tendency of correlation between rCBF and brain atrophy in MID was also observed. However, there was no correlation among those indices in SDAT. These findings suggest that the loss of brain substance dose not correspond to the reduction of rCBF in SDAT and simultaneous measurement of rCBF and brain atrophy was useful to differ SDAT from MID. (author)

  11. Regional cerebral blood flow abnormalities in late-life depression. Relation to refractoriness and chronification

    Energy Technology Data Exchange (ETDEWEB)

    Awata, Shuichi; Konno, Michiko; Sato, Mitsumoto [Tohoku Univ., Sendai (Japan). School of Medicine; Ito, Hiroshi; Ono, Shuichi; Kawashima, Ryuta; Fukuda, Hiroshi

    1998-02-01

    We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and {sup 99m}Tc-hexamethyl-propylenamine oxime ({sup 99m}Tc-HMPAO). Compared with 13 age-matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non-refractory subgroup. In the non-reflactory subgroup, rCBF decreased significantly in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late-life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression. (author). 60 refs.

  12. [Regional cerebral oxygen saturation as a marker of hemodynamic state following cardiac surgery].

    Science.gov (United States)

    García-Hernández, J A; Aldemira-Liz, A; Martínez-López, A I; Cayuela, A; Charlo-Molina, M T; Cano-Franco, J; Loscertales-Abril, M

    2013-10-01

    Regional cerebral oxygen saturation (rSO₂) is a measure of the general state of perfusion and oxygenation. We aim to analyze the relationship between this and various hemodynamic and respiratory parameters. Forty-three patients, operated on between October 2011 and July 2012, were included in this prospective observational descriptive study. The following parameters were measured: mean arterial pressure, both arterial and central venous oxygen saturation and partial pressures of oxygen and carbon dioxide, and lactate levels. From these parameters, the oxygenation index and the oxygen extraction ratio were calculated. These measurements were studied to evaluate whether rSO₂ correlated significantly with the other parameters. The average age and weight of the patients were 27.3 months and 9.2 kg, respectively. The rSO₂ correlated positively with both central venous oxygen saturation (r=0.73, P 0.4) between the rSO₂ and central venous oxygen saturation, and between the rSO₂ and oxygen extraction ratio. Regional cerebral oxygen saturation correlates well with hemodynamic parameters - mean arterial pressure, venous saturation, and the tissue oxygen extraction. However, it does not correlate with respiratory parameters. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. Regional cerebral blood flow changes associated with focal electrically administered seizure therapy (FEAST).

    Science.gov (United States)

    Chahine, George; Short, Baron; Spicer, Ken; Schmidt, Matthew; Burns, Carol; Atoui, Mia; George, Mark S; Sackeim, Harold A; Nahas, Ziad

    2014-01-01

    Use of electroconvulsive therapy (ECT) is limited by cognitive disturbance. Focal electrically-administered seizure therapy (FEAST) is designed to initiate focal seizures in the prefrontal cortex. To date, no studies have documented the effects of FEAST on regional cerebral blood flow (rCBF). A 72 year old depressed man underwent three single photon emission computed tomography (SPECT) scans to capture the onset and resolution of seizures triggered with right unilateral FEAST. We used Bioimage Suite for within-subject statistical analyses of perfusion differences ictally and post-ictally compared with the baseline scan. Early ictal increases in regional cerebral blood flow (rCBF) were limited to the right prefrontal cortex. Post-ictally, perfusion was reduced in bilateral frontal and occipital cortices and increased in left motor and precuneus cortex. FEAST appears to triggers focal onsets of seizure activity in the right prefrontal cortex with subsequent generalization. Future studies are needed on a larger sample. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. A neutral lipophilic technetium-99m complex for regional cerebral blood flow imaging

    International Nuclear Information System (INIS)

    Narra, R.K.; Nunn, A.D.; Kuczynski, B.L.; DiRocco, R.J.; Feld, T.; Silva, D.A.; Eckelman, W.C.

    1990-01-01

    Technetium-99m-DMG-2MP (Chloro[bis[2,3-butanedionedioxime(1-)-0][2,3- butanedionedioximato (2-)-N,N',N double-prime,N'double-prime,N double-prime double-prime,N'double-prime double-prime] (2-methylpropyl borato (2-))technetium]), also known as SQ 32097 is a member of a family of neutral lipophilic compounds generally known as boronic acid adducts of technetium dioxime complexes (BATOs). After i.v. administration, the concentration of [ 99m Tc]DMG-2MP in various regions of the brain appears to be proportional to blood flow. In rats, 1.1% ID was in the brain at 5 min postinjection when the blood contained less than 3% ID. Over 24 hr excretion was 59% in the feces and 23% in the urine. The activity in monkey brain at 5 min was 2.8% ID and it cleared with a t1/2 of 86 min. Autoradiographs of monkey brain sections showed excellent regional detail with a gray/white ratio of 3.6 at 10 min. The distribution of [ 99m Tc]DMG-2MP in the monkey brain corresponds to the known cytoarchitectural pattern of cerebral glucose metabolism. The properties of [ 99m Tc]DMG-2MP make it a potentially useful agent for cerebral perfusion imaging in man

  15. Hypocretin deficiency develops during onset of human narcolepsy with cataplexy

    DEFF Research Database (Denmark)

    Savvidou, Andri; Knudsen, Stine; Olsson-Engman, Mia

    2013-01-01

    Although hypothesized through animal studies, a temporal and causal association between hypocretin deficiency and the onset of narcolepsy with cataplexy (NC) has never been proven in humans.......Although hypothesized through animal studies, a temporal and causal association between hypocretin deficiency and the onset of narcolepsy with cataplexy (NC) has never been proven in humans....

  16. Olfactory Dysfunction in Narcolepsy with and without Cataplexy

    Czech Academy of Sciences Publication Activity Database

    Bušková, J.; Klaschka, Jan; Šonka, K.; Nevšímalová, S.

    2010-01-01

    Roč. 11, č. 6 (2010), s. 558-561 ISSN 1389-9457 Institutional research plan: CEZ:AV0Z10300504 Keywords : narcolepsy * cataplexy * narcolepsy without cataplexy * RBD * olfactory dysfunction Subject RIV: FH - Neurology Impact factor: 3.430, year: 2010

  17. Narcolepsy induced by chronic heavy alcohol consumption: a case report

    Science.gov (United States)

    Wang, Xinyuan

    2012-01-01

    Summary Narcolepsy is a chronic neurological disorder, characterized by uncontrollable excessive daytime sleepiness, cataplectic episodes, sleep paralysis, hypnagogic hallucinations, and night time sleep disruption. The paper reviewed the related literature and reported a case of long-term drinking induced narcolepsy which was significantly improved after treatment with paroxetine and dexzopiclone. PMID:25328357

  18. Narcolepsy and Orexins: An Example of Progress in Sleep Research

    Science.gov (United States)

    De la Herrán-Arita, Alberto K.; Guerra-Crespo, Magdalena; Drucker-Colín, René

    2011-01-01

    Narcolepsy is a chronic neurodegenerative disease caused by a deficiency of orexin-producing neurons in the lateral hypothalamus. It is clinically characterized by excessive daytime sleepiness and by intrusions into wakefulness of physiological aspects of rapid eye movement sleep such as cataplexy, sleep paralysis, and hypnagogic hallucinations. The major pathophysiology of narcolepsy has been recently described on the bases of the discovery of the neuropeptides named orexins (hypocretins) in 1998; considerable evidence, summarized below, demonstrates that narcolepsy is the result of alterations in the genes involved in the pathology of the orexin ligand or its receptor. Deficient orexin transmission is sufficient to produce narcolepsy, as we describe here, animal models with dysregulated orexin signaling exhibit a narcolepsy-like phenotype. Remarkably, these narcoleptic models have different alterations of the orexinergic circuit, this diversity provide us with the means for making comparison, and have a better understanding of orexin-cell physiology. It is of particular interest that the most remarkable findings regarding this sleep disorder were fortuitous and due to keen observations. Sleep is a highly intricate and regulated state, and narcolepsy is a disorder that still remains as one of the unsolved mysteries in science. Nevertheless, advances and development of technology in neuroscience will provide us with the necessary tools to unravel the narcolepsy puzzle in the near future. Through an evaluation of the scientific literature we traced an updated picture of narcolepsy and orexins in order to provide insight into the means by which neurobiological knowledge is constructed. PMID:21541306

  19. Challenges in the development of therapeutics for narcolepsy.

    Science.gov (United States)

    Black, Sarah Wurts; Yamanaka, Akihiro; Kilduff, Thomas S

    2017-05-01

    Narcolepsy is a neurological disorder that afflicts 1 in 2000 individuals and is characterized by excessive daytime sleepiness and cataplexy-a sudden loss of muscle tone triggered by positive emotions. Features of narcolepsy include dysregulation of arousal state boundaries as well as autonomic and metabolic disturbances. Disruption of neurotransmission through the hypocretin/orexin (Hcrt) system, usually by degeneration of the HCRT-producing neurons in the posterior hypothalamus, results in narcolepsy. The cause of Hcrt neurodegeneration is unknown but thought to be related to autoimmune processes. Current treatments for narcolepsy are symptomatic, including wake-promoting therapeutics that increase presynaptic dopamine release and anticataplectic agents that activate monoaminergic neurotransmission. Sodium oxybate is the only medication approved by the US Food and Drug Administration that alleviates both sleep/wake disturbances and cataplexy. Development of therapeutics for narcolepsy has been challenged by historical misunderstanding of the disease, its many disparate symptoms and, until recently, its unknown etiology. Animal models have been essential to elucidating the neuropathology underlying narcolepsy. These models have also aided understanding the neurobiology of the Hcrt system, mechanisms of cataplexy, and the pharmacology of narcolepsy medications. Transgenic rodent models will be critical in the development of novel therapeutics for the treatment of narcolepsy, particularly efforts directed to overcome challenges in the development of hypocretin replacement therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Regional cerebral blood flow using sup 133 Xenon intra-venous technique, 2; Evaluation of regional cerebral blood flow in patients with cerebrovascular ischemic disease

    Energy Technology Data Exchange (ETDEWEB)

    Yonekura, Masahiro; Teramoto, Shigeyoshi; Moriyama, Tadayoshi (Nagasaki Chuo National Hospital (Japan))

    1990-12-01

    Using the {sup 133}Xenon venous method, we have studied the regional cerebral blood flow (rCBF) in 947 patients with cerebrovascular ischemic disease. In 116 stroke or TIA patients with internal carotid artery occlusion or severe stenosis, their rCBF revealed 48.9 ml/100 g/min on average in the group of one side occlusion, 46.7 ml/100 g/min in the group of both sides occlusion. These values reduced approximately 12%, 16% and 15% of the rCBF in healthy volunteers of same age, respectively. In 28 patients with moya moya disease, their rCBF tended to be higher in younger cases and lower with advanced age. In the majority of the cases, their rCBF was age-dependent with 20{similar to}25 ml/100 g/min below the curve of age-matched rCBF of healthy volunteers. The reduction of rCBF was observed in 69 (48.3%) of 143 cases clinically diagnosed as small vessel disease, in 58 (41.4%) of 140 cases with vertebro-basilar insufficiency and in 23 (44.2%) of 52 cases with syncopal attack compared with the rCBF of healthy volunteers. (author).

  1. Regional cerebral blood flow and oxygen consumption during normal human sleep

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Ken [Toho Univ., Tokyo (Japan). School of Medicine

    1989-09-01

    Regional cerebral blood flow (rCBF), regional oxygen extraction fraction (rCEF) and regional cerebral metabolic rate for oxygen (rCMRO{sub 2}) were measured using the continuous inhalation technique for {sup 15}O with positron emission tomography (PET) during both wakefulness and sleep. Ten paid volunteers, with a mean age of 21.6 yrs., were deprived of sleep for a period of approximately 20 hours, and the experiments were performed mostly in the morning. {sup 15}O activity of both whole blood and the plasma, pixel count of PET, total arterial blood oxygen content were used for analysis of rCBF, rOEF and rCMRO{sub 2}. PET scannings were carried out mostly during the very light non-rapid eye movement (NREM) sleep, i.e. stage 1 and/or 2, and wakefulness. About 10 minutes after the start of continuous inhalation of {sup 15}O gas, the {sup 15}O activity of the brain was found to be in a steady-state condition. During this steady-state condition, PET scannings were performed for about 10 minutes. Regions of interest, square in shape and having an area of 2.8 cm{sup 3}, were set in each cortex on PET images of a horizontal cross-section of the brain, set at 45 mm above the orbitomeatal line. The rCBF and rCMRO{sub 2} were analysed in 5 of 10 male subjects during both wakefulness and NREM sleep, and only 3 were done during three sleep stages, including REM sleep. Levels of rCBF and rCMRO{sub 2} were found to be decreased in NREM sleep, and the decreasing rates were calculated at 10.2% and 7.6% from the level of wakefulness, respectively. There was no significant difference in the mean value of rOEF between wakefulness and NREM sleep. There were no significant regional differences found in the rate of decrease among the frontal, temporal and occipital cortices. It was considered that the decrease of rCBF and rCMRO{sub 2} during NREM sleep suggested a decrease of the activity levels in the cerebral functions. (author).

  2. Regional cerebral blood flow and oxygen consumption during normal human sleep

    International Nuclear Information System (INIS)

    Takahashi, Ken

    1989-01-01

    Regional cerebral blood flow (rCBF), regional oxygen extraction fraction (rCEF) and regional cerebral metabolic rate for oxygen (rCMRO 2 ) were measured using the continuous inhalation technique for 15 O with positron emission tomography (PET) during both wakefulness and sleep. Ten paid volunteers, with a mean age of 21.6 yrs., were deprived of sleep for a period of approximately 20 hours, and the experiments were performed mostly in the morning. 15 O activity of both whole blood and the plasma, pixel count of PET, total arterial blood oxygen content were used for analysis of rCBF, rOEF and rCMRO 2 . PET scannings were carried out mostly during the very light non-rapid eye movement (NREM) sleep, i.e. stage 1 and/or 2, and wakefulness. About 10 minutes after the start of continuous inhalation of 15 O gas, the 15 O activity of the brain was found to be in a steady-state condition. During this steady-state condition, PET scannings were performed for about 10 minutes. Regions of interest, square in shape and having an area of 2.8 cm 3 , were set in each cortex on PET images of a horizontal cross-section of the brain, set at 45 mm above the orbitomeatal line. The rCBF and rCMRO 2 were analysed in 5 of 10 male subjects during both wakefulness and NREM sleep, and only 3 were done during three sleep stages, including REM sleep. Levels of rCBF and rCMRO 2 were found to be decreased in NREM sleep, and the decreasing rates were calculated at 10.2% and 7.6% from the level of wakefulness, respectively. There was no significant difference in the mean value of rOEF between wakefulness and NREM sleep. There were no significant regional differences found in the rate of decrease among the frontal, temporal and occipital cortices. It was considered that the decrease of rCBF and rCMRO 2 during NREM sleep suggested a decrease of the activity levels in the cerebral functions. (author)

  3. Narcolepsy and Psychiatric Disorders: Comorbidities or Shared Pathophysiology?

    Directory of Open Access Journals (Sweden)

    Anne Marie Morse

    2018-02-01

    Full Text Available Narcolepsy and psychiatric disorders have a significant but unrecognized relationship, which is an area of evolving interest, but unfortunately, the association is poorly understood. It is not uncommon for the two to occur co-morbidly. However, narcolepsy is frequently misdiagnosed initially as a psychiatric condition, contributing to the protracted time to accurate diagnosis and treatment. Narcolepsy is a disabling neurodegenerative condition that carries a high risk for development of social and occupational dysfunction. Deterioration in function may lead to the secondary development of psychiatric symptoms. Inversely, the development of psychiatric symptoms can lead to the deterioration in function and quality of life. The overlap in pharmaceutical intervention may further enhance the difficulty to distinguish between diagnoses. Comprehensive care for patients with narcolepsy should include surveillance for psychiatric illness and appropriate treatment when necessary. Further research is necessary to better understand the underlying pathophysiology between psychiatric disease and narcolepsy.

  4. Narcolepsy in Adolescence—A Missed Diagnosis: A Case Report

    Science.gov (United States)

    Gupta, Anoop K.; Sahoo, Swapnajeet

    2017-01-01

    ABSTRACT: Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents. PMID:29616151

  5. Status Cataplecticus as Initial Presentation of Late Onset Narcolepsy

    Science.gov (United States)

    Panda, Samhita

    2014-01-01

    Narcolepsy, one of the important causes of hypersomnia, is an under diagnosed sleep disorder. It has a bimodal age of onset around 15 and 35 years. It is characterized by the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic/ hypnopompic hallucinations, and sleep paralysis. Cataplexy is by far the most predictive feature of narcolepsy. Status cataplecticus is the occurrence of cataplexy repeatedly for hours or days, a rare presentation of narcolepsy. This report describes an elderly gentleman with late onset narcolepsy in the sixth decade of life presenting with initial and chief symptom of status cataplecticus. Citation: Panda S. Status cataplecticus as initial presentation of late onset narcolepsy. J Clin Sleep Med 2014;10(2):207-209. PMID:24533005

  6. Regional cerebral blood flow after long-term exposure to carbon disulfide

    International Nuclear Information System (INIS)

    Aaserud, O.; Russell, D.; Nyberg-Hansen, R.; Joergensen, E.B.; Gjerstad, L.; Rootwelt, K.; Nakstad, P.; Hommeren, O.J.; Tvedt, B.

    1992-01-01

    Sixteen former rayon viscose workers were investigated four years after the exposure to carbon disulfide was discontinued. Median age was 58 years (range 43-65 years), median exposure time was 17 years (range 10-35 years). Encephalopathy was diagnosed in altogether 14 workers. To further explore pathophysiological mechanisms, cerebrovascular investigations were employed. Doppler ultrasound examination of the precerebral vessels in 15 workers showed a slight stenosis of the left internal carotid artery in one. Regional cerebral blood flow investigation (rCBF) with single photon emission computerized tomography (SPECT) with Xenon-133 gas was performed in 14. There was no significant difference from a control group. Regional side-to-side asymmetries beyond reference limits were demonstrated in eight workers. The abnormalities were modest, but may indicate a tendency toward focal blood flow disturbances in workers with long-term exposure to carbon disulfide. (au)

  7. Disodium cromoglycate, a mast-cell stabilizer, alters postradiation regional cerebral blood flow in primates

    International Nuclear Information System (INIS)

    Cockerham, L.G.; Doyle, T.F.; Pautler, E.L.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure, and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with systemic hypotension and a dramatic release of mast-cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomena and the postradiation decrease in cerebral blood flow, primates were given the mast-cell stabilizers disodium cromoglycate (DSCG) or BRL 22321 before exposure to 100 Gy whole-body gamma radiation. Hypothalamic and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. The data indicated that DSCG was successful in diminishing postradiation decrease in cerebral blood flow. Irradiated animals pretreated with DSCG, showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated, irradiated animals showed a 57% decrease. The cortical blood flow of DSCG treated, irradiated animals showed a triphasic response, with a decrease of 38% at 10 min postradiation, then a rise to 1% below baseline at 20 min, followed by a fall to 42% below baseline by 50 min postradiation. In contrast, the untreated, irradiated animals showed a steady decrease in cortical blood flow to 79% below baseline by 50 min postradiation. There was no significant difference in blood-pressure response between the treated and untreated, irradiated animals. Systemic blood pressure showed a 60% decrease at 10 min postradiation, falling to a 71% decrease by 60 min

  8. Facial expression recognition and emotional regulation in narcolepsy with cataplexy.

    Science.gov (United States)

    Bayard, Sophie; Croisier Langenier, Muriel; Dauvilliers, Yves

    2013-04-01

    Cataplexy is pathognomonic of narcolepsy with cataplexy, and defined by a transient loss of muscle tone triggered by strong emotions. Recent researches suggest abnormal amygdala function in narcolepsy with cataplexy. Emotion treatment and emotional regulation strategies are complex functions involving cortical and limbic structures, like the amygdala. As the amygdala has been shown to play a role in facial emotion recognition, we tested the hypothesis that patients with narcolepsy with cataplexy would have impaired recognition of facial emotional expressions compared with patients affected with central hypersomnia without cataplexy and healthy controls. We also aimed to determine whether cataplexy modulates emotional regulation strategies. Emotional intensity, arousal and valence ratings on Ekman faces displaying happiness, surprise, fear, anger, disgust, sadness and neutral expressions of 21 drug-free patients with narcolepsy with cataplexy were compared with 23 drug-free sex-, age- and intellectual level-matched adult patients with hypersomnia without cataplexy and 21 healthy controls. All participants underwent polysomnography recording and multiple sleep latency tests, and completed depression, anxiety and emotional regulation questionnaires. Performance of patients with narcolepsy with cataplexy did not differ from patients with hypersomnia without cataplexy or healthy controls on both intensity rating of each emotion on its prototypical label and mean ratings for valence and arousal. Moreover, patients with narcolepsy with cataplexy did not use different emotional regulation strategies. The level of depressive and anxious symptoms in narcolepsy with cataplexy did not differ from the other groups. Our results demonstrate that narcolepsy with cataplexy accurately perceives and discriminates facial emotions, and regulates emotions normally. The absence of alteration of perceived affective valence remains a major clinical interest in narcolepsy with cataplexy

  9. Update on the treatment of narcolepsy: clinical efficacy of pitolisant

    Directory of Open Access Journals (Sweden)

    Calik MW

    2017-04-01

    Full Text Available Michael W Calik1,2 1Department of Biobehavioral Health Science, 2Center for Narcolepsy, Sleep and Health Research, University of Illinois at Chicago, Chicago, IL, United States Abstract: Narcolepsy is a neurological disease that affects 1 in 2,000 individuals and is characterized by excessive daytime sleepiness (EDS. In 60–70% of individuals with narcolepsy, it is also characterized by cataplexy or a sudden loss of muscle tone that is triggered by positive or negative emotions. Narcolepsy decreases the quality of life of the afflicted individuals. Currently used drugs treat EDS alone (modafinil/armodafinil, methylphenidate, and amphetamine, cataplexy alone (“off-label” use of antidepressants, or both EDS and cataplexy (sodium oxybate. These drugs have abuse, tolerability, and adherence issues. A greater diversity of drug options is needed to treat narcolepsy. The small molecule drug, pitolisant, acts as an inverse agonist/antagonist at the H3 receptor, thus increasing histaminergic tone in the wake promoting system of the brain. Pitolisant has been studied in animal models of narcolepsy and used in clinical trials as a treatment for narcolepsy. A comprehensive search of online databases (eg, Medline, PubMed, EMBASE, the Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost CINAHL, ProQuest Research Library, Google Scholar, and ClinicalTrials.gov was performed. Nonrandomized and randomized studies were included. This review focuses on the outcomes of four clinical trials of pitolisant to treat narcolepsy. These four trials show that pitolisant is an effective drug to treat EDS and cataplexy in narcolepsy. Keywords: narcolepsy, pitolisant, histamine

  10. Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients---a PET-CT cerebral functional imaging study

    Directory of Open Access Journals (Sweden)

    Huang Yong

    2012-06-01

    Full Text Available Abstract Background Acupuncture has been applied to aid in the recovery of post-stroke patients, but its mechanism is unclear. This study aims to analyze the relationship between acupuncture and glucose metabolism in cerebral functional regions in post-stroke patients using 18 FDG PET-CT techniques. Forty-three ischemic stroke patients were randomly divided into 5 groups: the Waiguan (TE5 needling group, the TE5 sham needling group, the sham point needling group, the sham point sham needling group and the non-needling group. Cerebral functional images of all patients were then acquired using PET-CT scans and processed by SPM2 software. Results Compared with the non-needling group, sham needling at TE5 and needling/sham needling at the sham point did not activate cerebral areas. However, needling at TE5 resulted in the activation of Brodmann Area (BA 30. Needling/sham needling at TE5 and needling at the sham point did not deactivate any cerebral areas, whereas sham needling at the sham point led to deactivation in BA6. Compared with sham needling at TE5, needling at TE5 activated BA13, 19 and 47 and did not deactivate any areas. Compared with needling at the sham point, needling at TE5 had no associated activation but a deactivating effect on BA9. Conclusion Needling at TE5 had a regulating effect on cerebral functional areas shown by PET-CT, and this may relate to its impact on the recovery of post-stroke patients.

  11. Regional cerebral blood flow changes and neuropsychological functioning in early and late onset alcoholism

    International Nuclear Information System (INIS)

    Demir, B.; Ulug, B.; Ergun, E.; Erbas, B.

    2002-01-01

    Aim: Chronic alcoholism is strongly associated with morphologic and functional abnormalities in the brain. The age-of-onset of alcoholism symptoms might be of discriminating value and can be used to subdivide the population into more homogeneous groups. The aim of the study was to compare late and early onset alcoholism with regard to regional cerebral blood flow (rCBF) and neuropsychological functioning. Methods: Ten late onset (Type I) and thirteen early onset (Type II) male alcoholics were included in the study, the criterion being the age of onset for alcohol abuse. Six healthy, age-matched, male volunteers were included as a control group. rCBF changes were assessed using Tc-99m-HMPAO/SPECT after a detoxification period. Transaxial slices were assessed visually and semi quantitatively. Regional mean counts were divided to the mean counts of cerebellar and occipital regions to obtain semiquantitative ratios for superior frontal, middle frontal, inferior frontal, temporal and parietal lobes for the left and right hemispheres. The neuropsychological battery consisted of the Wisconsin Card Sorting Test, the Wechsler Memory Scale and the Word Fluency Test. Results: Type I and II groups had significantly asymmetric blood flow in the frontal region compared to control group (Left frontal percentage; Type I%46.8±2, Type II=48.3±2.3, Control=50.8±3, p=0.008). The semiquantitative ratios for the frontal subregions were lower for the patients compared to those of control group, however, statistically significant difference was observed only for the ratio of superior frontal region to occipital region in type I patients, for both left and right. The difference between the two subgroups was not statistically significant. Both groups of alcoholic patients also displayed impairment in frontal lobe functions and non-verbal memory. No significant difference was detected between the alcoholic subgroups on neuropsychological measures. There was no significant correlation

  12. Traditional biomarkers in narcolepsy: experience of a Brazilian sleep centre

    Directory of Open Access Journals (Sweden)

    Fernando Morgadinho Santos Coelho

    2010-10-01

    Full Text Available This study was thought to characterized clinical and laboratory findings of a narcoleptic patients in an out patients unit at São Paulo, Brazil. METHOD: 28 patients underwent polysomnographic recordings (PSG and Multiple Sleep Latency Test (MSLT were analyzed according to standard criteria. The analysis of HLADQB1*0602 allele was performed by PCR. The Hypocretin-1 in cerebral spinal fluid (CSF was measured using radioimmunoassay. Patients were divided in two groups according Hypocretin-1 level: Normal (N - Hypocretin-1 higher than 110pg/ml and Lower (L Hypocretin-1 lower than 110 pg/ml. RESULTS: Only 4 patients of the N group had cataplexy when compared with 14 members of the L group (p=0.0002. DISCUSSION: This results were comparable with other authors, confirming the utility of using specific biomarkers (HLA-DQB1*0602 allele and Hypocretin-1 CSF level in narcolepsy with cataplexy. However, the HLADQB1*0602 allele and Hypocretin-1 level are insufficient to diagnose of narcolepsy without cataplexy.Este estudo foi idealizado para avaliar as características clinicas e laboratoriais de uma população de narcolépticos atendidos num centro de referência na cidade de São Paulo (Brasil. MÉTODO: 28 pacientes realizaram polissonografia e teste de múltiplas latências do sono segundo critérios internacionais. O alelo HLADQB1*0602 foi identificado por PCR. A Hipocretina-1 no líquido cefalorradiano (LCR foi mensurada por radioimunoensaio. Os pacientes foram divididos em 2 grupos conforme o nível de Hipocretina-1. Normal (N - Hypocretin-1 >110pg/ml e baixa (B - Hypocretina-1 <110pg/ml. RESULTADOS: Somente 4 pacientes do grupo N tinham cataplexia quando comparados com 14 pacientes do grupo B (p=0,0002. DISCUSSÃO: Estes resultados foram comparáveis com outros autores, confirmando a utilidade do uso de biomarcadores específicos (HLA-DQB1*0602 e nível da hipocretina-1 no LCR em narcolepsia com cataplexia. Porém, o alelo HLADQB1*0602 e a dosagem

  13. Proteomic identification of altered cerebral proteins in the complex regional pain syndrome animal model.

    Science.gov (United States)

    Nahm, Francis Sahngun; Park, Zee-Yong; Nahm, Sang-Soep; Kim, Yong Chul; Lee, Pyung Bok

    2014-01-01

    Complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP) model, a novel experimental model of CRPS. After generating the CPIP animal model, we performed a proteomic analysis of the rat cerebrum using a multidimensional protein identification technology, and screened the proteins differentially expressed between the CPIP and control groups. Results. A total of 155 proteins were differentially expressed between the CPIP and control groups: 125 increased and 30 decreased; expressions of proteins related to cell signaling, synaptic plasticity, regulation of cell proliferation, and cytoskeletal formation were increased in the CPIP group. However, proenkephalin A, cereblon, and neuroserpin were decreased in CPIP group. Altered expression of cerebral proteins in the CPIP model indicates cerebral involvement in the pathogenesis of CRPS. Further study is required to elucidate the roles of these proteins in the development and maintenance of CRPS.

  14. Proteomic Identification of Altered Cerebral Proteins in the Complex Regional Pain Syndrome Animal Model

    Directory of Open Access Journals (Sweden)

    Francis Sahngun Nahm

    2014-01-01

    Full Text Available Background. Complex regional pain syndrome (CRPS is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP model, a novel experimental model of CRPS. Materials and Methods. After generating the CPIP animal model, we performed a proteomic analysis of the rat cerebrum using a multidimensional protein identification technology, and screened the proteins differentially expressed between the CPIP and control groups. Results. A total of 155 proteins were differentially expressed between the CPIP and control groups: 125 increased and 30 decreased; expressions of proteins related to cell signaling, synaptic plasticity, regulation of cell proliferation, and cytoskeletal formation were increased in the CPIP group. However, proenkephalin A, cereblon, and neuroserpin were decreased in CPIP group. Conclusion. Altered expression of cerebral proteins in the CPIP model indicates cerebral involvement in the pathogenesis of CRPS. Further study is required to elucidate the roles of these proteins in the development and maintenance of CRPS.

  15. Investigation of regional cerebral blood flow in alcoholic Korsakoff's syndrome with 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Nakamura, Makoto; Nomura, Soichiro; Kato, Motoichiro; Nakazawa, Tsuneyuki.

    1995-01-01

    Regional cerebral blood flow (rCBF) was determined quantitatively by single photon emission computed tomography (SPECT) using N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP) in 6 patients with alcoholic Korsakoff's syndrome (A group). The findings were compared with concurrently available findings from 6 alcoholic patients with no evidence of cerebral disordres such as Korsakoff's syndrome and dementia (B group) and 4 healthy persons (C group). In both A and B groups, diffuse decrease in blood flow was significantly observed in the entire brain, as compared with the C group; no significant difference in the decreased blood flow existed between the A and B groups. According to the WAIS results, the patients in the A group were classified as 'typical Korsakoff's syndrome' (full IQ of 90 or more) and as 'serious Korsakoff's syndrome' (full IQ of 89 or less). rCBF in the thalamus was significantly lower in the A group of patients with typical Korsakoff's syndrome than the B group. These findings may reflect the variety of alcoholic Korsakoff's syndrome. This may also have an implication for the possible classification of several types in this syndrome. (N.K.)

  16. Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling

    DEFF Research Database (Denmark)

    Miranda Gimenez-Ricco, Maria Jo; Olofsson, K; Sidaros, Karam

    2006-01-01

    Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term-born neon......Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term...

  17. Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. A regional cerebral blood flow study

    DEFF Research Database (Denmark)

    Friberg, L; Olsen, T S; Roland, P E

    1987-01-01

    During the course of hemiplegic migraine in 3 patients, changes in regional cerebral blood flow (rCBF) were recorded by the intracarotid 133Xe method and a 254 multidetector camera covering one hemisphere. The rCBF measurements were performed in conjunction with cerebral angiography. During...... the patients developed transient motor and/or sensory deficits and subsequently severe headache. No signs of arterial occlusion were found. In the over and underperfused regions blood flow fluctuated rapidly because of instability of cerebrovascular tone, defined as transient constriction of the smallest...

  18. Use of electrical impedance tomography to monitor regional cerebral edema during clinical dehydration treatment.

    Directory of Open Access Journals (Sweden)

    Feng Fu

    Full Text Available OBJECTIVE: Variations of conductive fluid content in brain tissue (e.g. cerebral edema change tissue impedance and can potentially be measured by Electrical Impedance Tomography (EIT, an emerging medical imaging technique. The objective of this work is to establish the feasibility of using EIT as an imaging tool for monitoring brain fluid content. DESIGN: a prospective study. SETTING: In this study EIT was used, for the first time, to monitor variations in cerebral fluid content in a clinical model with patients undergoing clinical dehydration treatment. The EIT system was developed in house and its imaging sensitivity and spatial resolution were evaluated on a saline-filled tank. PATIENTS: 23 patients with brain edema. INTERVENTIONS: The patients were continuously imaged by EIT for two hours after initiation of dehydration treatment using 0.5 g/kg intravenous infusion of mannitol for 20 minutes. MEASUREMENT AND MAIN RESULTS: Overall impedance across the brain increased significantly before and after mannitol dehydration treatment (p = 0.0027. Of the all 23 patients, 14 showed high-level impedance increase and maintained this around 4 hours after the dehydration treatment whereas the other 9 also showed great impedance gain during the treatment but it gradually decreased after the treatment. Further analysis of the regions of interest in the EIT images revealed that diseased regions, identified on corresponding CT images, showed significantly less impedance changes than normal regions during the monitoring period, indicating variations in different patients' responses to such treatment. CONCLUSIONS: EIT shows potential promise as an imaging tool for real-time and non-invasive monitoring of brain edema patients.

  19. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc- HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, Ra Hyeong; Suh, Tae Suk; Kwark, Chul Eun; Choe, Bo Young; Lee, Hyoung Koo; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo [College of Medicine, The Catholic Univ. of Seoul, Seoul (Korea, Republic of)

    2002-06-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of '9{sup 9m}Tc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and {sup 99m}Tc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map(SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  20. Quantitative evaluation of regional cerebral blood flow by visual stimulation in 99mTc-HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Juh, R. H.; Suh, T. S.; Chung, Y. A.

    2002-01-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of 99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99mTc- HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50±5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann

  1. Quantitative evaluation of regional cerebral blood flow by visual stimulation in 99mTc- HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Juh, Ra Hyeong; Suh, Tae Suk; Kwark, Chul Eun; Choe, Bo Young; Lee, Hyoung Koo; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo

    2002-01-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of '9 9m Tc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99m Tc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map(SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50±5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann

  2. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc-HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, R. H.; Suh, T. S.; Chung, Y. A. [The Catholic Univ., of Korea, Seoul (Korea, Republic of)

    2002-07-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of 99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99mTc- HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  3. Regional cerebral energy metabolism during intravenous anesthesia with etomidate, ketamine or thiopental

    International Nuclear Information System (INIS)

    Davis, D.W.

    1987-01-01

    Regional brain glucose utilization (rCMRglc) was measured in rats during steady-state levels of intravenous anesthesia to determine if alterations in brain function due to anesthesia could provide information on the mechanisms of anesthesia. Intravenous anesthetics from three different chemical classes were studied: etomidate, ketamine and thiopental. All rCMRglc experiments were conducted in freely moving rats in isolation chambers, with the use of [6- 14 C] glucose and guantitative autoradiography. Etomidate caused a rostral-to-caudal gradient of depression of rCMRglc. The four doses of etomidate did not differ in their effects on energy metabolism. Sub-anesthetic (5 mg kg -1 ) and anesthetic (30 mg kg -1 ) doses of ketamine produced markedly different patterns of behavior. Brain energy metabolism during the sub-anesthetic dose was stimulated in most regions, while the anesthetic dose selectively stimulated the hippocampus, leaving most brain regions unaffected. Thiopental produced a dose-dependent reduction of rCMRglc in all gray matter regions. No brain region was selectively affected. Comparison of the drug-specific alterations of cerebral energy metabolism suggests these anesthetics do not act through a common mechanism. The hypothesis that each acts by binding to specific cell membrane receptors is consistent with these observations

  4. SPECT determination of regional cerebral blood flow in hypertensive patients before and after clonidine

    International Nuclear Information System (INIS)

    Devous, M.D.; Reed, W.G.; Chehabi, H.H.; Bonte, F.J.

    1985-01-01

    Regional cerebral blood flow (rCBF) was determined by SPECT of 133-Xe inert gas washout in 18 hypertensive patients (PTS) upon admission and after treatment with oral clonidine (CL, 0.2 mg, then 0.1 mg/hr until diastolic pressure reached 105 mm Hg or fell by 30 mm Hg). CL reduced mean arterial pressure (MAP) from 160 (200/140) to 133 (150/100) mm Hg over 4-6 hr. RCBF was quantitated in 14 gray matter regions from cross-sectional images and analyzed for differences from normal controls and changes with CL. Initial rCBF was lower in HI PTS than in either normal controls of LO PTS in all brain regions. CL lowered MAP in HI PTS by 52 +- 15 mm Hg and caused reduction in all gray matter regions except right frontal and right temporal (mean reduction 5 +- 2 ml/min/100 g, rho<.05). RCBF images were also evaluated by two trained observers for initial regional defects and for changes with CL. LO PTS were more likely to have defects in rCBF images at rest which would resolve with CL. HI PTS frequently had normal images at rest and developed defects with CL. In summary, the study suggests that SPECT may be useful in detecting rCBF abnormalities in hypertensive PTS at rest and following reductions in MAP

  5. Regional cerebral blood flow analysis of vascular dementia by the single photon emission computed tomography

    International Nuclear Information System (INIS)

    Miyakawa, Kouichi; Watanabe, Sho; Suzuki, Michiyo; Kamijima, Gonbei

    1989-01-01

    In order to evaluate the relationship between the regional cerebral blood flow (CBF) and cerebrovascular dementia, eleven patients with vascular dementia and eight patients with non-demented infarction were studied and regional CBF were measured quantitatively with single photon emission computed tomography (SPECT) by using N-isopropyl-p-(I-123) iodoamphetamine. All cases were basal infarction and vascular dementia were diagnosed by less than 21.5 of the Hasegawa's dementia score and more than 7 of Hachinsk's ischemic score. The results of the present study were as follows: (1) Cerebrovascular dementia showed lower mean CBF value compared with non-demented group. (2) Regional CBF of bilateral frontal areas and affected basal ganglia were significantly reduced than occipital area in the dementia group. (3) A comparison of regional CBF and the Hasegawa's dementia score revealed a statistically significant correlation at the bilateral frontal areas in the dementia group. It is possible that measuring the regional CBF quantitatively by IMP-SPECT is useful for clinical analysis of vascular dementia. (author)

  6. Regional cerebral blood flow in normal pressure hydrocephalus: diagnostic and prognostic aspects

    International Nuclear Information System (INIS)

    Larsson, A.; Bergh, A.C.; Bilting, M.; Aerlig, AA.; Jacobsson, L.; Stephensen, H.; Wikkelsoe, C.

    1994-01-01

    Relative regional cerebral blood flow (rrCBF) was measured by SPET using 99m Tc-HMPAO as flow tracer, in 23 patients with normal pressure hydrocephalus (NPH). 1000 MBq 99m Tc-HMPAO was given intravenously and the rrCBF calculated as regional/cerebellar count level ratios. The patients were examined before and 3-12 months after ventriculoperitoneal shunt surgery. rrCBF was also determined in ten healthy aged matched volunteers who served as controls. The NPH patients had decreased rrCBF in the hippocampal regions and in the frontal and parietal white matter as compared to the controls. The frontal/parietal rrCBF ratio correlated with both psychiatric disability and the preoperative degree of incontinence. Decreased flow in frontal white matter, frontoparietal and hippocampal grey matter and a low frontalparietal grey matter flow ratio preoperatively correlated with improvement in both Mini Mental State score and psychiatric disability after shunt surgery. After shunt surgery the rrCBF increased in the mesencephalon, frontal grey and white matter, parietal white matter and hippocampus. The flow increase in hippocampal regions and frontal white matter correlated with improvement in psychiatric symptomatology. The results of this study regarding the frontal and hippocampal rrCBF patterns, and the clinical correlation, support the hypothesis that CBF changes in these regions are of patohphysiological and prognostic importance in NPH. (orig./MG)

  7. Regional cerebral blood flow in older patients with chronic subdural hematoma

    International Nuclear Information System (INIS)

    Hoshi, Yutaka; Fuse, Masaaki; Iio, Masahiro; Fuziwara, Keigo; Kawaguchi, Shinichiro

    1978-01-01

    Regional cerebral blood flow (rCBF) was measured in 4 regions (frontal, parietal, occipital, and temporal) over the entire hemisphere using modified 133 Xe clearance method in 5 patients with chronic subdural hematoma. In 5 patients, rCBF was measured both pre- and postoperation and those values were compared. CBF (average cerebral blood flow) measurements were compared. CBF measurements were carried out in each patients respectively, that is before the operation and 3 weeks after the operation. Before the operation, the presence of chronic subdural hematoma, but brought about only slight or moderate generalized decrease in rCBF. The older patients presented subnormal values of 31.5 - 45.1 ml/100 g/min. Mean f sub(g) (the flow in the grey matter) of 5 patients was 66.8 +- 5.0 ml/100 g/min on the hematoma site, 58.1 +- 2.8 ml/100 g/min on the non-hematoma site before operation. Three weeks after operation mean f sub(g) was 65.5 +- 7.6 ml/100 g/min on the non-hematoma site, 64.2 +- 3.5 ml/100 g/min on the hematoma site, and CBFr of non-hematoma site was 40.2 +- 5.7 ml/100 g/min and that of hematoma site, 38.5 +- 8.8 ml/100 g/min. These figures are moderately smaller than that of the normal values. A comparison between regional flow values noted in patients of pre- and post-operation who has a removal of hematomas indicated that the flow values of non-hematoma site increased slightly 3 weeks after operation, inspite of the only slight or no improvement in neurological features. But the flow values (f sub(g), CBFr) of hematoma site decreased 3 weeks after operation. It seems that post-operative follow up of mean cerebral blood flow change might be of help in the assessment of prognosis of operation. (auth.)

  8. Regional cerebral blood flow in older patients with chronic subdural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, Y; Fuse, M; Iio, M; Fuziwara, K; Kawaguchi, S [Tokyo Metropolitan Geriatric Medical Center (Japan)

    1978-02-01

    Regional cerebral blood flow (rCBF) was measured in 4 regions (frontal, parietal, occipital, and temporal) over the entire hemisphere using modified /sup 133/Xe clearance method in 5 patients with chronic subdural hematoma. In 5 patients, rCBF was measured both pre- and postoperation and those values were compared. CBF (average cerebral blood flow) measurements were compared. CBF measurements were carried out in each patients respectively, that is before the operation and 3 weeks after the operation. Before the operation, the presence of chronic subdural hematoma, but brought about only slight or moderate generalized decrease in rCBF. The older patients presented subnormal values of 31.5 - 45.1 ml/100 g/min. Mean f sub(g) (the flow in the grey matter) of 5 patients was 66.8 +- 5.0 ml/100 g/min on the hematoma site, 58.1 +- 2.8 ml/100 g/min on the non-hematoma site before operation. Three weeks after operation mean f sub(g) was 65.5 +- 7.6 ml/100 g/min on the non-hematoma site, 64.2 +- 3.5 ml/100 g/min on the hematoma site, and CBFr of non-hematoma site was 40.2 +- 5.7 ml/100 g/min and that of hematoma site, 38.5 +- 8.8 ml/100 g/min. These figures are moderately smaller than that of the normal values. A comparison between regional flow values noted in patients of pre- and post-operation who has a removal of hematomas indicated that the flow values of non-hematoma site increased slightly 3 weeks after operation, inspite of the only slight or no improvement in neurological features. But the flow values (f sub(g), CBFr) of hematoma site decreased 3 weeks after operation. It seems that post-operative follow up of mean cerebral blood flow change might be of help in the assessment of prognosis of operation.

  9. Regional cerebral blood flow and cognitive function in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Huirong Guo

    2014-01-01

    Full Text Available Objective: To explore the relationship between regional cerebral blood flow (CBF and cognitive function in obsessive-compulsive disorder (OCD. Method: Single-photon emission computed tomography (SPECT was performed for 139 OCD patients and 139 controls, and the radioactivity rate (RAR was calculated. Cognitive function was assessed by the Wisconsin Card Sorting Test (WCST. Results: The RARs of the prefrontal, anterior temporal, and right occipital lobes were higher in patients than controls. For the WCST, correct and classification numbers were significantly lower, and errors and persistent errors were significantly higher in OCD patients. Right prefrontal lobe RAR was negatively correlated with correct numbers, right anterior temporal lobe RAR was positively correlated with errors, and the RARs of the right prefrontal lobe and left thalamus were positively correlated with persistent errors. Conclusion: OCD patients showed higher CBF in the prefrontal and anterior temporal lobes, suggesting that these areas may be related with cognitive impairment.

  10. Regional cerebral metabolic rate for glucose and cerebrospinal fluid monoamine metabolites in subacute sclerosing panencephalitis

    International Nuclear Information System (INIS)

    Yanai, Kazuhiko; Miyabayashi, Shigeaki; Iinuma, Kazuie; Tada, Keiya; Fukuda, Hiroshi; Ito, Masatoshi; Matsuzawa, Taiju.

    1987-01-01

    Regional cerebral metabolic rate for glucose (rCMRglu) and cerebrospinal fluid monoamine metabolites were measured in two cases of subacute sclerosing panencephalitis (SSPE) with different clinical courses. A marked decrease in rCMRglu was found in the cortical gray matter of a patient with rapidly developing SSPE (3.6 - 4.2 mg/100 g brain tissue/min). However, the rCMRglu was preserved in the caudate and lenticular nuclei of the patient (7.7 mg/100 g/min). The rCMRglu in a patient with slowly developing SSPE revealed patterns and values similar to those of the control. Cerebrospinal fluid monoamine metabolites ; homovanilic acid and 5-hydroxyindoleacetic acid, were decreased in both rapidly and slowly developing SSPE. These data indicated that rCMRglu correlated better with the neurological and psychological status and that dopaminergic and serotonergic abnormalities have been implicated in pathophysiology of SSPE. (author)

  11. Cyclotron production of krypton-77 for regional cerebral blood flow measurement

    International Nuclear Information System (INIS)

    Houdayer, A.J.; Meyer, E.; Yamamoto, Y.L.

    1977-01-01

    Krypton-77 has favourable decay characteristics for use in studies of regional cerebral blood flow, and the gas may be administered by inhalation. A description is given of the preparation and separation of radioactive sources of 77 Kr gas of strength between 1 and 5 mCi. The sources were produced via the reaction 79 Br(p,3n) 77 Kr induced by 30 MeV protons in targets of NaBr powder enriched to 99.75% 79 Br. A simple and rapid separation of the other contaminants produced in the target was achieved by means of cold traps. The fresh product showed no gamma ray spectra other than those of 77 Kr and 79 Kr, and only traces of 79 Kr were present. (U.K.)

  12. Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy

    International Nuclear Information System (INIS)

    Seibert, Tyler M.; Karunamuni, Roshan; Kaifi, Samar; Burkeen, Jeffrey; Connor, Michael; Krishnan, Anitha Priya; White, Nathan S.; Farid, Nikdokht; Bartsch, Hauke; Murzin, Vyacheslav; Nguyen, Tanya T.; Moiseenko, Vitali; Brewer, James B.; McDonald, Carrie R.; Dale, Anders M.; Hattangadi-Gluth, Jona A.

    2017-01-01

    Purpose and Objectives: Neurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy. Methods and Materials: We measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests. Results: Cortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significant radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002). Conclusions: Areas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations

  13. Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy

    Energy Technology Data Exchange (ETDEWEB)

    Seibert, Tyler M.; Karunamuni, Roshan; Kaifi, Samar; Burkeen, Jeffrey; Connor, Michael [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States); Krishnan, Anitha Priya; White, Nathan S.; Farid, Nikdokht; Bartsch, Hauke [Department of Radiology, University of California, San Diego, La Jolla, California (United States); Murzin, Vyacheslav [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States); Nguyen, Tanya T. [Department of Psychiatry, University of California, San Diego, La Jolla, California (United States); Moiseenko, Vitali [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States); Brewer, James B. [Department of Radiology, University of California, San Diego, La Jolla, California (United States); Department of Neurosciences, University of California, San Diego, La Jolla, California (United States); McDonald, Carrie R. [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States); Department of Psychiatry, University of California, San Diego, La Jolla, California (United States); Dale, Anders M. [Department of Radiology, University of California, San Diego, La Jolla, California (United States); Department of Psychiatry, University of California, San Diego, La Jolla, California (United States); Department of Neurosciences, University of California, San Diego, La Jolla, California (United States); Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States)

    2017-04-01

    Purpose and Objectives: Neurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy. Methods and Materials: We measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests. Results: Cortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significant radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002). Conclusions: Areas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations

  14. Specific metabolomics adaptations define a differential regional vulnerability in the adult human cerebral cortex

    Directory of Open Access Journals (Sweden)

    Rosanna Cabré

    2016-12-01

    Full Text Available Brain neurons offer diverse responses to stresses and detrimental factors during development and aging, and as a result of both neurodegenerative and neuropsychiatric disorders. This multiplicity of responses can be ascribed to the great diversity among neuronal populations. Here we have determined the metabolomic profile of three healthy adult human brain regions—entorhinal cortex, hippocampus, and frontal cortex—using mass spectrometry-based technologies. Our results show the existence of a lessened energy demand, mitochondrial stress, and lower one-carbon metabolism (particularly restricted to the methionine cycle specifically in frontal cortex. These findings, along with the better antioxidant capacity and lower mTOR signaling also seen in frontal cortex, suggest that this brain region is especially resistant to stress compared to the entorhinal cortex and hippocampus, which are more vulnerable regions. Globally, our results show the presence of specific metabolomics adaptations in three mature, healthy human brain regions, confirming the existence of cross-regional differences in cell vulnerability in the human cerebral cortex.

  15. Executive control of attention in narcolepsy.

    Directory of Open Access Journals (Sweden)

    Sophie Bayard

    Full Text Available BACKGROUND: Narcolepsy with cataplexy (NC is a disabling sleep disorder characterized by early loss of hypocretin neurons that project to areas involved in the attention network. We characterized the executive control of attention in drug-free patients with NC to determine whether the executive deficits observed in patients with NC are specific to the disease itself or whether they reflect performance changes due to the severity of excessive daytime sleepiness. METHODOLOGY: Twenty-two patients with NC compared to 22 patients with narcolepsy without cataplexy (NwC matched for age, gender, intellectual level, objective daytime sleepiness and number of sleep onset REM periods (SOREMPs were studied. Thirty-two matched healthy controls were included. All participants underwent a standardized interview, completed questionnaires, and neuropsychological tests. All patients underwent a polysomnography followed by multiple sleep latency tests (MSLT, with neuropsychological evaluation performed the same day between MSLT sessions. PRINCIPAL FINDINGS: Irrespective of diagnosis, patients reported higher self-reported attentional complaints associated with the intensity of depressive symptoms. Patients with NC performed slower and more variably on simple reaction time tasks than patients with NwC, who did not differ from controls. Patients with NC and NwC generally performed slower, reacted more variably, and made more errors than controls on executive functioning tests. Individual profile analyses showed a clear heterogeneity of the severity of executive deficit. This severity was related to objective sleepiness, higher number of SOREMPs on the MSLT, and lower intelligence quotient. The nature and severity of the executive deficits were unrelated to NC and NwC diagnosis. CONCLUSIONS: We demonstrated that drug-free patients with NC and NwC complained of attention deficit, with altered executive control of attention being explained by the severity of objective

  16. Mechanism of action of narcolepsy medications.

    Science.gov (United States)

    Gowda, Chandan R; Lundt, Leslie P

    2014-12-01

    The medications used to treat narcolepsy are targeted toward alleviating symptoms such as excessive sleepiness and cataplexy. The cause of this neurological sleep disorder is still not completely clear, though a destruction of hypocretin/orexin neurons has been implicated. The destruction of these neurons is linked to inactivity of neurotransmitters including histamine, norepinephrine, acetylcholine, and serotonin, causing a disturbance in the sleep/wake cycles of narcoleptic patients. Stimulants and MAOIs have traditionally been used to counteract excessive daytime sleepiness and sleep attacks by inhibiting the breakdown of catecholamines. Newer drugs, called wake-promoting agents, have recently become first-line agents due to their better side-effect profile, efficacy, and lesser potential for abuse. These agents similarly inhibit reuptake of dopamine, but have a novel mechanism of action, as they have been found to increase neuronal activity in the tuberomamillary nucleus and in orexin neurons. Sodium oxybate, a sodium salt of gamma-hydroxybutyrate (GHB), is another class that is used to treat many symptoms of narcolepsy, and is the only U.S. Food and Drug Administration (FDA)-approved medication for cataplexy. It has a different mechanism of action than either stimulants or wake-promoting agents, as it binds to its own unique receptor. Antidepressants, like selective serotonin re-uptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), have also been used, as similar to stimulants, they inhibit reuptake of specific catecholamines. In this article, we seek to review the mechanisms behind these classes of drugs in relation to the proposed pathophysiology of narcolepsy. Appropriate clinical strategies will be discussed, including specific combinations of medications that have been shown to be effective.

  17. A consensus definition of cataplexy in mouse models of narcolepsy.

    Science.gov (United States)

    Scammell, Thomas E; Willie, Jon T; Guilleminault, Christian; Siegel, Jerome M

    2009-01-01

    People with narcolepsy often have episodes of cataplexy, brief periods of muscle weakness triggered by strong emotions. Many researchers are now studying mouse models of narcolepsy, but definitions of cataplexy-like behavior in mice differ across labs. To establish a common language, the International Working Group on Rodent Models of Narcolepsy reviewed the literature on cataplexy in people with narcolepsy and in dog and mouse models of narcolepsy and then developed a consensus definition of murine cataplexy. The group concluded that murine cataplexy is an abrupt episode of nuchal atonia lasting at least 10 seconds. In addition, theta activity dominates the EEG during the episode, and video recordings document immobility. To distinguish a cataplexy episode from REM sleep after a brief awakening, at least 40 seconds of wakefulness must precede the episode. Bouts of cataplexy fitting this definition are common in mice with disrupted orexin/hypocretin signaling, but these events almost never occur in wild type mice. It remains unclear whether murine cataplexy is triggered by strong emotions or whether mice remain conscious during the episodes as in people with narcolepsy. This working definition provides helpful insights into murine cataplexy and should allow objective and accurate comparisons of cataplexy in future studies using mouse models of narcolepsy.

  18. Pharmacological management of narcolepsy with and without cataplexy.

    Science.gov (United States)

    Kallweit, Ulf; Bassetti, Claudio L

    2017-06-01

    Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy has a major impact on workableness and quality of life. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. First- and second-line options are discussed as well as combination therapies. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Finally, this review considers potential future management strategies. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies.

  19. Sleep Transitions in Hypocretin-Deficient Narcolepsy

    DEFF Research Database (Denmark)

    Sorensen, Gertrud Laura; Knudsen, Stine; Jennum, Poul

    2013-01-01

    Narcolepsy is characterized by instability of sleep-wake, tonus, and rapid eye movement (REM) sleep regulation. It is associated with severe hypothalamic hypocretin deficiency, especially in patients with cataplexy (loss of tonus). As the hypocretin neurons coordinate and stabilize the brain......'s sleep-wake pattern, tonus, and REM flip-flop neuronal centers in animal models, we set out to determine whether hypocretin deficiency and/or cataplexy predicts the unstable sleep-wake and REM sleep pattern of the human phenotype....

  20. New developments in the management of narcolepsy

    Directory of Open Access Journals (Sweden)

    Abad VC

    2017-03-01

    Full Text Available Vivien C Abad, Christian Guilleminault Department of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University Outpatient Center, Redwood City, CA, USA Abstract: Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%–0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy’s strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss. Current treatment modalities alleviate the main symptoms of excessive daytime somnolence (EDS and cataplexy and, to a lesser extent, reduce nocturnal sleep disruption, hypnagogic hallucinations, and sleep paralysis. Sodium oxybate (SXB, a sodium salt of γ hydroxybutyric acid, is a first-line agent for cataplexy and EDS and may help sleep disruption, hypnagogic hallucinations, and sleep paralysis. Various antidepressant medications including norepinephrine serotonin reuptake inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants are second-line agents for treating cataplexy. In addition to SXB, modafinil and armodafinil are first-line agents to treat EDS. Second-line agents for EDS are stimulants such as methylphenidate and extended-release amphetamines. Emerging therapies include non-hypocretin-based therapy, hypocretin-based treatments, and immunotherapy to prevent hypocretin neuronal death. Non-hypocretin-based novel treatments for narcolepsy include pitolisant (BF2.649, tiprolisant; JZP-110 (ADX-N05 for EDS in adults; JZP 13-005 for children; JZP-386, a deuterated sodium oxybate oral suspension; FT 218 an extended-release formulation of SXB; and JNJ-17216498, a new formulation of modafinil. Clinical trials are

  1. New developments in the management of narcolepsy.

    Science.gov (United States)

    Abad, Vivien C; Guilleminault, Christian

    2017-01-01

    Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%-0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy's strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss. Current treatment modalities alleviate the main symptoms of excessive daytime somnolence (EDS) and cataplexy and, to a lesser extent, reduce nocturnal sleep disruption, hypnagogic hallucinations, and sleep paralysis. Sodium oxybate (SXB), a sodium salt of γ hydroxybutyric acid, is a first-line agent for cataplexy and EDS and may help sleep disruption, hypnagogic hallucinations, and sleep paralysis. Various antidepressant medications including norepinephrine serotonin reuptake inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants are second-line agents for treating cataplexy. In addition to SXB, modafinil and armodafinil are first-line agents to treat EDS. Second-line agents for EDS are stimulants such as methylphenidate and extended-release amphetamines. Emerging therapies include non-hypocretin-based therapy, hypocretin-based treatments, and immunotherapy to prevent hypocretin neuronal death. Non-hypocretin-based novel treatments for narcolepsy include pitolisant (BF2.649, tiprolisant); JZP-110 (ADX-N05) for EDS in adults; JZP 13-005 for children; JZP-386, a deuterated sodium oxybate oral suspension; FT 218 an extended-release formulation of SXB; and JNJ-17216498, a new formulation of modafinil. Clinical trials are investigating efficacy and safety of SXB, modafinil, and armodafinil in children. γ-amino butyric acid (GABA) modulation with GABA A receptor agonists clarithromycin and flumazenil may help daytime somnolence

  2. Degenerative pontine lesions in patients with familial narcolepsy.

    Science.gov (United States)

    Stepień, Adam; Staszewski, Jacek; Domzał, Teofan M; Tomczykiewicz, Kazimierz; Skrobowska, Ewa; Durka-Kesy, Marta

    2010-01-01

    Narcolepsy is characterized by chronic excessive daytime sleepiness with episodic sleep attacks. There are several associated symptoms of narcolepsy: cataplexy (bilateral muscle weakness without loss of consciousness provoked by an emotional trigger, e.g. laughter), sleep paralysis and hypnagogic-hypnopompic hallucinations. Most cases are sporadic; familial narcolepsy contributes to only 1-5% of all cases. While most cases of narcolepsy are idiopathic and are not associated with clinical or radiographic evidence of brain pathology, symptomatic or secondary narcolepsy may occur occasionally in association with lesions caused by tumours, demyelination or strokes of the diencephalon, midbrain, and pons. There are some examples of non-specific brainstem lesions found in magnetic resonance imaging (MRI) in patients with idiopathic narcolepsy. The authors present eleven patients from a five-generation family with many members who suffer from episodic excessive daytime sleepiness. Narcolepsy was diagnosed in 9 patients. Sleepiness was frequently associated with cataplexy, hypnagogic-hypnopompic hallucinations and sleep paralysis. Improvement in their clinical state was observed during the treatment with modafinil. All probands had MRI of the brain, routine blood tests, EEG, polysomnography, examination of the level of hypocretin in cerebrospinal fluid and evaluation by means of Epworth and Stanford Sleepiness Scales. In 9 patients with narcolepsy, decreased thickness of the substantia nigra was found and in six of them degenerative lesions in the pontine substantia nigra were also noticed. The significance of these changes remains unclear. No data have been published until now concerning the presence of any brain lesions in patients with familial narcolepsy.

  3. The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery.

    Science.gov (United States)

    Song, Inkyung; Kim, Dong Yeon; Kim, Youn Jin

    2012-11-01

    Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixty-five years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO(2)) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. The decrease of rSO(2) was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.

  4. Determinants of inclusive education of 8-12 year-old children with cerebral palsy in 9 European regions

    DEFF Research Database (Denmark)

    Sentenac, Mariane; Ehlinger, Virginie; Michelsen, Susan Ishøy

    2013-01-01

    The principle of inclusive education has been increasingly recognised over recent decades and most countries officially support schooling of children with disabilities in mainstream settings. The SPARCLE study offers the opportunity to report on the schooling practices for children with cerebral...... on inclusion in mainstream school, depending on the region....

  5. Regional cerebral blood flow during rest and skilled hand movements by xenon-133 inhalation and emission computerized tomography

    DEFF Research Database (Denmark)

    Lauritzen, M; Henriksen, L; Lassen, N A

    1981-01-01

    Regional cerebral blood flow (CBF) was studied in 16 normal adult volunteers during rest and in 10 the study was repeated during skilled hand movements. A fast-rotating ("dynamic"), single-photon emission computerized tomograph (ECT) with four detector heads was used. Xenon-133 was inhaled over a 1...... motor area on both sides by 34 +/- 15% (p less than 0.025)....

  6. Characteristic regional cerebral blood flow patterns in anorexia nervosa patients with binge/purge behavior.

    Science.gov (United States)

    Naruo, T; Nakabeppu, Y; Sagiyama, K; Munemoto, T; Homan, N; Deguchi, D; Nakajo, M; Nozoe, S

    2000-09-01

    The authors' goal was to investigate the effect of imagining food on the regional cerebral blood flow (rCBF) of anorexia nervosa patients with and without habitual binge/purge behavior. The subjects included seven female patients with purely restrictive anorexia, seven female patients with anorexia and habitual binge/purge behavior, and seven healthy women. Single photon emission computed tomography examination was performed before and after the subjects were asked to imagine food. Changes in rCBF count ratios (percent change) were then calculated and compared. The subjects were also asked to assess their degree of fear regarding their control of food intake. The anorexia nervosa patients with habitual binge/purge behavior had a significantly higher percent change in the inferior, superior, prefrontal, and parietal regions of the right brain than the patients with purely restrictive anorexia and the healthy volunteers. The patients with habitual binge/purge behavior also had the highest level of apprehension in regard to food intake. Specific activation in cortical regions suggests an association between habitual binge/purge behavior and the food recognition process linked to anxiety in patients with anorexia nervosa.

  7. Single-photon tomographic determination of regional cerebral blood flow in psychiatric disorders

    International Nuclear Information System (INIS)

    Devous, M.D. Sr.; Rush, A.J.; Schlesser, M.A.; Debus, J.; Raese, J.D.; Chehabi, H.H.; Bonte, F.J.

    1984-01-01

    Regional cerebral blood flow (rCBF) was measured by single-photon emission computed tomography (SPECT) of 133-Xe washout in 29 normal volunteers, 22 unipolar endogenous depressives (UPE), 9 unipolar nonendogenous depressives (UPNE), 13 bipolar depressed patients (BPD), and 14 schizophrenic patients (SCHZ). RCBF was measured 2 and 6 cm above and parallel to the cantho-meatal line and quantitated in 14 gray matter regions. Most subjects were drug-free for 4-14 days. Diagnoses were made by experienced clinicians employing the Research Diagnostic Criteria, the Hamilton Rating Scale, and the dexamethasone suppression test. SCHZ were rated with the Brief Psychiatric Rating Scale. UPE had reduced flow compared to normals in the right parietal and temporal lobes and a nonsignificant trend toward left temporal flow reductions. UPNE were not different from normal or other patient groups. BPD had significant flow elevations in the left hemisphere relative to normal, and in both hemispheres relative to UPE. SCHZ were not significantly different from normal or other patient groups. Anterior-posterior flow shifts were evaluated by subtracting parietal or temporal flows from frontal flows. SCHZ demonstrated a greater posterior shift (lower relative frontal lobe flow) in comparison to both UPE and UPNE. The most significant regional flow abnormalities were observed as frontal flow reductions in individual SCHZ, although these were not significant in the whole group in comparison to normal

  8. Regional cerebral blood flow (rCBF) changes in major depression

    International Nuclear Information System (INIS)

    Ohtaki, Junichi

    1992-01-01

    Regional cerebral blood flow (rCBF) in patients with major depression and in normal controls was measured by single photon emission computed tomography (SPECT) using N-isopropyl-p [ 123 I]-iodoamphetamine (IMP). The subjects were 22 patients with major depression and 14 normal controls. The rCBF was calculated by the ratio of activity per pixel in the cortical regions to activity per pixel in the cerebellum. IMP-SPECT was conducted in patients with major depression under the depressive and remitted states. rCBF values in the frontal, parietal, temporal, basal ganglia and the occipital regions, and the mean rCBF values were significantly lower in depressive patients than in the controls. Increased rCBF values were observed, and the mean rCBF became normal in the state of remittence. There was no significant difference in mean rCBF between depressive patients and the controls. Therefore, because the lower rCBF was normalized following improvement in expressive symptoms, the rCBF values could be useful as 'state dependent markers' in patients with major depression. (author)

  9. Regional cerebral blood volume (rCBV) in the cerebral and cerebellar hemispheres in nomal 52 healthy adults. Measurement with contrast-enhanced dynamic echo-planar imaging

    Energy Technology Data Exchange (ETDEWEB)

    Muroi, Kenzo; Kurihara, Hiroaki; Amauchi, Hiroshi; Nozawa, Takeo; Matsubara, Sho; Yamamoto, Isao [Yokohama City Univ. (Japan). Hospital; Iwasawa, Tae

    2001-05-01

    The aim of this study was to investigate the possibility of absolute quantification of mean transit time (MTT) and rCBV in normal 52 healthy adults using contrast-enhanced dynamic echo-planar imaging, changes in signals in the middle cerebral arteries (MCAs) in the Sylvian fissures as AIF. MR was performed with a 1.5 T magnet (Horizon, GE Medical System, Milwaukee, WI). Dynamic susceptibility contrast-enhanced imaging was obtained every 1.8 second using echo-planar imaging (EPI) sequence (TE=42 msec, matrices=128 x 128) in six slices (6 mm slice thickness with 10 mm gap) including the cerebellar hemisphere at the level of middle cerebellar peduncles. The regional cerebral blood volume (rCBV) was calculated based on dilution theory. We calculated rCBV of the cerebral white matter (WM), cortical gray matter (GM), and cerebellar hemispheres (CH), and the effect of age on MTT and rCBV were evaluated linear regression analyses. The MTT of MCAs did not change with age, and the area under the curve of MCAs declined slightly with age. The mean rCBV of cortical GM, cerebral WM and cerebellar hemispheres were 8.2{+-}2.8, 2.0{+-}0.8 and 8.8{+-}2.1 respectively. The rCBV of cortical GM and the CH decreased slightly with age, however, that of WM remained to be a greater extent than those in GM. From these results, the method using AIF determined in bilateral MCAs was considered as an practical approach for the quantification of rCBV. Further clinical and/or comparative studies with other modalities will be necessary for the application of this method for patients with atherosclerosis and/or major vessel occlusion. (author)

  10. Facing emotions in narcolepsy with cataplexy: haemodynamic and behavioural responses during emotional stimulation.

    Science.gov (United States)

    de Zambotti, Massimiliano; Pizza, Fabio; Covassin, Naima; Vandi, Stefano; Cellini, Nicola; Stegagno, Luciano; Plazzi, Giuseppe

    2014-08-01

    Narcolepsy with cataplexy is a complex sleep disorder that affects the modulation of emotions: cataplexy, the key symptom of narcolepsy, is indeed strongly linked with emotions that usually trigger the episodes. Our study aimed to investigate haemodynamic and behavioural responses during emotional stimulation in narco-cataplexy. Twelve adult drug-naive narcoleptic patients (five males; age: 33.3 ± 9.4 years) and 12 healthy controls (five males; age: 30.9 ± 9.5 years) were exposed to emotional stimuli (pleasant, unpleasant and neutral pictures). Heart rate, arterial blood pressure and mean cerebral blood flow velocity of the middle cerebral arteries were continuously recorded using photoplethysmography and Doppler ultrasound. Ratings of valence and arousal and coping strategies were scored by the Self-Assessment Manikin and by questionnaires, respectively. Narcoleptic patients' haemodynamic responses to pictures overlapped with the data obtained from controls: decrease of heart rate and increase of mean cerebral blood flow velocity regardless of pictures' content, increase of systolic blood pressure during the pleasant condition, and relative reduction of heart rate during pleasant and unpleasant conditions. However, when compared with controls, narcoleptic patients reported lower arousal scores during the pleasant and neutral stimulation, and lower valence scores during the pleasant condition, respectively, and also a lower score at the 'focus on and venting of emotions' dimensions of coping. Our results suggested that adult narcoleptic patients, compared with healthy controls, inhibited their emotion-expressive behaviour to emotional stimulation, and that may be related to the development of adaptive cognitive strategies to face emotions avoiding cataplexy. © 2014 European Sleep Research Society.

  11. Decreased regional cerebral glucose metabolism in the prefrontal regions in adults' with internet game addiction

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Soo; Bang, Soong Ae; Yoon, Eun Jin; Cho, Sang Soo; Kim, Sang Hee; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Internet Game Addiction (IGA) is known to be associated with poor decision-making and diminished impulse control; however, the underlying neural substrates of IGA have not been identified. To investigate the neural substrates of IGA, we compared regional cerebral glucose metabolism between adults with and without IGA, primarily in the prefrontal brain regions, which have been implicated in inhibitory control. We studied 10 right-handed participants (5 controls: male, 23.8{+-}0.75 y, 5 IGAs: male, 22.6{+-}2.42 y) with FDG PET. A standardized questionnaire was used to assess the severity of IGA. Before scanning, all subjects carried out a computerized version of the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART), as measures of behavioral inhibitory control. Statistical Parametric Mapping 2 (SPM2) was used to analyze differences in regional brain glucose metabolism between adults with and without IGA. Consistent with our predictions, compared to controls, significant reductions in FDG uptake in individuals with IGA were found in the bilateral orbitofrontal gyrus (BA 11, 47), bilateral inferior frontal gyrus (BA 44, 48), cingulate cortex (BA 24), and bilateral supplementary motor area (SMA) (BA 6); whereas increases were found in the bilateral hippocampus. Correlation analyses within the IGA group further showed that the level of glucose metabolism in the right orbitofrontal gyrus was marginally positively correlated with task scores in BART. Our results showed that IGA is associated with reduced glucose metabolism in the prefrontal regions involved in inhibitory control. This finding highlights dysfunctional inhibitory brain systems in individuals with IGA and offers implications for the development for therapeutic paradigms for IGA.

  12. Improvement in regional CBF by L-serine contributes to its neuroprotective effect in rats after focal cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Tao-Jie Ren

    Full Text Available To investigate the mechanisms underlying the neuroprotective effect of L-serine, permanent focal cerebral ischemia was induced by occlusion of the middle cerebral artery while monitoring cerebral blood flow (CBF. Rats were divided into control and L-serine-treated groups after middle cerebral artery occlusion. The neurological deficit score and brain infarct volume were assessed. Nissl staining was used to quantify the cortical injury. L-serine and D-serine levels in the ischemic cortex were analyzed with high performance liquid chromatography. We found that L-serine treatment: 1 reduced the neurological deficit score, infarct volume and cortical neuron loss in a dose-dependent manner; 2 improved CBF in the cortex, and this effect was inhibited in the presence of apamin plus charybdotoxin while the alleviation of both neurological deficit score and infarct volume was blocked; and 3 increased the amount of L-serine and D-serine in the cortex, and inhibition of the conversion of L-serine into D-serine by aminooxyacetic acid did not affect the reduction of neurological deficit score and infarct volume by L-serine. In conclusion, improvement in regional CBF by L-serine may contribute to its neuroprotective effect on the ischemic brain, potentially through vasodilation which is mediated by the small- and intermediate-conductance Ca(2+-activated K(+ channels on the cerebral blood vessel endothelium.

  13. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  14. Gender differences in age-related decline in regional cerebral glucose metabolism

    International Nuclear Information System (INIS)

    Bang, Seong Ae; Cho, Sang Soo; Yoon, Eun Jin; Park, Hyun Soo; Lee, Eun Ju; Kim, Yu Kyeong; Kim, Sang Sun

    2007-01-01

    In this study, we investigated gender differences in age-related declines in regional cerebral glucose metabolism using FDG-PET in a large population sample with a broad age range. 230 healthy subjects (90 male; age: 34-80 y, 140 females; age: 33-82 y) participated. Correlation maps showing age related declines in glucose uptake were created separately for each gender in SPM2. Using population-based probabilistic volume of interests (VOIs), VOIs were defined for the regions showing significant decline with aging. Age related declines were separately assessed within each age range using analysis of covariate in SPSS 13.0. In the total population without gender effect, age-related negative correlation of glucose metabolism was found in the bilateral inferior frontal gyri, bilateral caudate, bilateral thalamus, left insula, left superior frontal gyrus, left uncus, right superior temporal gyrus, right medial frontal gyrus, right parahippocampal gyrus, right anterior cingulate gyrus (P < 0.001 corrected, extent threshold k = 100). 14 VOIs values of brain regions were calculated based on this negative correlation results. The rate of decline across all defined VOIs assessed in the age category of 'more than 70' referenced to the category of '30- 39years' were 7.85% in the entire sample; 7.62% in male and 8.09% in female. Detailed analyses of declines in each age range showed separable patterns of declines across gender. In males, greater decline was observed after the age 60 (20.45%) than the ages of 30 and 50(7.98%). Whereas in females, greater declines were found in age 60s (20.15%) compared to 50s, and in 40(14.84%) compared to 30s. Age-related decline in cerebral glucose metabolism was found in both genders. We further observed that males show a relatively constant pattern of decline across a life span; whereas, females show a pattern of steep changes aging to 60s and to 40s, which may be related to changes in sex hormone levels after menopause

  15. Gender differences in age-related decline in regional cerebral glucose metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Seong Ae; Cho, Sang Soo; Yoon, Eun Jin; Park, Hyun Soo; Lee, Eun Ju; Kim, Yu Kyeong; Kim, Sang Sun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    In this study, we investigated gender differences in age-related declines in regional cerebral glucose metabolism using FDG-PET in a large population sample with a broad age range. 230 healthy subjects (90 male; age: 34-80 y, 140 females; age: 33-82 y) participated. Correlation maps showing age related declines in glucose uptake were created separately for each gender in SPM2. Using population-based probabilistic volume of interests (VOIs), VOIs were defined for the regions showing significant decline with aging. Age related declines were separately assessed within each age range using analysis of covariate in SPSS 13.0. In the total population without gender effect, age-related negative correlation of glucose metabolism was found in the bilateral inferior frontal gyri, bilateral caudate, bilateral thalamus, left insula, left superior frontal gyrus, left uncus, right superior temporal gyrus, right medial frontal gyrus, right parahippocampal gyrus, right anterior cingulate gyrus (P < 0.001 corrected, extent threshold k = 100). 14 VOIs values of brain regions were calculated based on this negative correlation results. The rate of decline across all defined VOIs assessed in the age category of 'more than 70' referenced to the category of '30- 39years' were 7.85% in the entire sample; 7.62% in male and 8.09% in female. Detailed analyses of declines in each age range showed separable patterns of declines across gender. In males, greater decline was observed after the age 60 (20.45%) than the ages of 30 and 50(7.98%). Whereas in females, greater declines were found in age 60s (20.15%) compared to 50s, and in 40(14.84%) compared to 30s. Age-related decline in cerebral glucose metabolism was found in both genders. We further observed that males show a relatively constant pattern of decline across a life span; whereas, females show a pattern of steep changes aging to 60s and to 40s, which may be related to changes in sex hormone levels after menopause.

  16. Baseline and cognition activated regional cerebral brain flow of naive paranoid schizophrenics

    International Nuclear Information System (INIS)

    Li Huafang; Gu Niufan; Xiu Yan; Chen Shaoliang

    2002-01-01

    Objective: To investigate the baseline and cognition activated regional cerebral blood flow (rCBF) in naive paranoid schizophrenics and the relationships between the symptoms and rCBF. Methods: The scale of positive and negative syndrome scale (PANSS) was adopted to evaluate the symptoms of schizophrenia. The baseline and cognition activated 99 Tc m -ethylcysteinate dimmer (ECD) SPECT were performed one after the other within two days. Wisconsin card sorting test (WCST) was used as cognitive task. Semi-quantitative analyses were applied. Results: There were no significant differences of WCST results between two groups. Compared with normal controls, the baseline rCBF ratios of left to right interior posterior temporal cortex in patients were significantly higher, while that of left mid-medial frontal cortex was significantly lower in patients. There was no significant difference of rCBF ratios of baseline to cognition activated states in patients. WCST couldn't activate the frontal function in patients. The total score of PANSS, score of positive subscale and general syndrome subscale were correlated with the rCBF ratio of several regions of interest (ROIs) . Some symptoms were correlated with the rCBF ratio of some ROIs. Conclusions: The hyperperfusion of left and right temporal inferior posterior cortex and hypoperfusion of left mid-medial frontal cortex could be seen in naive paranoid schizophrenics. Hypofrontality existed in patients before treatment. Some positive symptoms were correlated with the rCBF of some ROI

  17. Regional cerebral blood flow in diagnosis of childhood onset partial epilepsy

    International Nuclear Information System (INIS)

    Mitsuyoshi, Izuru; Tamaki, Kyoko; Mutoh, Kozo; Iwasaki, Yasushi; Konishi, Junji; Mikawa, Haruki; Okuno, Takehiko.

    1993-01-01

    We compared regional cerebral blood flow assessed by [ 123 I]N-isopropyl-p-iodoamphetamine (IMP) single-photon emission tomography (SPECT) with magnetic resonance imaging (MRI), computed tomography (CT) and interictal surface electroencephalography (EEG) to evaluate its diagnostic potential in 24 patients with partial seizures with onset in childhood. Focal low uptake areas were observed in SPECT scans of 18 patients and were presumed to represent epileptogenic areas in 17. MRI revealed an abnormality in 12 and CT in 6 patients, and all organic lesions showed SPECT abnormalities, too. Six patients without focal structural abnormalities showed regional perfusion deficit on SPECT. Routine scalp EEG revealed an epileptic focus in 17 patients and three of them showed discordant results between SPECT and EEG, which suggested more serious brain disorders. In two patients without EEG localization only SPECT showed focal abnormalities in the probable epileptic area. [ 123 I]IMP-SPECT was useful in locating the epileptic focus, particularly during the early period after the onset of partial seizures when the EEG gave inconclusive results. (author)

  18. Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia

    International Nuclear Information System (INIS)

    Ohnishi, T.; Hoshi, H.; Nagamachi, S.; Jinnouchi, S.; Futami, S.; Watanabe, K.; Mitsuyama, Y.

    1991-01-01

    Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia

  19. Identification by functional MRI of human cerebral region activated by taste stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Kakimoto, Naoya [Osaka Univ. (Japan). Faculty of Dentistry

    2000-09-01

    The purpose of this study was the examination of possible imaging of the primary taste region of human cerebral cortex by functional MRI (fMRI). Subjects were 19-36 years old, healthy adult male and female volunteers given information concerning the purpose, significance and method of the study. MRI equipment was 1.5 T Signa Horizon (GE) with Head Coil. Images were processed by the software FuncTool on the Advantage Windows Workstation (GE). Taste stimulation was done by swab bearing the solution of 4% quinine hydrochloride, 20% sodium chloride or distilled water (control) or by dripping from the syringe of the solutions, 8% tartaric acid or 80% sugar. Preliminary examinations with the swab suggested the possibility of the identification. Further, with use of dripping apparatus, the taste active region was shown to be identified by fMRI and of which area tended to be larger in male than in female: a significant difference was seen for the quinine hydrochloride. As above, the method was suggested to be a diagnostic mean for the taste perception. (K.H.)

  20. Identification by functional MRI of human cerebral region activated by taste stimulation

    International Nuclear Information System (INIS)

    Kakimoto, Naoya

    2000-01-01

    The purpose of this study was the examination of possible imaging of the primary taste region of human cerebral cortex by functional MRI (fMRI). Subjects were 19-36 years old, healthy adult male and female volunteers given information concerning the purpose, significance and method of the study. MRI equipment was 1.5 T Signa Horizon (GE) with Head Coil. Images were processed by the software FuncTool on the Advantage Windows Workstation (GE). Taste stimulation was done by swab bearing the solution of 4% quinine hydrochloride, 20% sodium chloride or distilled water (control) or by dripping from the syringe of the solutions, 8% tartaric acid or 80% sugar. Preliminary examinations with the swab suggested the possibility of the identification. Further, with use of dripping apparatus, the taste active region was shown to be identified by fMRI and of which area tended to be larger in male than in female: a significant difference was seen for the quinine hydrochloride. As above, the method was suggested to be a diagnostic mean for the taste perception. (K.H.)

  1. Measurement of regional cerebral blood flow by intravenous administation of 133 xenon

    International Nuclear Information System (INIS)

    Ryding, E.

    1986-01-01

    Reviewing the background and the theory for rCFB measurements the following conditions are established for the use of flow measurement with 133-Xenon as a reliable indicator for indirect measurements of cerebral functional activity. 1. There is a strict coupling between rCBF and regional metabolism. This condition can only be considered to be fulfilled in the normal non-anoxic bran tissue. 2. There is a close correlation between the tissue and the venous concentration of 133-Xenin which can be reliably approximated by the blood-brain partition coefficient. This condition can be considered to be fullfilled in the normal flow range, but not in pathological conditions such as cerebrovascular occlusions. 3. Intercompartment diffusion of 133-Xenon has no significant effect upon the measurement of rCBF values. This condition appear to share its limitations for fulfilement with condition 2. 4. There is no significant contamination by the extracerebral flow components at IH or IV rCBF measurements. 5. There is a negligible 'look through' effect from surrounding areas to region with focal high or low blood flow. (U.W.)

  2. Radiotracer transit measurements as an index of regional cerebral blood flow. Pt. 1. Methodological and clinical results in chronic alcoholics cortical blood flow

    International Nuclear Information System (INIS)

    Dobrzanski, T.

    1975-01-01

    The numerical mean values of the cerebral radiorheographic index in healthy control subjects and in patients with cerebrovascular disease were not significantly different from the values of regional cerebral blood flow reported, respectively, by other authors using a modification of the Xe-133 method. In the group of chronic alcoholics there was a significant correlation between the duration of alcoholism and certain numerical values of the cerebral radiorheographic index. (author)

  3. Regional cerebral blood flow changes associated with transcranial magnetic stimulation in refractory depressed patients

    International Nuclear Information System (INIS)

    Kim, C. H.; Chung, Y. A.; Chae, J. H.; Oh, J. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K.

    2005-01-01

    Imaging studies by repetitive transcranial magnetic stimulation (rTMS) demonstrates biological activities of the brain. The aim of this study was to investigate the patterns of regional cerebral blood flow (rCBF) after a series of therapeutic rTMS sessions. Nine patients with refractory depression who had not been responsive to appropriate pharmacotherapy over 1 year were randomly assigned to daily 1 Hz right-sided rTMS or 20 Hz left-sided rTMS sessions for over 3 weeks. Baseline and 3-week post-rTMS treatment SPECT images were obtained 40 minutes after intravenous injection of approximately 740925 MBq of Tc-99m ECD using a multi-detector scanner (ECAM plus; Siemens, Erlangen, Germany) equipped with a low-energy, fan-beam collimator. All patients showed a good clinical outcome. Statistically significant common increase in rCBF patterns was found in the fusiform gyrus of left temporal lobe, left hippocampus, left superior parietal lobule, superior frontal gyrus of right frontal lobe, right lateral globus pallidus and cingulated gyrus of both limbic lobes. And in the fusiform gyrus of left occipital lobe and middle frontal gyrus of right frontal lobe decreased uptake was seen compared to controls. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased activity in specific brain regions in patients with treatment refractory depression. Therapeutic TMS seems to influence distinct cortical regions, as well as different pathways, affecting rCBF in a homogeneous manner that is probably region dependent and illness related

  4. Regional cerebral glucose metabolism in frontotemporal dementia: a study with FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Cho, S. S.; Jeong, J.; Kang, S. J.; Na, D. L.; Choe, Y. S.; Lee, K. H.; Choi, Y.; Kim, B. T.; Kim, S. E. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    Frontotemporal dementia (FTD) is a common cause of presenile dementia. We investigated the regional cerebral glucose metabolic impairments in patients with FTD using FDG PET. We analysed the regional metabolic patterns on FDG PET images obtained from 30 patients with FTD and age- and sex-matched 15 patients with Alzheimers disease (AD) and 11 healthy subjects using SPM99. We also compared the inter-hemispheric metabolic asymmetry among the three groups by counting the total metabolic activity of each hemisphere and computing asymmetry index (AL) between hemispheres. The hypometabolic brain regions in FTD patients compared with healthy controls were as follows: superior middle and medial frontal lobules, superior and middle temporal lobules, anterior and posterior cingulate gyri, uncus, insula, lateral globus pallidus and thalamus. The regions with decreased metabolism in FTD patients compared with AD patients were as follows: superior, inferior and medial frontal lobules, anterior cingulate gyrus, and caudate nucleus. Twenty-five (83%) out of the 30 FTD patients had AI values that was beyond the 95% confidence interval of the AI values obtained from healthy controls; 10 patients had hypometabolism more severe on the right and 15 patients had the opposite pattern. In comparison, 10 (67%) out of the 15 AD patients had asymmetric metabolism. Our SPM analysis of FDG PET revealed additional areas of decreased metabolism in FTD patients compared with prior studies using the ROI method, involving frontal, temporal, cingulate gyrus, corpus callosum, uncus, insula, and some subcortical areas. The inter-hemispheric metabolic asymmetry was common in FTD patients, which can be another metabolic feature that helps differentiate FTD from AD.

  5. Regional cerebral blood flow changes associated with transcranial magnetic stimulation in refractory depressed patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, C. H.; Chung, Y. A.; Chae, J. H.; Oh, J. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    Imaging studies by repetitive transcranial magnetic stimulation (rTMS) demonstrates biological activities of the brain. The aim of this study was to investigate the patterns of regional cerebral blood flow (rCBF) after a series of therapeutic rTMS sessions. Nine patients with refractory depression who had not been responsive to appropriate pharmacotherapy over 1 year were randomly assigned to daily 1 Hz right-sided rTMS or 20 Hz left-sided rTMS sessions for over 3 weeks. Baseline and 3-week post-rTMS treatment SPECT images were obtained 40 minutes after intravenous injection of approximately 740925 MBq of Tc-99m ECD using a multi-detector scanner (ECAM plus; Siemens, Erlangen, Germany) equipped with a low-energy, fan-beam collimator. All patients showed a good clinical outcome. Statistically significant common increase in rCBF patterns was found in the fusiform gyrus of left temporal lobe, left hippocampus, left superior parietal lobule, superior frontal gyrus of right frontal lobe, right lateral globus pallidus and cingulated gyrus of both limbic lobes. And in the fusiform gyrus of left occipital lobe and middle frontal gyrus of right frontal lobe decreased uptake was seen compared to controls. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased activity in specific brain regions in patients with treatment refractory depression. Therapeutic TMS seems to influence distinct cortical regions, as well as different pathways, affecting rCBF in a homogeneous manner that is probably region dependent and illness related.

  6. Regional cerebral glucose metabolism in frontotemporal dementia: a study with FDG PET

    International Nuclear Information System (INIS)

    Cho, S. S.; Jeong, J.; Kang, S. J.; Na, D. L.; Choe, Y. S.; Lee, K. H.; Choi, Y.; Kim, B. T.; Kim, S. E.

    2002-01-01

    Frontotemporal dementia (FTD) is a common cause of presenile dementia. We investigated the regional cerebral glucose metabolic impairments in patients with FTD using FDG PET. We analysed the regional metabolic patterns on FDG PET images obtained from 30 patients with FTD and age- and sex-matched 15 patients with Alzheimers disease (AD) and 11 healthy subjects using SPM99. We also compared the inter-hemispheric metabolic asymmetry among the three groups by counting the total metabolic activity of each hemisphere and computing asymmetry index (AL) between hemispheres. The hypometabolic brain regions in FTD patients compared with healthy controls were as follows: superior middle and medial frontal lobules, superior and middle temporal lobules, anterior and posterior cingulate gyri, uncus, insula, lateral globus pallidus and thalamus. The regions with decreased metabolism in FTD patients compared with AD patients were as follows: superior, inferior and medial frontal lobules, anterior cingulate gyrus, and caudate nucleus. Twenty-five (83%) out of the 30 FTD patients had AI values that was beyond the 95% confidence interval of the AI values obtained from healthy controls; 10 patients had hypometabolism more severe on the right and 15 patients had the opposite pattern. In comparison, 10 (67%) out of the 15 AD patients had asymmetric metabolism. Our SPM analysis of FDG PET revealed additional areas of decreased metabolism in FTD patients compared with prior studies using the ROI method, involving frontal, temporal, cingulate gyrus, corpus callosum, uncus, insula, and some subcortical areas. The inter-hemispheric metabolic asymmetry was common in FTD patients, which can be another metabolic feature that helps differentiate FTD from AD

  7. Predictors of hypocretin (orexin) deficiency in narcolepsy without cataplexy

    DEFF Research Database (Denmark)

    Andlauer, Olivier; Moore, Hyatt; Hong, Seung-Chul

    2012-01-01

    To compare clinical, electrophysiologic, and biologic data in narcolepsy without cataplexy with low (≤ 110 pg/ml), intermediate (110-200 pg/ml), and normal (> 200 pg/ml) concentrations of cerebrospinal fluid (CSF) hypocretin-1.......To compare clinical, electrophysiologic, and biologic data in narcolepsy without cataplexy with low (≤ 110 pg/ml), intermediate (110-200 pg/ml), and normal (> 200 pg/ml) concentrations of cerebrospinal fluid (CSF) hypocretin-1....

  8. Increased immune complexes of hypocretin autoantibodies in narcolepsy.

    Science.gov (United States)

    Deloumeau, Aude; Bayard, Sophie; Coquerel, Quentin; Déchelotte, Pierre; Bole-Feysot, Christine; Carlander, Bertrand; Cochen De Cock, Valérie; Fetissov, Sergueï O; Dauvilliers, Yves

    2010-10-13

    Hypocretin peptides participate in the regulation of sleep-wake cycle while deficiency in hypocretin signaling and loss of hypocretin neurons are causative for narcolepsy-cataplexy. However, the mechanism responsible for alteration of the hypocretin system in narcolepsy-cataplexy and its relevance to other central hypersomnias remain unknown. Here we studied whether central hypersomnias can be associated with autoantibodies reacting with hypocretin-1 peptide present as immune complexes. Serum levels of free and dissociated (total) autoantibodies reacting with hypocretin-1 peptide were measured by enzyme-linked immunosorbent assay and analyzed with regard to clinical parameters in 82 subjects with narcolepsy-cataplexy, narcolepsy without cataplexy or idiopathic hypersomnia and were compared to 25 healthy controls. Serum levels of total but not free IgG autoantibodies against hypocretin-1 were increased in narcolepsy-cataplexy. Increased levels of complexed IgG autoantibodies against hypocretin-1 were found in all patients groups with a further increase in narcolepsy-cataplexy. Levels of total IgM hypocretin-1 autoantibodies were also elevated in all groups of patients. Increased levels of anti-idiotypic IgM autoantibodies reacting with hypocretin-1 IgG autoantibodies affinity purified from sera of subjects with narcolepsy-cataplexy were found in all three groups of patients. Disease duration correlated negatively with serum levels of hypocretin-1 IgG and IgM autoantibodies and with anti-idiotypic IgM autoantibodies. Central hypersomnias and particularly narcolepsy-cataplexy are characterized by higher serum levels of autoantibodies directed against hypocretin-1 which are present as immune complexes most likely with anti-idiotypic autoantibodies suggesting their relevance to the mechanism of sleep-wake cycle regulation.

  9. Increased immune complexes of hypocretin autoantibodies in narcolepsy.

    Directory of Open Access Journals (Sweden)

    Aude Deloumeau

    Full Text Available BACKGROUND: Hypocretin peptides participate in the regulation of sleep-wake cycle while deficiency in hypocretin signaling and loss of hypocretin neurons are causative for narcolepsy-cataplexy. However, the mechanism responsible for alteration of the hypocretin system in narcolepsy-cataplexy and its relevance to other central hypersomnias remain unknown. Here we studied whether central hypersomnias can be associated with autoantibodies reacting with hypocretin-1 peptide present as immune complexes. METHODOLOGY: Serum levels of free and dissociated (total autoantibodies reacting with hypocretin-1 peptide were measured by enzyme-linked immunosorbent assay and analyzed with regard to clinical parameters in 82 subjects with narcolepsy-cataplexy, narcolepsy without cataplexy or idiopathic hypersomnia and were compared to 25 healthy controls. PRINCIPAL FINDINGS: Serum levels of total but not free IgG autoantibodies against hypocretin-1 were increased in narcolepsy-cataplexy. Increased levels of complexed IgG autoantibodies against hypocretin-1 were found in all patients groups with a further increase in narcolepsy-cataplexy. Levels of total IgM hypocretin-1 autoantibodies were also elevated in all groups of patients. Increased levels of anti-idiotypic IgM autoantibodies reacting with hypocretin-1 IgG autoantibodies affinity purified from sera of subjects with narcolepsy-cataplexy were found in all three groups of patients. Disease duration correlated negatively with serum levels of hypocretin-1 IgG and IgM autoantibodies and with anti-idiotypic IgM autoantibodies. CONCLUSION: Central hypersomnias and particularly narcolepsy-cataplexy are characterized by higher serum levels of autoantibodies directed against hypocretin-1 which are present as immune complexes most likely with anti-idiotypic autoantibodies suggesting their relevance to the mechanism of sleep-wake cycle regulation.

  10. Narcolepsy and Orexins: An Example of Progress in Sleep Research

    Directory of Open Access Journals (Sweden)

    Alberto K De La Herrán-Arita

    2011-04-01

    Full Text Available Narcolepsy is a chronic neurodegenerative disease caused by a deficiency of orexin-producing neurons in the lateral hypothalamus (LH. It is clinically characterized by excessive daytime sleepiness and by intrusions into wakefulness of physiological aspects of rapid eye movement (REM sleep such as cataplexy, sleep paralysis and hypnagogic hallucinations. The major pathophysiology of narcolepsy has been recently described on the bases of the discovery of the neuropeptides named orexins (hypocretins in 1998; considerable evidence, summarized below, demonstrates that narcolepsy is the result of alterations in the genes involved in the pathology of the orexin ligand or its receptor. Deficient orexin transmission is sufficient to produce narcolepsy, as we describe here, animal models with dysregulated orexin signaling exhibit a narcolepsy-like phenotype. Remarkably, these narcoleptic models have different alterations of the orexinergic circuit, this diversity provide us with the means for making comparison, and have a better understanding of orexin cell physiology.It is of particular interest that the most remarkable findings regarding this sleep disorder were fortuitous and due to keen observations. Sleep is a highly intricate and regulated state, and narcolepsy is a disorder that still remains as one of the unsolved mysteries in science. Nevertheless, advances and development of technology in neuroscience will provide us with the necessary tools to unravel the narcolepsy puzzle in the near future.Through an evaluation of the scientific literature we traced an updated picture of narcolepsy and orexins in order to provide insight into the means by which neurobiological knowledge is constructed.

  11. Changes of cognition and regional cerebral activity during acute hypoglycemia in normal subjects

    DEFF Research Database (Denmark)

    Bie-Olsen, Lise G; Kjaer, Troels W; Pedersen-Bjergaard, Ulrik

    2009-01-01

    cerebral blood flow (rCBF) as a marker of cerebral activity. Hypoglycemia was induced by intravenous insulin infusion in 19 healthy men performing two different cognitive tasks of varying complexity. The hypoglycemic stimulus [plasma glucose 2.2 mmol/liter (0.4)] produced a significant hormonal...

  12. Regional cerebral perfusion for surgical correction of neonatal aortic arch obstruction.

    Science.gov (United States)

    Zhang, Hui; Cheng, Pei; Hou, Jia; Li, Lei; Liu, Hu; Liu, Ruifang; Ji, Bingyang; Luo, Yi

    2009-05-01

    One-stage repair of aortic arch obstruction and associated cardiac anomalies is a surgical challenge in infants.The purpose of the present study is to review the current outcome using regional cerebral perfusion (RCP) during a procedure correcting interrupted aortic arch (IAA) and also isolated aortic coarctation (CoA) and CoA combined with hypoplastic aortic arch (CoA-HyAA) in our center. Between January 2007 and July 2008, 24 infant patients with interrupted aortic arch (IAA) (n=3), isolated aortic coarctation (iCoA) (n=9) and aortic coarctation with hypoplastic aortic arch (CoA-HyAA) (n=12) underwent one-stage surgical correction in our hospital. End-to-end anastomosis was employed in 12 infants (IAA n=3 and iCoA n=9); for the other 12 patients with CoA-HyAA, an end-to-end extended anastomosis was used in 8 cases, end-to-side anastomosis in 2 cases, and composite heterologous pericardial patch in 2 cases. RCP with 40 mL/kg/min through the innominate artery during aortic arch reconstruction was employed for all pediatric patients. One single-dose histidine-ketoglutarate-tryptophan (HTK) solution was used for myocardial protection during CPB. Cardiopulmonary bypass time and aortic cross-clamp time were 165.6+/-32.4 min and 81.7+/-30.0 min, respectively. The mean regional cerebral perfusion time was 31.0+/-10.6 min; lowest nasopharyngeal temperature was 19.1+/-1.1 degrees C. Operative mortality rate in both groups was 8.3%. Mean follow-up was 10.5+/-4.8 months. There was no late mortality or postoperative neurologic, renal or hepatic complications. All patients are asymptomatic and are developing normally. One-stage total arch repair using the RCP technique is an excellent method that may minimize neurologic and renal complications. Our surgical strategy for arch anomaly has a low rate of residual and recurrent coarctation when performed in these infants.

  13. Delusional Confusion of Dreaming and Reality in Narcolepsy

    Science.gov (United States)

    Wamsley, Erin; Donjacour, Claire E.H.M.; Scammell, Thomas E.; Lammers, Gert Jan; Stickgold, Robert

    2014-01-01

    Study Objectives: We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. Design: We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. Setting: Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. Participants: Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). Interventions: N/A. Measurements and Results: “Dream delusions” were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. Conclusions: The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized. Citation: Wamsley E; Donjacour CE; Scammell TE; Lammers GJ; Stickgold R. Delusional confusion of dreaming and reality in narcolepsy. SLEEP 2014;37(2):419-422. PMID:24501437

  14. A Global View on Narcolepsy - A Review Study.

    Science.gov (United States)

    Klimova, Blanka; Maresova, Petra; Novotny, Michal; Kuca, Kamil

    2018-02-14

    Narcolepsy is an incurable neurological disorder when the brain is not able to regulate a sleep and wakefulness cycle correctly. The affected person suddenly falls asleep during the day or he/she suffers from excessive day sleepiness. In addition, people may also suffer from cataplexy, hypnagogic hallucinations, sleep paralysis, and disturbed nighttime sleep. The purpose of this review study is to provide the latest information on both clinical and socioeconomic issues in the field of narcolepsy treatment and emphasize its benefits and limitations. The methodological approaches include a method of literature review of available sources exploring the issue of narcolepsy, both from a global and specific perspective point of view. On the basis of evaluation of these literature sources, the researched issue is examined. The main benefits (e.g., new drugs are being tested or non-invasive cognitive behavioral therapies are being applied) and limitations (e.g., late diagnosis of the disease or lifelong and costly treatment) of the treatment of narcolepsy are highlighted. The findings call for more research in the field of the development of novel drugs reflecting understanding of the neurological basis of narcolepsy and early diagnosis in order to eliminate the symptoms of narcolepsy and prevent the development of this disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Regional Cerebral Disease Progression in Friedreich's Ataxia: A Longitudinal Diffusion Tensor Imaging Study.

    Science.gov (United States)

    Mascalchi, Mario; Toschi, Nicola; Giannelli, Marco; Ginestroni, Andrea; Della Nave, Riccardo; Tessa, Carlo; Piacentini, Silvia; Dotti, Maria Teresa; Aiello, Marco; Nicolai, Emanuele; Soricelli, Andrea; Salvi, Fabrizio; Diciotti, Stefano

    2016-01-01

    Imaging biomarkers of disease progression are desirable in inherited ataxias. MRI has demonstrated brain damage in Friedreich ataxia (FRDA) in form of regional atrophy of the medulla, peridentate cerebellar white matter (WM) and superior cerebellar peduncles (visible in T1-weighted images) and of change of microstructural characteristics of WM tracts of the brainstem, cerebellar peduncles, cerebellum, and supratentorial structures (visible through diffusion-weighted imaging). We explored the potential of brain MR morphometry and diffusion tensor imaging (DTI) to track the progression of neurodegeneration in FRDA. Eight patients (5F, 3M; age 13.4-41.2 years) and 8 healthy controls (2F, 6M; age 26.2-48.3 years) underwent 2 MRI examinations (mean 3.9 and 4.1 years apart, respectively) on the same 1.5T scanner. The protocol included 3D T1-weighted images and axial diffusion-weighted images (b-value 1,000 s/mm(2)) for calculating maps of fractional anisotropy, mean, axial and radial diffusivity, and mode of anisotropy. Tensor-based morphometry was used to investigate regional volume changes and tract-based spatial statistics was used to investigate microstructural changes in WM tracts. Longitudinal analyses showed no differences in regional volume changes but a significant difference in axial diffusivity changes in cerebral and corpus callosum WM of patients as compared to controls (mean longitudinal rate of change for axial diffusivity: -.02 × 10(-3) mm(2)/s/year in patients vs. .01 × 10(-3) mm(2)/s/year in controls). No correlation with number of triplets, disease duration, and worsening of the clinical deficit was observed. DTI can track brain microstructural changes in FRDA and can be considered a potential biomarker of disease progression. Copyright © 2015 by the American Society of Neuroimaging.

  16. Revealing the cerebral regions and networks mediating vulnerability to depression: oxidative metabolism mapping of rat brain.

    Science.gov (United States)

    Harro, Jaanus; Kanarik, Margus; Kaart, Tanel; Matrov, Denis; Kõiv, Kadri; Mällo, Tanel; Del Río, Joaquin; Tordera, Rosa M; Ramirez, Maria J

    2014-07-01

    The large variety of available animal models has revealed much on the neurobiology of depression, but each model appears as specific to a significant extent, and distinction between stress response, pathogenesis of depression and underlying vulnerability is difficult to make. Evidence from epidemiological studies suggests that depression occurs in biologically predisposed subjects under impact of adverse life events. We applied the diathesis-stress concept to reveal brain regions and functional networks that mediate vulnerability to depression and response to chronic stress by collapsing data on cerebral long term neuronal activity as measured by cytochrome c oxidase histochemistry in distinct animal models. Rats were rendered vulnerable to depression either by partial serotonergic lesion or by maternal deprivation, or selected for a vulnerable phenotype (low positive affect, low novelty-related activity or high hedonic response). Environmental adversity was brought about by applying chronic variable stress or chronic social defeat. Several brain regions, most significantly median raphe, habenula, retrosplenial cortex and reticular thalamus, were universally implicated in long-term metabolic stress response, vulnerability to depression, or both. Vulnerability was associated with higher oxidative metabolism levels as compared to resilience to chronic stress. Chronic stress, in contrast, had three distinct patterns of effect on oxidative metabolism in vulnerable vs. resilient animals. In general, associations between regional activities in several brain circuits were strongest in vulnerable animals, and chronic stress disrupted this interrelatedness. These findings highlight networks that underlie resilience to stress, and the distinct response to stress that occurs in vulnerable subjects. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Anxiety and mood disorders in narcolepsy: a case-control study.

    NARCIS (Netherlands)

    Fortuyn, H.A.; Lappenschaar, M.A.; Furer, J.W.; Hodiamont, P.P.G.; Rijnders, C.A.T.; Renier, W.O.; Buitelaar, J.K.; Overeem, S.

    2010-01-01

    INTRODUCTION: Narcolepsy is a primary sleeping disorder with excessive daytime sleepiness and cataplexy as core symptoms. There is increasing interest in the psychiatric phenotype of narcolepsy. Although many authors suggest an overrepresentation of mood disorders, few systematic studies have been

  18. Anxiety and mood disorders in narcolepsy: A case-control study

    NARCIS (Netherlands)

    Droogleever Fortuyn, H.A.; Lappenschaar, G.A.M.; Furer, J.W.; Hodiamont, P.P.G.; Rijnders, C.A.T.; Renier, W.O.; Buitelaar, J.K.; Overeem, S.

    2010-01-01

    Introduction: Narcolepsy is a primary sleeping disorder with excessive daytime sleepiness and cataplexy as core symptoms. There is increasing interest in the psychiatric phenotype of narcolepsy. Although many authors suggest an overrepresentation of mood disorders, few systematic studies have been

  19. A study on regional cerebral blood flow at rest and stress state in anxiety disorder patients

    International Nuclear Information System (INIS)

    Wan Li; Liu Jian

    2002-01-01

    Objective: To investigate he characteristics of rest and stress regional cerebral blood flow (rCBF) in naive anxiety disorder patients. Methods: Twenty naive anxiety disorder patients were enrolled in the study with twenty healthy volunteers as controls. The rest and stress 99 Tc m -ethylene cystein dimer (ECD) SPECT were performed separately at 2 consecutive days, Raven reasoning test was used as a stressor. Results: 1) Compared to the healthy controls, the patients' rest rCBF of the frontal lobe, temporal lobe, thalamus and basal ganglia were significantly lower (P<0.05 and 0.01). 2)The patients' stress rCBF of the frontal lobe, temporal lobe, part occipital lobe, part parietal lobe, thalamus and basal ganglia were significantly lower compared to the healthy controls' (P<0.05 and 0.01). 3) Opposite to the healthy controls, the rCBF of patients increased significantly after stressor simulating. Conclusions: The hypofunction of frontal lobe, temporal lobe, thalamus and basal ganglia may exist in naive anxiety disorder patients. The abnormal rCBF of patients after simulating may be one of the characteristics of anxiety disorder

  20. Regional cerebral blood flow in various pediatric neurological patients using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-01-01

    The recent development of a new radiopharmaceutical 123 I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using 123 I-IMP SPECT may reveal functional abnormalities as well as organic lesions. 123 I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases. (author)

  1. Regional cerebral blood flow in neuropediatrics; Regionalny przeplyw mozgowy krwi w chorobach neuropediatrycznych

    Energy Technology Data Exchange (ETDEWEB)

    Junik, R [Katedra i Klinika Endokrynologii i Diabetologii, Akademia Medyczna, Bydgoszcz (Poland); Katedra i Klinika Endokrynologii i Przemiany Materii, Akademia Medyczna, Poznan (Poland)

    2001-07-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  2. Influence of the language dominant hemisphere on the activation region of the cerebral cortex during mastication

    International Nuclear Information System (INIS)

    Matsushima, Yasuhiko

    2005-01-01

    We used functional magnetic resonance imaging (fMRI) to examine the relationship of the activation region of the cerebral cortex during mastication with the language dominant hemisphere. Twelve healthy subjects were asked to chew a special gum 50 times on each side of the mouth, the gum changed color, becoming a deeper red, as it was chewed. The depth of red of the chewed gum was used to ascertain the habitual masticatory side. Measurements were also performed on a conventional whole body 1.5 T clinical scanner using a single shot, multislice echo-planar imaging sequence. The subjects were asked to masticate first on the right side, and then on the left side. As well, they were instructed to do a shiritori test, which is a word game. Computer analysis of the fMRI was done using statistical parametric mapping (SPM) 99 software (p<0.001, paired t-test). We found that the sensorimotor cortex activated by masticatory movements always contains language dominant hemisphere. (author)

  3. The evaluation of regional cerebral blood flow in the chronic alcohol abuse patients

    International Nuclear Information System (INIS)

    Chung, Y. A.; Kim, D. J.; Oh, J. H.; Kim, C. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K.

    2005-01-01

    The use of alcohol is increasingly prevalent in our country and remains associated with innumerable social and economic problems. In addition, brain abnormalities have been proved by means of neuroimaging techniques not only in the first days of withdrawal, but also months after the last use of the substance in the patients. The purpose of the present study was to investigate patterns of the regional cerebral blood flow (rCBF) in alcoholic dementia. Six patients (all men; 44-67 years, mean age = 57.5 years) who fulfilled DSM-IV criteria for alcoholic dementia were enrolled in the study. RCBF measurements of resting state using Tc-99m ethyl cysteinate dimmer (ECD) SPECT were performed. The SPECT image was obtained 40 minutes after intravenous injection of 1110 MBq of Tc-99m ECD using a dual-head gamma camera (ECAM plus; Siemens, Erlangen, Germany). The normalized SPECT data from the alcoholic dementia group were compared with those from 12 healthy subjects. Alcoholic dementia patients showed significant decrement of rCBF in the left thalamus, superior frontal gyrus of left frontal lobe, left insula, postcentral gyrus of left parietal lobe, parahippocapal gyrus of left limbic lobe, right caudate, and cingulate gyrus of right limbic lobe than age-matched healthy subjects. Despite the small number of patients examined, the study supports the belief that patients with alcohol induced cognitive dysfunction have the neuro pathophysiology as those with classical alcoholic dementia

  4. Mutation in the 3'untranslated region of APP as a genetic determinant of cerebral amyloid angiopathy.

    Science.gov (United States)

    Nicolas, Gaël; Wallon, David; Goupil, Claudia; Richard, Anne-Claire; Pottier, Cyril; Dorval, Véronique; Sarov-Rivière, Mariana; Riant, Florence; Hervé, Dominique; Amouyel, Philippe; Guerchet, Maelenn; Ndamba-Bandzouzi, Bebene; Mbelesso, Pascal; Dartigues, Jean-François; Lambert, Jean-Charles; Preux, Pierre-Marie; Frebourg, Thierry; Campion, Dominique; Hannequin, Didier; Tournier-Lasserve, Elisabeth; Hébert, Sébastien S; Rovelet-Lecrux, Anne

    2016-01-01

    Aβ-related cerebral amyloid angiopathy (CAA) is a major cause of primary non-traumatic brain hemorrhage. In families with an early onset of the disease, CAA can be due to amyloid precursor protein (APP) pathogenic variants or duplications. APP duplications lead to a ~1.5-fold increased APP expression, resulting in Aβ overproduction and deposition in the walls of leptomeningeal vessels. We hypothesized that rare variants in the 3'untranslated region (UTR) of APP might lead to APP overexpression in patients with CAA and no APP pathogenic variant or duplication. We performed direct sequencing of the whole APP 3'UTR in 90 patients with CAA and explored the functional consequences of one previously unreported variant. We identified three sequence variants in four patients, of which a two-base pair deletion (c.*331_*332del) was previously unannotated and absent from 175 controls of same ethnicity. This latter variant was associated with increased APP expression in vivo and in vitro. Bioinformatics and functional assays showed that the APP c.*331_*332del variant affected APP messenger RNA (mRNA) structure and binding of two microRNAs (miR-582-3p and miR-892b), providing a mechanism for the observed effects on APP expression. These results identify APP 3'UTR sequence variants as genetic determinants of Aβ-CAA.

  5. Deficits in Regional Cerebral Blood Flow on Brain SPECT Predict Treatment Resistant Depression.

    Science.gov (United States)

    Amen, Daniel G; Taylor, Derek V; Meysami, Somayeh; Raji, Cyrus A

    2018-03-22

    Depression remains an important risk factor for Alzheimer's disease, yet few neuroimaging biomarkers are available to identify treatment response in depression. To analyze and compare functional perfusion neuroimaging in persons with treatment resistant depression (TRD) compared to those experiencing full remission. A total of 951 subjects from a community psychiatry cohort were scanned with perfusion single photon emission computed tomography (SPECT) of the brain in both resting and task related settings. Of these, 78% experienced either full remission (n = 506) or partial remission (n = 237) and 11% were minimally responsive (n = 103) or non-responsive (11%. n = 106). Severity of depression symptoms were used to define these groups with changes in the Beck Depression Inventory prior to and following treatment. Voxel-based analyses of brain SPECT images from full remission compared to the worsening group was conducted with the statistical parametric mapping software, version 8 (SPM 8). Multiple comparisons were accounted for with a false discovery rate (p <  0.001). Persons with depression that worsened following treatment had reduced cerebral perfusion compared to full remission in the multiple regions including the bilateral frontal lobes, right hippocampus, left precuneus, and cerebellar vermis. Such differences were observed on both resting and concentration SPECT scans. Our findings identify imaging-based biomarkers in persons with depression related to treatment response. These findings have implications in understanding both depression to prognosis and its role as a risk factor for dementia.

  6. Neurodevelopmental Outcomes Following Regional Cerebral Perfusion with Neuromonitoring for Neonatal Aortic Arch Reconstruction

    Science.gov (United States)

    Andropoulos, Dean B.; Easley, R. Blaine; Brady, Ken; McKenzie, E. Dean; Heinle, Jeffrey S.; Dickerson, Heather A.; Shekerdemian, Lara S.; Meador, Marcie; Eisenman, Carol; Hunter, Jill V.; Turcich, Marie; Voigt, Robert G.; Fraser, Charles D.

    2013-01-01

    Background In this study we report magnetic resonance imaging (MRI) brain injury, and 12 month neurodevelopmental outcomes, when regional cerebral perfusion (RCP) is utilized for neonatal aortic arch reconstruction. Methods Fifty seven neonates receiving RCP during aortic arch reconstruction were enrolled in a prospective outcome study. RCP flows were determined by near-infrared spectroscopy and transcranial Doppler monitoring. Brain MRI were performed preoperatively and 7 days postoperatively. Bayley Scales of Infant Development III was performed at 12 months. Results Mean RCP time was 71 ± 28 minutes (range 5–121), mean flow 56.6 ± 10.6 ml/kg/min. New postoperative MRI brain injury was seen in 40% of patients. For 35 RCP patients at age 12 months, mean Bayley III composite standard scores were: Cognitive = 100.1 ± 14.6,(range 75–125); Language = 87.2 ± 15.0, (range 62–132); Motor = 87.9 ± 16.8, (range 58–121).Increasing duration of RCP was not associated with adverse neurodevelopmental outcomes. Conclusions Neonatal aortic arch repair with RCP utilizing a neuromonitoring strategy results in 12-month cognitive outcomes that are at reference population norms; language and motor outcomes are lower than the reference population norms by 0.8–0.9 standard deviation. This largest RCP group with neurodevelopmental outcomes published to date demonstrates that this technique is effective and safe in supporting the brain during neonatal aortic arch reconstruction. PMID:22766302

  7. Study of regional cerebral blood flow SPECT imaging for sudden sensorineural deafness

    International Nuclear Information System (INIS)

    Xie Changhui; Kui Xixiao; Xiong Qibin; Wen Hui; Xie Jiabiao

    1998-01-01

    Purpose: To study the clinical value of regional cerebral blood flow (rCBF) SPECT imaging for sudden sensorineural deafness (SSD). Methods: 10 normal persons, 19 conductive deafness and 31 SSD patients were examined by rCBF SPECT imaging, and compared with X CT at the same time. All SSD patients were followed up for 6∼12 months with repeated rCBF SPECT imaging. Results: 1) The radioactivity of diseased and normal horizontal temporal gyrus ratio (T/NT) in SSD patients was the lowest among three groups (P < 0.01). 2) The sensitivity (80.6%) and accurate rate (88.3%) of rCBF SPECT imaging in SSD patients were much higher than those of CT (3.2% and 50%, P < 0.01). 3) There was a significant correlation between degree of deafness and T/NT in SSD patients. 4) Good prognosis of SSD patients with normal rCBF SPECT was found. 5) The rCBF SPECT had close concordance between rCBF SPECT imaging and clinical prognosis (84.6%). Conclusions: rCBF SPECT imaging was superior to X CT in diagnosis of SSD and played an important clinical role

  8. Regional cerebral blood flow analysis of vascular dementia by the 133Xe inhalation method

    International Nuclear Information System (INIS)

    Watanabe, Sho; Maruyama, Michiyuki; Miyakawa, Koichi; Kamijima, Gonbei; Sasaki, Yasuto.

    1987-01-01

    Eighty-one cases of ischemic cerebrovascular disease were investigated using the 133 Xe inhalation method. Fifty-six were male and 25 were female. ages ranged from 25 to 84, with a mean age of 65.4 years. Thirty-two had cerebrovascular dementia and 49 had non dementia infarction. Two criteria were used for a diagnosis of cerebrovascular dementia: 1) the presense of cerebrovascular disease and 2) a score of less than 21.5 Hasegawa's dementia scale. By computed tomographic findings all cases were classified into three groups: lesion on a right hemisphere, a left hemisphere and bilateral hemispheres. Regional cerebral blood flow (rCBF) was calculated by 2-compartmental analysis and initial slope index method. The results are as follows: 1) Cases of cerebrovascular dementia tended to have a lower mean rCBF value. (p < 0.001). 2)rCBF patterns showed lower values in the central area for cases of laterality as determined by CT scan. 3) Both interhemispheric mean rCBF and mean rCBF classified from main lesion were no significant different between dementia group and non dementia group. 4) A comparison of mean rCBF with Hasegawa's dementia scale revealed a statistically significant correlation. (p < 0.001). (author)

  9. Double-label autoradiographic deoxyglucose method for sequential measurement of regional cerebral glucose utilization

    Energy Technology Data Exchange (ETDEWEB)

    Redies, C; Diksic, M; Evans, A C; Gjedde, A; Yamamoto, Y L

    1987-08-01

    A new double-label autoradiographic glucose analog method for the sequential measurement of altered regional cerebral metabolic rates for glucose in the same animal is presented. This method is based on the sequential injection of two boluses of glucose tracer labeled with two different isotopes (short-lived /sup 18/F and long-lived /sup 3/H, respectively). An operational equation is derived which allows the determination of glucose utilization for the time period before the injection of the second tracer; this equation corrects for accumulation and loss of the first tracer from the metabolic pool occurring after the injection of the second tracer. An error analysis of this operational equation is performed. The double-label deoxyglucose method is validated in the primary somatosensory (''barrel'') cortex of the anesthetized rat. Two different rows of whiskers were stimulated sequentially in each rat; the two periods of stimulation were each preceded by an injection of glucose tracer. After decapitation, dried brain slices were first exposed, in direct contact, to standard X-ray film and then to uncoated, ''tritium-sensitive'' film. Results show that the double-label deoxyglucose method proposed in this paper allows the quantification and complete separation of glucose utilization patterns elicited by two different stimulations sequentially applied in the same animal.

  10. Verbal or Visual Memory Score and Regional Cerebral Blood Flow in Alzheimer Disease

    Directory of Open Access Journals (Sweden)

    Satoshi Hayashi

    2018-01-01

    Full Text Available Objective: Among many cognitive function deficits, memory impairment is an initial and cardinal symptom in Alzheimer disease (AD. In most cases, verbal and visual memory scores correlate highly, but in some cases the deficit of verbal or visual memory is very different from that of the other memory. In this study, we examined the neural substrates of verbal and visual memory in patients with AD. Methods: One hundred eighty-eight consecutive patients with AD were recruited from outpatient units. Verbal and visual memory scores were evaluated using the Wechsler Memory Scale – revised. The patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. Results: After removing the effects of age, sex, education, and Mini-Mental State Examination scores, correlation analysis showed a significant correlation of verbal memory scores to regional cerebral blood flow (rCBF in the bilateral cingulate gyrus and left precuneus. Similarly, a significant correlation of visual memory scores to rCBF was found in the right precuneus and right cingulate gyrus. Conclusion: The posterior medial cortices (PMC are very important areas in episodic memory among patients with mild AD. Verbal memory is more closely related to the both sides of the PMC, while visual memory is more closely related to the right PMC.

  11. Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Kimura, Mahito; Shimoda, Kengo; Mizumura, Sunao; Tateno, Amane; Fujito, Tatsuma; Mori, Takao; Endo, Shunkichi

    2003-01-01

    As the prevalence of white matter hyperintensities detected on T2 weighted MRI scans in patients with late-onset depression is higher than that in nondepressed patients, the concept of ''vascular depression'' (VDep) was introduced in 1997. However, the pathology of vascular depression has not been clarified. This study examined the differences in functional imaging between vascular and non-vascular depression (non-VDep). We utilized 123 I-IMP single photon emission computed tomography (SPECT) to compare regional cerebral blood flows (rCBF) between 9 patients with VDep (Krishnan criteria) and 11 age- and sex-matched patients with non-VDep in both depressed and remitted states. In both VDep and non-VDep patients, mean rCBF increased significantly as depression improved, partially aided by changes in left anterior temporal blood flow. In addition, compared to non-VDep patients, the left anterior frontal rCBF for VDep patients was significantly lower in both depressed and remitted states. Left anterior temporal rCBF therefore appears to represent a state marker that increases as symptoms associated with late-onset depression improve, regardless of vascular changes. Furthermore, in VDep patients, left anterior frontal rCBF was low in both states compared to non-VDep patients, and might not only represent a trait marker, but also correlated with the duration of disease and likelihood of recurrence and relapse. (author)

  12. Presentation of regional cerebral blood flow in amphetamine abusers by 99Tcm-HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Kao, C.H.; Wang, S.J.; Yeh, S.H.

    1994-01-01

    The aim of this study was to describe the effectiveness of 99 Tc m -hexamethylpropyleneamine oxime ( 99 Tc m -HMPAO) brain single photon emission computed tomography (SPECT) in the assessment of the regional cerebral blood flow (rCBF) in amphetamine abusers. Twenty-one amphetamine abusers were included and 99 Tc m -HMPAO brain SPECT performed to evaluate rCBF. The drug-using periods ranged from 1 month to several years. The demonstrated neuropsychogenic symptoms and signs of the abusers were from normal presentation to various neurologic complications. The brain SPECT scans were interpreted visually as either normal or abnormal. The degree of abnormality was classified into mild or severe. The results revealed that (a) most SPECT studies in abusers show small defects (95%, 20/21 cases); 71% (15/21) of cases revealed multiple defects over both hemispheres (classified as severe); 24% (5/21) of the cases had focal defects (classified as mild); and only one case (5%, 1/21) demonstrated a normal SPECT finding; (b) the degree of abnormality on SPECT scans was not related to the dose and duration of drug use or the severity of the neuropsychiatric symptoms and signs. In conclusion, 99 Tc m -HMPAO brain SPECT is a sensitive but not specific test for neuropsychogenic abnormalities associated with amphetamine abuse. (Author)

  13. Regional cerebral blood flow using 133Xenon intra-venous technique, 1

    International Nuclear Information System (INIS)

    Yonekura, Masahiro; Teramoto, Shigeyoshi; Moriyama, Tadayoshi

    1990-01-01

    We used the noninvasive 133 Xenon venous technique to measure 3622 regional cerebral blood flows (rCBFs) in 1955 cases for last about six years. The majority of patients was in their fifties or sixties, and their diagnosis was ischemic cerebrovascular disease. Sixty-four healthy, non-hospitalized volunteers (10∼76 years) were studied as control value. The age-related curve of rCBF showed a rapid decrease in young age groups and a gradual decrease in older age groups. The curve was well fitted to the hyperbola (X-13.0621)(Y-42.6038)=556.493. The correlation coefficient was 0.93. This finding showed that the declined rCBF related with age was attributed to more than two factors. When cerebrovascular CO 2 reactivity was tested in the healthy control group, the rCBF on average increased to 90.5 ml/100 g/min from 70.2 ml/100 g/min (28.9%) being accompanied with the elevation of Pco 2 of 11.4 mmHg in arterial blood gas on average. The CO 2 reactivity index was 2.75 ± 1.65 on average. On the other hand, following an intravenous injection of Diamox (1 g) the rCBF increased to 80.0 ml/100 g/min from 59.6 ml/100 g/min (34.2%) on average in the control group. (author)

  14. Verbal or Visual Memory Score and Regional Cerebral Blood Flow in Alzheimer Disease.

    Science.gov (United States)

    Hayashi, Satoshi; Terada, Seishi; Oshima, Etsuko; Sato, Shuhei; Kurisu, Kairi; Takenoshita, Shintaro; Yokota, Osamu; Yamada, Norihito

    2018-01-01

    Among many cognitive function deficits, memory impairment is an initial and cardinal symptom in Alzheimer disease (AD). In most cases, verbal and visual memory scores correlate highly, but in some cases the deficit of verbal or visual memory is very different from that of the other memory. In this study, we examined the neural substrates of verbal and visual memory in patients with AD. One hundred eighty-eight consecutive patients with AD were recruited from outpatient units. Verbal and visual memory scores were evaluated using the Wechsler Memory Scale - revised. The patients underwent brain SPECT with 99m Tc-ethylcysteinate dimer. After removing the effects of age, sex, education, and Mini-Mental State Examination scores, correlation analysis showed a significant correlation of verbal memory scores to regional cerebral blood flow (rCBF) in the bilateral cingulate gyrus and left precuneus. Similarly, a significant correlation of visual memory scores to rCBF was found in the right precuneus and right cingulate gyrus. The posterior medial cortices (PMC) are very important areas in episodic memory among patients with mild AD. Verbal memory is more closely related to the both sides of the PMC, while visual memory is more closely related to the right PMC.

  15. Regional cerebral blood flow during the auditory oddball task measured by positron emission tomography

    International Nuclear Information System (INIS)

    Mochida, Masahiko

    1997-01-01

    Regional cerebral blood flow (rCBF) was measured by employing PET in nine healthy right-handed male subjects, while they simultaneously performed the auditory oddball task using tone bursts. Results showed that the rCBF value was highest in the transverse gyrus of Heschl in both right and left hemispheres. When comparing the rCBF values between right and left hemispheres, four areas had higher rCBF values in the left hemisphere and eight areas had higher rCBF values in the right hemisphere. Of these, the anterior and posterior parts of the superior temporal gyrus, especially, showed significant differences. The hemispheric differences in the rCBF values of the auditory areas can be attributed to the performance of the oddball task which requires higher processing of non verbal auditory input. The P300 amplitude which reflects the amount of the allocated information processing resources correlated positively with rCBF in the following areas: left piriform cortex, the transverse gyrus of Heschl in both left and right hemispheres. Mean-while, P300 amplitude correlated negatively with rCBF in the nucleus accumbens septi in both right and left hemispheres. The N100 amplitude evoked by frequent stimulus did not correlate with rCBF in almost all ROIs. (K.H.)

  16. Receiver operating characteristic analysis of regional cerebral blood flow in Alzheimer's disease

    International Nuclear Information System (INIS)

    Zemcov, A.; Barclay, L.L.; Sansone, J.; Metz, C.E.

    1985-01-01

    Receiver operating characteristic (ROC) curves were used to quantitatively assess the ability of individual detectors in a 32-detector 133 Xe inhalation system to discriminate between two populations over the range of regional cerebral blood flow (rCBF) values. These populations were clinically evaluated as normal (age 63.1 +/- 13.1, n = 23) and presumed Alzheimer's disease (age 72.7 +/- 7.0, n = 82). Summary statistics showed that for homologous detectors the average value of blood flow in the normal group was greater than the flow value in the group of subjects with Alzheimer's disease. Conclusions drawn from single values of flow or mean hemispheric flow can lead to erroneous conclusions about hemisphere asymmetries. However, the dynamic relationship between the correct identifications (true positives) compared with incorrect identifications (false positives) of Alzheimer's disease at each detector varies over the range of blood flow values, and quantitative characterization of this relationship in terms of an ROC curve provides more insight into the structure of the data. Detectors approximating the speech, auditory and association cortex were most effective in discriminating between groups. Frontal detectors were marginally useful diagnostically

  17. Quantification of regional cerebral blood flow and volume with dynamic susceptibility contrast-enhanced MR imaging.

    Science.gov (United States)

    Rempp, K A; Brix, G; Wenz, F; Becker, C R; Gückel, F; Lorenz, W J

    1994-12-01

    Quantification of regional cerebral blood flow (rCBF) and volume (rCBV) with dynamic magnetic resonance (MR) imaging. After bolus administration of a paramagnetic contrast medium, rapid T2*-weighted gradient-echo images of two sections were acquired for the simultaneous creation of concentration-time curves in the brain-feeding arteries and in brain tissue. Absolute rCBF and rCBV values were determined for gray and white brain matter in 12 subjects with use of principles of the indicator dilution theory. The mean rCBF value in gray matter was 69.7 mL/min +/- 29.7 per 100 g tissue and in white matter, 33.6 mL/min +/- 11.5 per 100 g tissue; the average rCBV was 8.0 mL +/- 3.1 per 100 g tissue and 4.2 mL +/- 1.0 per 100 g tissue, respectively. An age-related decrease in rCBF and rCBV for gray and white matter was observed. Preliminary data demonstrate that the proposed technique allows the quantification of rCBF and rCBV. Although the results are in good agreement with data from positron emission tomography studies, further evaluation is needed to establish the validity of method.

  18. Confidence limits for regional cerebral blood flow values obtained with circular positron system, using krypton-77

    International Nuclear Information System (INIS)

    Meyer, E.; Yamamoto, Y.L.; Thompson, C.J.

    1978-01-01

    The 90% confidence limits have been determined for regional cerebral blood flow (rCBF) values obtained in each cm 2 of a cross section of the human head after inhalation of radioactive krypton-77, using the MNI circular positron emission tomography system (Positome). CBF values for small brain tissue elements are calculated by linear regression analysis on the semi-logarithmically transformed clearance curve. A computer program displays CBF values and their estimated error in numeric and gray scale forms. The following typical results have been obtained on a control subject: mean CBF in the entire cross section of the head: 54.6 + - 5 ml/min/100 g tissue, rCBF for small area of frontal gray matter: 75.8 + - 9 ml/min/100 g tissue. Confidence intervals for individual rCBF values varied between + - 13 and + - 55% except for areas pertaining to the ventricular system where particularly poor statistics have been obtained. Knowledge of confidence limits for rCBF values improves their diagnostic significance, particularly with respect to the assessment of reduced rCBF in stroke patients. A nomogram for convenient determination of 90% confidence limits for slope values obtained in linear regression analysis has been designed with the number of fitted points (n) and the correlation coefficient (r) as parameters. (author)

  19. The evaluation of regional cerebral blood flow in the chronic alcohol abuse patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. A.; Kim, D. J.; Oh, J. H.; Kim, C. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The use of alcohol is increasingly prevalent in our country and remains associated with innumerable social and economic problems. In addition, brain abnormalities have been proved by means of neuroimaging techniques not only in the first days of withdrawal, but also months after the last use of the substance in the patients. The purpose of the present study was to investigate patterns of the regional cerebral blood flow (rCBF) in alcoholic dementia. Six patients (all men; 44-67 years, mean age = 57.5 years) who fulfilled DSM-IV criteria for alcoholic dementia were enrolled in the study. RCBF measurements of resting state using Tc-99m ethyl cysteinate dimmer (ECD) SPECT were performed. The SPECT image was obtained 40 minutes after intravenous injection of 1110 MBq of Tc-99m ECD using a dual-head gamma camera (ECAM plus; Siemens, Erlangen, Germany). The normalized SPECT data from the alcoholic dementia group were compared with those from 12 healthy subjects. Alcoholic dementia patients showed significant decrement of rCBF in the left thalamus, superior frontal gyrus of left frontal lobe, left insula, postcentral gyrus of left parietal lobe, parahippocapal gyrus of left limbic lobe, right caudate, and cingulate gyrus of right limbic lobe than age-matched healthy subjects. Despite the small number of patients examined, the study supports the belief that patients with alcohol induced cognitive dysfunction have the neuro pathophysiology as those with classical alcoholic dementia.

  20. Regional cerebral blood flow in various pediatric neurological patients using /sup 123/I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-03-01

    The recent development of a new radiopharmaceutical /sup 123/I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using /sup 123/I-IMP SPECT may reveal functional abnormalities as well as organic lesions. /sup 123/I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases.

  1. Regional cerebral blood flow in elderly patients with heart failure evaluated with SPECT

    International Nuclear Information System (INIS)

    Alves, T.C.T.F.; Fraguas, R.; Busatto, G.; Garrido, G.; Buchpiguel, C.A.; Rays, J.; Wajngarten, M.; Robilotta, C.C.; Meneghetti, J.C.

    2002-01-01

    Introduction: Heart failure (HF) may be related to brain dysfunction due to reduced cerebral blood flow (CBF) and white matter lesions. However, no studies have yet used quantitative regional CBF (rCBF) techniques to demonstrate the presence of significant functional abnormalities in representative samples of cardiac patients compared with normal controls. Aim: The purpose of this study was to investigate the rCBF distribution as assessed with SPECT in a group of elderly patients with HF in comparison with a normal control group. The hypothesis were: (1) HF would be associated with rCBF reductions in comparison to healthy controls. Methodology: We studied a group of 36 HF patients functional class II or III from New York Heart Association (NYHA), divided in 19 depressed (74.6 +/- 6.8 years) and 17 non depressed (73.7 +/- 5.4 years), and compared to 19 normal subjects (71.1 +/- 4.8 years), matched for age, sex, cerebral dominance and social level. Brain perfusion was evaluated with a double-headed SPECT system (Sophy-DST) with high-resolution collimators (128x128 matrix, 128 views, 30s/view) after 30mcI 99mTc-HMPAO injection. Group differences were investigated using SPM99, with a p<0.001 statistical threshold (uncorrected for multiple comparisons). Results: Significant rCBF reductions were seen in the HF non depressed group relative to healthy controls in the right lateral temporal lobe, cuneus and precuneus, as well as in a small area of the medial prefrontal cortex. In the HF depressed group, significant cortical rCBF reductions relative to healthy controls were seen in similar locations but more extensively. In addition, the HF depressed group showed significant rCBF reductions relative to controls limbic and subcortical areas, including the right parahypocampal gyrus, posterior cingulate, thalamus and caudate at the border of the lateral ventricle, and bilaterally in the posterior insula. Conclusion: The presence of greater areas of hypoperfusion in the HF

  2. Regional vulnerability of longitudinal cortical association connectivity: Associated with structural network topology alterations in preterm children with cerebral palsy.

    Science.gov (United States)

    Ceschin, Rafael; Lee, Vince K; Schmithorst, Vince; Panigrahy, Ashok

    2015-01-01

    Preterm born children with spastic diplegia type of cerebral palsy and white matter injury or periventricular leukomalacia (PVL), are known to have motor, visual and cognitive impairments. Most diffusion tensor imaging (DTI) studies performed in this group have demonstrated widespread abnormalities using averaged deterministic tractography and voxel-based DTI measurements. Little is known about structural network correlates of white matter topography and reorganization in preterm cerebral palsy, despite the availability of new therapies and the need for brain imaging biomarkers. Here, we combined novel post-processing methodology of probabilistic tractography data in this preterm cohort to improve spatial and regional delineation of longitudinal cortical association tract abnormalities using an along-tract approach, and compared these data to structural DTI cortical network topology analysis. DTI images were acquired on 16 preterm children with cerebral palsy (mean age 5.6 ± 4) and 75 healthy controls (mean age 5.7 ± 3.4). Despite mean tract analysis, Tract-Based Spatial Statistics (TBSS) and voxel-based morphometry (VBM) demonstrating diffusely reduced fractional anisotropy (FA) reduction in all white matter tracts, the along-tract analysis improved the detection of regional tract vulnerability. The along-tract map-structural network topology correlates revealed two associations: (1) reduced regional posterior-anterior gradient in FA of the longitudinal visual cortical association tracts (inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, optic radiation, posterior thalamic radiation) correlated with reduced posterior-anterior gradient of intra-regional (nodal efficiency) metrics with relative sparing of frontal and temporal regions; and (2) reduced regional FA within frontal-thalamic-striatal white matter pathways (anterior limb/anterior thalamic radiation, superior longitudinal fasciculus and cortical spinal tract) correlated with

  3. Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women.

    Science.gov (United States)

    Georgiadis, Janniko R; Kortekaas, Rudie; Kuipers, Rutger; Nieuwenburg, Arie; Pruim, Jan; Reinders, A A T Simone; Holstege, Gert

    2006-12-01

    There is a severe lack of knowledge regarding the brain regions involved in human sexual performance in general, and female orgasm in particular. We used [15O]-H2O positron emission tomography to measure regional cerebral blood flow (rCBF) in 12 healthy women during a nonsexual resting state, clitorally induced orgasm, sexual clitoral stimulation (sexual arousal control) and imitation of orgasm (motor output control). Extracerebral markers of sexual performance and orgasm were rectal pressure variability (RPstd) and perceived level of sexual arousal (PSA). Sexual stimulation of the clitoris (compared to rest) significantly increased rCBF in the left secondary and right dorsal primary somatosensory cortex, providing the first account of neocortical processing of sexual clitoral information. In contrast, orgasm was mainly associated with profound rCBF decreases in the neocortex when compared with the control conditions (clitoral stimulation and imitation of orgasm), particularly in the left lateral orbitofrontal cortex, inferior temporal gyrus and anterior temporal pole. Significant positive correlations were found between RPstd and rCBF in the left deep cerebellar nuclei, and between PSA and rCBF in the ventral midbrain and right caudate nucleus. We propose that decreased blood flow in the left lateral orbitofrontal cortex signifies behavioural disinhibition during orgasm in women, and that deactivation of the temporal lobe is directly related to high sexual arousal. In addition, the deep cerebellar nuclei may be involved in orgasm-specific muscle contractions while the involvement of the ventral midbrain and right caudate nucleus suggests a role for dopamine in female sexual arousal and orgasm.

  4. Prolonged disturbances of regional cerebral blood flow in transient ischemic attacks

    International Nuclear Information System (INIS)

    Hartmann, A.

    1985-01-01

    Regional cerebral blood flow (rCBF) was measured over both hemispheres in 20 patients with unilateral transient ischemic attacks (TIA) of the territory of the internal carotid artery on the day of the TIA. rCBF was estimated with the nontraumatic Xenon 133-inhalation technique using the initial slope index. 13 patients experienced their first TIA, 7 had several attacks. In 14 patients the first rCBF-measurement was performed during the presentation of clinical symptoms. The 2nd rCBF-measurement was done on day 2, the last one on day 7. Scans of the 15 patients studied with CT were normal. On day 1 mean rCBF of the TIA-side was significantly lower than that of the contralateral hemispheres. 22% of all areas showed a significant reduction of flow compared to mean rCBF. Mean rCBF of both the TIA- and the contralateral side was significantly reduced compared to the bi-hemispheric mean rCBF of a control group with no history of TIA or completed strokes but at least 2 risk factors for cerebrovascular disease. Whereas mean rCBF did not change in the contralateral side it increased significantly (+6.9%) in the TIA-side from day 1 to day 2 but not from there to day 7. This is reflected by the increase of the total number of ROI with normal flow from day 1 to day 2. Considering the actual flow and the flow course of that tissue which was believed to be responsible for the clinical symptoms the following regional patterns were observed: normal rCBF in 6 patients; early return to normal concomitant to the clinical course (n = 4)

  5. Relationship between salivary cortisol levels and regional cerebral glucose metabolism in nondemented elderly subjects

    International Nuclear Information System (INIS)

    Kwak, Young Bin; Cho, Sang Soo; Lee, Sung Ha; Chey, Jean Yung; Kim, Sang Eun

    2004-01-01

    Cortisol is a primary stress hormone for flight-or-fight response in human. Increased levels of cortisol have been associated with memory and learning impairments. However, little is known about the role of cortisol on brain/cognitive functions in older adults. We compared regional cerebral glucose metabolism between elderly subjects with high and low cortisol levels using FDG PET. Salivary cortisol levels were measured four times during a day, and an average of the four measurements was used as the standard cortisol level for the analyses. From a population of 120 nondemented elderly subjects, 19 (mean age, 70.1±4.9 y: 2 males and 17 females) were identified as the high (> mean + 1 SD of the total population) cortisol subjects (mean cortisol, 0.69±0.09 μ g/dL), while 14 (mean age, 67.2±4.5 y: all females) as the low (< mean 1 SD) cortisol (mean cortisol, 0.27±0.03 μ g/dL). A voxel-wise comparison of FDG PET images from the high and low cortisol subjects was performed using SPM99. When compared with the low cortisol group, the high cortisol group had significant hypometabolism in the right middle temporal gyrus, left precuneus, right parahippocampal gyrus, right inferior temporal and superior temporal gyri (P < 0.01 uncorrected, k = 100). There was no significant increase of glucose metabolism in the high cortisol group compared with the low cortisol group (P < 0.01 uncorrected, k = 100). The high cortisol elderly subjects had hypometabolism in the parahippocampal and temporal gyri and precuneus, regions involved in memory and other cognitive functions. This may represent the preclinical metabolic correlates of forthcoming cognitive dysfunction associated with stress in the elderly. Longitudinal studies of brain metabolism and cognitive function are warranted

  6. Acute effects of electroconvulsive therapy on regional cerebral blood flow (rCBF) in psychiatric disorders

    International Nuclear Information System (INIS)

    Prohovnik, I.; Alderson, P.O.; Sackheim, H.A.; Decina, P.; Kahn, D.

    1984-01-01

    Electroconvulsive therapy (ECT) is frequently used in the treatment of major depression and other psychiatric disorders; its mechanism of action is not established, but previous evidence suggests that it is associated with postictal metabolic suppression. The authors have used measurements of rCBF as an index of cortical metabolic activity to study the acute effects of ECT. Measurements of rCBF were made in 32 cortical regions in 10 patients (pts) following one minute breathing of Xe-133 (5mCi/L); the measurements were performed 30min before and 50min after ECT. Bilateral ECT was administered to six pts (five diagnosed as major depressives and one schizophrenic) and unilateral ECT to four (all diagnosed as unipolar or bipolar affective disorder). The total rCBF material consists of 52 measurements in these pts, made before and after 16 bilateral and 10 unilateral treatments. ECT was found to cause significant reduction of rCBF. Mean hemispheric flows (using the Initial Slope Index to measure grey-matter flow) were reduced by about 5% in both hemispheres following bilateral treatment. Unilateral treatment caused a 9% reduction of flow in the treated hemisphere, but only 2% contralaterally. Regional patterns of flow decreases also differed between the two treatment modes: bilateral frontal reductions were found after bilateral treatment, whereas unilateral ECT caused a widespread flow reduction in the treated hemisphere, and almost no effect contralaterally. These results suggest that rCBF studies are useful for assessing ECT, and indicate that the acute cerebral effects of ECT vary with the mode of treatment

  7. First Episode Schizophrenia Regional Cerebral Blood Flow Assessment after Atypical Antipsychotics

    International Nuclear Information System (INIS)

    Rimbu, A.; Mititelu, R.; Marinescu, G.; Ghita, S.; Mazilu, C.; Codorean, I.; Gheorghe, M.

    2006-01-01

    Full text: Aim: Since regional cerebral blood flow (rCBF) findings in schizophrenic patients are inconsistent, the aim of our study was to evaluate and compare rCBF in the first episode of schizophrenia, before and after atypical antipsychotic treatment. Method: 21 patients who met criteria for schizophrenia were assessed PANSS score and tomographic brain perfusion (SPECT). The treatment was administered for 10-12 weeks and the dose was 4.8mg/day Risperidone, 11.6mg/day Olanzepine, 440mg/day Quetiapine. After finishing treatment all patients underwent a control SPECT study. Results: PANSS scores revealed two groups: group A-14 patients with predominant positive symptoms; 9 received Olanzapine and 5 Quetiapine. In group B -7 patients with predominant negative symptoms received Risperidone. Positive symptoms were associated with hypoperfusion in posterior parietal regions and superior temporal gyrus, bilaterally; for negative symptoms we found hypoperfusion in prefrontal cortex, predominantly in left side and a hyper perfusion in left basal ganglia. All patients that received atypical antipsychotic drugs had clinical improvement and decreases in PANSS scores; the control SPECT analysis revealed the same cortical changes as first studies in 15 patients and an increase of the rCBF in frontal lobes for 4 patients. 14 patients we noticed an increased rCBF at subcortical level, especially in left caudate nuclei. Conclusions: We found nonspecific features of rCBF in patients with first episode of schizophrenia, suggesting a perfusion dynamic balance rather than a fixed model. Those aspects are much more related to clinical symptoms, than to the therapeutical response. The rCBF changes in subcortical level after treatment (64.4% increase of rCBF; 35.6% not modified), can have a good prognostic value for therapeutic response. (author)

  8. Relationship between salivary cortisol levels and regional cerebral glucose metabolism in nondemented elderly subjects

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Young Bin; Cho, Sang Soo; Lee, Sung Ha; Chey, Jean Yung; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2004-07-01

    Cortisol is a primary stress hormone for flight-or-fight response in human. Increased levels of cortisol have been associated with memory and learning impairments. However, little is known about the role of cortisol on brain/cognitive functions in older adults. We compared regional cerebral glucose metabolism between elderly subjects with high and low cortisol levels using FDG PET. Salivary cortisol levels were measured four times during a day, and an average of the four measurements was used as the standard cortisol level for the analyses. From a population of 120 nondemented elderly subjects, 19 (mean age, 70.1{+-}4.9 y: 2 males and 17 females) were identified as the high (> mean + 1 SD of the total population) cortisol subjects (mean cortisol, 0.69{+-}0.09 {mu} g/dL), while 14 (mean age, 67.2{+-}4.5 y: all females) as the low (< mean 1 SD) cortisol (mean cortisol, 0.27{+-}0.03 {mu} g/dL). A voxel-wise comparison of FDG PET images from the high and low cortisol subjects was performed using SPM99. When compared with the low cortisol group, the high cortisol group had significant hypometabolism in the right middle temporal gyrus, left precuneus, right parahippocampal gyrus, right inferior temporal and superior temporal gyri (P < 0.01 uncorrected, k = 100). There was no significant increase of glucose metabolism in the high cortisol group compared with the low cortisol group (P < 0.01 uncorrected, k = 100). The high cortisol elderly subjects had hypometabolism in the parahippocampal and temporal gyri and precuneus, regions involved in memory and other cognitive functions. This may represent the preclinical metabolic correlates of forthcoming cognitive dysfunction associated with stress in the elderly. Longitudinal studies of brain metabolism and cognitive function are warranted.

  9. Multivariate evaluation of brain function by measuring regional cerebral blood flow and event-related potentials

    Energy Technology Data Exchange (ETDEWEB)

    Koga, Yoshihiko; Mochida, Masahiko; Shutara, Yoshikazu; Nakagawa, Kazumi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Nagata, Ken

    1998-07-01

    To measure the effect of events on human cognitive function, effects of odors by measurement regional cerebral blood flow (rCBF) and P300 were evaluated during the auditory odd-ball exercise. PET showed the increase in rCBF on the right hemisphere of the brain by coffee aroma. rCBF was measured by PET in 9 of right-handed healthy adults men, and P300 was by event-related potential (ERP) in each sex of 20 right-handed healthy adults. ERP showed the difference of the P300 amplitude between men and women, and showed the tendency, by odors except the lavender oil, that women had higher in the P300 amplitude than men. These results suggest the presence of effects on the cognitive function through emotional actions. Next, the relationship between rCBF and ERP were evaluated. The subjects were 9 of the right-handed healthy adults (average: 25.6{+-}3.4 years old). rCBF by PET and P300 amplitude by ERP were simultaneously recorded during the auditory odd-ball exercise using the tone-burst method (2 kHz of the low frequency aimed stimuli and 1 kHz of the high frequency non-aimed stimuli). The rCBF value was the highest at the transverse gyrus of Heschl and the lowest at the piriform cortex among 24 regions of interest (ROI) from both sides. The difference of P300 peak latent time among ROI was almost the same. The brain waves from Cz and Pz were similar and the average amplitude was highest at Pz. We found the high correlation in the right piriform cortex (Fz), and right (Fz, Cz) and left (Cz, Pz) transverse gyrus of Heschl between the P300 amplitude and rCBF. (K.H.)

  10. Multivariate evaluation of brain function by measuring regional cerebral blood flow and event-related potentials

    International Nuclear Information System (INIS)

    Koga, Yoshihiko; Mochida, Masahiko; Shutara, Yoshikazu; Nakagawa, Kazumi; Nagata, Ken

    1998-01-01

    To measure the effect of events on human cognitive function, effects of odors by measurement regional cerebral blood flow (rCBF) and P300 were evaluated during the auditory odd-ball exercise. PET showed the increase in rCBF on the right hemisphere of the brain by coffee aroma. rCBF was measured by PET in 9 of right-handed healthy adults men, and P300 was by event-related potential (ERP) in each sex of 20 right-handed healthy adults. ERP showed the difference of the P300 amplitude between men and women, and showed the tendency, by odors except the lavender oil, that women had higher in the P300 amplitude than men. These results suggest the presence of effects on the cognitive function through emotional actions. Next, the relationship between rCBF and ERP were evaluated. The subjects were 9 of the right-handed healthy adults (average: 25.6±3.4 years old). rCBF by PET and P300 amplitude by ERP were simultaneously recorded during the auditory odd-ball exercise using the tone-burst method (2 kHz of the low frequency aimed stimuli and 1 kHz of the high frequency non-aimed stimuli). The rCBF value was the highest at the transverse gyrus of Heschl and the lowest at the piriform cortex among 24 regions of interest (ROI) from both sides. The difference of P300 peak latent time among ROI was almost the same. The brain waves from Cz and Pz were similar and the average amplitude was highest at Pz. We found the high correlation in the right piriform cortex (Fz), and right (Fz, Cz) and left (Cz, Pz) transverse gyrus of Heschl between the P300 amplitude and rCBF. (K.H.)

  11. Interictal "patchy" regional cerebral blood flow patterns in migraine patients. A single photon emission computerized tomographic study

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, J; Iversen, Helle Klingenberg

    1994-01-01

    In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right-left asymme......In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right...... rCBF images is insufficient to pick up abnormalities; (2) almost 50% of the migraine sufferers had abnormal rCBF/asymmetries. However, these are discrete compared with those typically seen during the aura phase of a migraine attack. One explanation to the patchy rCBF patterns might...

  12. Changes in intracranial morphology, regional cerebral water content and vital physiological variables during epidural bleeding

    International Nuclear Information System (INIS)

    Ganz, J.C.; Inst. of Surgical Research, National Hospital, Oslo; Thuomas, K.AA.; Inst. of Surgical Research, National Hospital, Oslo; Vlajkovic, S.; Inst. of Surgical Research, National Hospital, Oslo; Nilsson, P.; Inst. of Surgical Research, National Hospital, Oslo; Bergstroem, K.; Inst. of Surgical Research, National Hospital, Oslo; Ponten, U.; Inst. of Surgical Research, National Hospital, Oslo; Zwetnow, N.N.; Inst. of Surgical Research, National Hospital, Oslo

    1993-01-01

    Epidural bleeding was produced in 8 anaesthetised and heparinised dogs by an artificial system. Changes in vital physiological variables were related to intracranial shifts and tissue water content assessed with MR imaging. Six animals survived while 2 succumbed. In the surviving animals intracranial shifts and compressions remained unchanged from an early stage. The cerebral perfusion pressure was reduced from between 80 and 110 mm Hg to between 40 and 60 mm Hg. Some increase in supratentorial white matter tissue water was observed. In the lethal experiments cerebral perfusion pressure fell to less than 40 mm Hg. Moreover, secondary delayed anatomical changes were seen including hydrocephalus. Increase in cerebral tissue water was more intense and widespread than in the survivors. These findings indicate that the outcome of epidural bleeding is related to cerebral perfusion pressure with secondary deterioration resulting from additional volume loading from increased tissue water and hydrocephalus. (orig.)

  13. Patient-Reported Measures of Narcolepsy: The Need for Better Assessment.

    Science.gov (United States)

    Kallweit, Ulf; Schmidt, Markus; Bassetti, Claudio L

    2017-05-15

    Narcolepsy, a chronic disorder of the central nervous system, is clinically characterized by a symptom pentad that includes excessive daytime sleepiness, cataplexy, sleep paralysis, hypnopompic/hypnagogic hallucinations, and disrupted nighttime sleep. Ideally, screening and diagnosis instruments that assist physicians in evaluating a patient for type 1 or type 2 narcolepsy would be brief, easy for patients to understand and physicians to score, and would identify or rule out the need for electrophysiological testing. A search of the literature was conducted to review patient-reported measures used for the assessment of narcolepsy, mainly in clinical trials, with the goal of summarizing existing scales and identifying areas that may require additional screening questions and clinical practice scales. Of the seven scales reviewed, the Epworth Sleepiness Scale continues to be an important outcome measure to screen adults for excessive daytime sleepiness, which may be associated with narcolepsy. Several narcolepsy-specific scales have demonstrated utility, such as the Ullanlinna Narcolepsy Scale, Swiss Narcolepsy Scale, and Narcolepsy Symptom Assessment Questionnaire, but further validation is required. Although the narcolepsy-specific scales currently in use may identify type 1 narcolepsy, there are no validated questionnaires to identify type 2 narcolepsy. Thus, there remains a need for short, easily understood, and well-validated instruments that can be readily used in clinical practice to distinguish narcolepsy subtypes, as well as other hypersomnias, and for assessing symptoms of these conditions during treatment. © 2017 American Academy of Sleep Medicine

  14. Age-matched normal values and topographic maps for regional cerebral blood flow measurements by Xe-133 inhalation

    International Nuclear Information System (INIS)

    Matsuda, H.; Maeda, T.; Yamada, M.; Gui, L.X.; Tonami, N.; Hisada, K.

    1984-01-01

    The relationship between normal aging and regional cerebral blood flow (rCBF) computed as initial slope index (ISI) by Fourier method was investigated in 105 right-handed healthy volunteers (132 measurements) by Xe-133 inhalation method, and age-matched normal values were calculated. Mean brain ISI values showed significant negative correlation with advancing age (r . 0.70, p less than 0.001), and the regression line and its 95% confidence interval was Y . -0.32 (X - 19) + 63.5 +/- 11.2 (19 less than or equal to X less than or equal to 80). Regional ISI values also showed significant negative correlations for the entire brain (p less than 0.001). The regional reductions of ISI values with advancing age were significantly greater in the regional distribution of the middle cerebral arteries bilaterally, compared with regions in the distribution of the other arteries (p less than 0.05). Therefore, measured rCBF values for patients must be compared to age-matched normal values for mean hemispheric and each region examined. Two kinds of topographic maps, brain map showing rCBF compared to age-matched normal values and showing hemispheric differences were made by dividing patient's values by the 95% confidence limits for age-matched normal values and displaying laterality index calculated as follows, respectively. (formula; see text) These maps were useful for evaluating significantly decreased or increased regions and regional hemispheric differences

  15. Neurodevelopmental outcomes after regional cerebral perfusion with neuromonitoring for neonatal aortic arch reconstruction.

    Science.gov (United States)

    Andropoulos, Dean B; Easley, R Blaine; Brady, Ken; McKenzie, E Dean; Heinle, Jeffrey S; Dickerson, Heather A; Shekerdemian, Lara S; Meador, Marcie; Eisenman, Carol; Hunter, Jill V; Turcich, Marie; Voigt, Robert G; Fraser, Charles D

    2013-02-01

    In this study we report magnetic resonance imaging (MRI) brain injury and 12-month neurodevelopmental outcomes when regional cerebral perfusion (RCP) is used for neonatal aortic arch reconstruction. Fifty-seven neonates receiving RCP during aortic arch reconstruction were enrolled in a prospective outcome study. RCP flows were determined by near-infrared spectroscopy and transcranial Doppler monitoring. Brain MRI was performed preoperatively and 7 days postoperatively. Bayley Scales of Infant Development III was performed at 12 months. Mean RCP time was 71 ± 28 minutes (range, 5 to 121 minutes) and mean flow was 56.6 ± 10.6 mL/kg/min. New postoperative MRI brain injury was seen in 40% of patients. For 35 RCP patients at age 12 months, mean Bayley Scales III Composite standard scores were: Cognitive, 100.1 ± 14.6 (range, 75 to 125); Language, 87.2 ± 15.0 (range, 62 to 132); and Motor, 87.9 ± 16.8 (range, 58 to 121). Increasing duration of RCP was not associated with adverse neurodevelopmental outcomes. Neonatal aortic arch repair with RCP using a neuromonitoring strategy results in 12-month cognitive outcomes that are at reference population norms. Language and motor outcomes are lower than the reference population norms by 0.8 to 0.9 standard deviations. The neurodevelopmental outcomes in this RCP cohort demonstrate that this technique is effective and safe in supporting the brain during neonatal aortic arch reconstruction. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Changes in Regional Cerebral Blood Flow with Cognitive Behavioral Therapy in the Treatment of Panic Disorder

    International Nuclear Information System (INIS)

    Won, K. S.; Jun, S. K.; Kim, J. B.; Jang, E. J.

    2003-01-01

    This study attempted to prospectively investigate changes in regional cerebral blood flow (rCBF) on SPECT and clinical response to cognitive behavioral therapy (CBT) in patients with panic disorder with (PDA) and without (PD) agoraphobia. Using 99mTc-ECD brain SPECT, we assessed brain perfusion in 5 out patients at rest before and after CBT. The subjects received 12 weekly sessions of CBT. Subjects were assessed by Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, Anxiety Sensitivity Index, Beck Depression Inventory-II, Panic Disorder Severity Scale (PDSS) and clinical global improvement (CGI) scale measurement were used as outcome measures. Patients were considered responders to CBT if they are much or very much improved on CGI scale and have a PDSS score at least 30% below their baseline. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The baseline scans were compared to the post-CBT scans by using the statistics option multi subject, different conditions. Of 5 subjects 4 were male, 3 diagnosed PDA, and 4 on anti-anxiety medication. All of the subjects were classified as CBT responders. Their mean pretreatment and posttreatment PDSS were 17.4 (SD=8.2) and 4.2 (SD=3.1), respectively. The results of SPM analysis showed a significant decrease in blood flow after CBT in the thalamus bilaterally and right middle frontal gyrus (Brodmann's area 6). All results were thresholded at an uncorrected p<0.001 (for voxel height) and a corrected p<0.04 (for spatial extent). These preliminary data suggest that SPM analysis of 99mTc-ECD brain SPECT can reveal the change of rCBF in patient with panic disorder before and after CBT and the CBT effect may be associated with limbic and thalamic networks. However this study was a short trial with small number of subjects. Further studies with larger patient cohorts are needed

  17. Regional cerebral blood flow patterns in extremely elderly patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Hirao, Kentaro; Hanyu, Haruo; Kanetaka, Hidekazu; Shimizu, Soichiro; Sato, Tomohiko; Iwamoto, Toshihiko

    2008-01-01

    Clinical and pathologic features in Alzheimer's disease (AD) patients differ depending on the age of onset. The aim of our study was to compare the regional cerebral blood flow (rCBF) patterns of younger, elderly, and extremely elderly patients with AD with that of controls to characterize the rCBF patterns in extremely elderly patients with AD. Single photon emission CT (SPECT) was performed in 113 patients with probable AD, including 34 younger (<70 years), 41 elderly (70-84 years), and 38 extremely elderly (≥85 years) patients divided according to age at examination. The SPECT data were analyzed using three-dimensional stereotactic surface projection (3D-SSP). No significant differences regarding gender, duration of disease, education, and Mini-Mental State Examination score were found among the groups. As compared with controls, younger and elderly AD demonstrated significant reduction of rCBF in the temporo-parietal areas, posterior cingulate cortices and precunei, which is considered to be a characteristic rCBF pattern in AD. On the other hand, the extremely elderly AD group demonstrated significant reduction of rCBF in the frontal and medial temporal areas, in addition to the temporo-parietal areas, posterior cingulate cortices and precunei, but the reductions were milder than in those in younger and elderly AD groups. The extremely elderly patients with AD showed atypical rCBF patterns in AD compared to younger and elderly patients with AD. Our data suggest that pathological features in extremely elderly AD may be different from those in younger and elderly AD and that diseases different from AD, such as senile dementia of the neurofibrillary tangle type may be clinically diagnosed as extremely elderly AD. (author)

  18. Abnormal regional cerebral blood flow in systemic lupus erythematosus patients with psychiatric symptoms.

    Science.gov (United States)

    Oda, Kenji; Matsushima, Eisuke; Okubo, Yoshiro; Ohta, Katsuya; Murata, Yuji; Koike, Ryuji; Miyasaka, Nobuyuki; Kato, Motoichiro

    2005-07-01

    Single-photon emission computed tomography (SPECT) studies have demonstrated decreased regional cerebral blood flow (rCBF) in systemic lupus erythematosus (SLE) patients. However, no study has done voxel-based analysis using statistical parametric mapping (SPM) that can evaluate rCBF objectively, and the relationship between rCBF and psychiatric symptoms has not been well investigated. Using L,L-ethyl cysteinate dimer (99mTc ECD) SPECT and SPM, we aimed to clarify the association of rCBF changes with psychiatric symptoms in SLE patients whose magnetic resonance imaging (MRI) showed no morphological abnormalities. Twenty SLE patients and 19 healthy volunteers underwent 99mTc ECD SPECT. Data were collected from August 2000 to March 2003. SLE was diagnosed according to American College of Rheumatology criteria, and psychiatric symptoms were diagnosed according to ICD-10 criteria. On the basis of the modified Carbotte, Denburg, and Denburg method, the patients were classified into 3 groups: a group with major psychiatric symptoms (hallucinosis, delusional disorder, and mood disorder), a group with minor psychiatric symptoms (anxiety disorder, dissociative disorder, and emotionally labile disorder), and a group without psychiatric symptoms. Gross organic lesions were ruled out by brain MRI. Group comparisons of rCBF were performed with analysis using SPM99. SLE patients without MRI lesions showed decreased rCBF in the posterior cingulate gyrus and thalamus. The reduction in rCBF was overt in patients with major psychiatric symptoms. Our study indicated that SLE patients may have dysfunction in the posterior cingulate gyrus and thalamus and that this may be associated with the severity of psychiatric symptoms.

  19. Changes in Regional Cerebral Blood Flow with Cognitive Behavioral Therapy in the Treatment of Panic Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Won, K. S.; Jun, S. K.; Kim, J. B.; Jang, E. J. [College of Medicine, Univ. of Kyemyoung, Taegu (Korea, Republic of)

    2003-07-01

    This study attempted to prospectively investigate changes in regional cerebral blood flow (rCBF) on SPECT and clinical response to cognitive behavioral therapy (CBT) in patients with panic disorder with (PDA) and without (PD) agoraphobia. Using 99mTc-ECD brain SPECT, we assessed brain perfusion in 5 out patients at rest before and after CBT. The subjects received 12 weekly sessions of CBT. Subjects were assessed by Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, Anxiety Sensitivity Index, Beck Depression Inventory-II, Panic Disorder Severity Scale (PDSS) and clinical global improvement (CGI) scale measurement were used as outcome measures. Patients were considered responders to CBT if they are much or very much improved on CGI scale and have a PDSS score at least 30% below their baseline. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The baseline scans were compared to the post-CBT scans by using the statistics option multi subject, different conditions. Of 5 subjects 4 were male, 3 diagnosed PDA, and 4 on anti-anxiety medication. All of the subjects were classified as CBT responders. Their mean pretreatment and posttreatment PDSS were 17.4 (SD=8.2) and 4.2 (SD=3.1), respectively. The results of SPM analysis showed a significant decrease in blood flow after CBT in the thalamus bilaterally and right middle frontal gyrus (Brodmann's area 6). All results were thresholded at an uncorrected p<0.001 (for voxel height) and a corrected p<0.04 (for spatial extent). These preliminary data suggest that SPM analysis of 99mTc-ECD brain SPECT can reveal the change of rCBF in patient with panic disorder before and after CBT and the CBT effect may be associated with limbic and thalamic networks. However this study was a short trial with small number of subjects. Further studies with larger patient cohorts are needed.

  20. Clinical and practical considerations in the pharmacologic management of narcolepsy.

    Science.gov (United States)

    Thorpy, Michael J; Dauvilliers, Yves

    2015-01-01

    Despite published treatment recommendations and the availability of approved and off-label pharmacologic therapies for narcolepsy, the clinical management of this incurable, chronic neurologic disorder remains challenging. While treatment is generally symptomatically driven, decisions regarding which drug(s) to use need to take into account a variety of factors that may affect adherence, efficacy, and tolerability. Type 1 narcolepsy (predominantly excessive daytime sleepiness with cataplexy) or type 2 narcolepsy (excessive daytime sleepiness without cataplexy) may drive treatment decisions, with consideration given either to a single drug that targets multiple symptoms or to multiple drugs that each treat a specific symptom. Other drug-related characteristics that affect drug choice are dosing regimens, tolerability, and potential drug-drug interactions. Additionally, the patient should be an active participant in treatment decisions, and the main symptomatic complaints, treatment goals, psychosocial setting, and use of lifestyle substances (ie, alcohol, nicotine, caffeine, and cannabis) need to be discussed with respect to treatment decisions. Although there is a lack of narcolepsy-specific instruments for monitoring therapeutic effects, clinically relevant subjective and objective measures of daytime sleepiness (eg, Epworth Sleepiness Scale and Maintenance of Wakefulness Test) can be used to provide guidance on whether treatment goals are being met. These considerations are discussed with the objective of providing clinically relevant recommendations for making treatment decisions that can enhance the effective management of patients with narcolepsy. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Comparison of driving simulator performance and neuropsychological testing in narcolepsy.

    Science.gov (United States)

    Kotterba, Sylvia; Mueller, Nicole; Leidag, Markus; Widdig, Walter; Rasche, Kurt; Malin, Jean-Pierre; Schultze-Werninghaus, Gerhard; Orth, Maritta

    2004-09-01

    Daytime sleepiness and cataplexy can increase automobile accident rates in narcolepsy. Several countries have produced guidelines for issuing a driving license. The aim of the study was to compare driving simulator performance and neuropsychological test results in narcolepsy in order to evaluate their predictive value regarding driving ability. Thirteen patients with narcolepsy (age: 41.5+/-12.9 years) and 10 healthy control patients (age: 55.1+/-7.8 years) were investigated. By computer-assisted neuropsychological testing, vigilance, alertness and divided attention were assessed. In a driving simulator patients and controls had to drive on a highway for 60 min (mean speed of 100 km/h). Different weather and daytime conditions and obstacles were presented. Epworth Sleepiness Scale-Scores were significantly raised (narcolepsy patients: 16.7+/-5.1, controls: 6.6+/-3.6, P divided attention (56.9+/-25.4) and vigilance (58.7+/-26.8) were in a normal range. There was, however, a high inter-individual difference. There was no correlation between driving performance and neuropsychological test results or ESS Score. Neuropsychological test results did not significantly change in the follow-up. The difficulties encountered by the narcolepsy patient in remaining alert may account for sleep-related motor vehicle accidents. Driving simulator investigations are closely related to real traffic situations than isolated neuropsychological tests. At the present time the driving simulator seems to be a useful instrument judging driving ability especially in cases with ambiguous neuropsychological results.

  2. Juvenile myoclonic epilepsy and narcolepsy: A series of three cases.

    Science.gov (United States)

    Joshi, Puja Aggarwal; Poduri, Annapurna; Kothare, Sanjeev V

    2015-10-01

    This paper sets out to demonstrate the coexistence of juvenile myoclonic epilepsy (JME) and narcolepsy that raises the possibility of a shared genetic predisposition to both conditions. The electronic medical records (EMRs) were searched for narcolepsy and JME over 10years. We identified three young adult women diagnosed with JME in their teenage years, with myoclonic, generalized tonic-clonic, and absence seizure semiologies, along with psychiatric comorbidity, well managed on lamotrigine and/or levetiracetam. Our patients were also found to have disturbed sleep preceding the diagnosis of JME by many years, including excessive daytime sleepiness (EDS), fragmented nocturnal sleep, hypnagogic vivid hallucinations, and REM behavior disorder along with daytime cataplexy. They were ultimately diagnosed with coexisting narcolepsy, confirmed by sleep studies and multiple sleep latency testing, along with positive genetic testing for HLA-DQB1*0602 in all three patients. Stimulants, selective serotonin receptor inhibitors, and/or sodium oxybate were used to successfully treat their narcolepsy. The coexistence of JME and narcolepsy has not been well recognized and may be clinically relevant. In addition, it raises the possibility of a shared genetic predisposition to both conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Analysis of Regional Cerebral Blood Flow Using {sup 99m}Tc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-03-15

    {sup 99m}Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, {sup 99m}Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  4. Findings of 99mTc-HMPAO Regional Cerebral Blood Flow SPECT in a Case of Herpes Simplex Encephalitis

    International Nuclear Information System (INIS)

    Ahn, Myeong Im; Lee, Sung Yong; Kim, Jong Woo; Bahk, Yong Whee

    1989-01-01

    Herpes simplex encephalitis (HSE) is one of the fulminant necrotizing, often fatal sporadic form of the encephalitis caused by herpes simplex type I virus. Characteristically, there is early and almost constant involvement of one or both temporal lobes, although there are common additional areas of involvement. Appropriate early treatment following correct diagnosis by clinical findings, CSF study, EEG and several radiological studies including angiography, radionuclide studies, CT or MRI can reduce its mortality and severity of the sequelae. We report a case of HSE diagnosed by adjuvant study of 99m Tc-HMPAO regional cerebral blood flow SPECT, which showed a marked increase in bitemporal cerebral blood flow in a 24-year-old man.

  5. Advances in regional cerebral blood flow measurement and patho-physiological analysis by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo [Niigata Univ. (Japan). School of Medicine

    1994-04-01

    Recently, two kinds of radiopharmaceuticals have been developed to represent the biodistribution of regional blood flow, which are N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and [sup 99m]Tc-hexamethylpropylene-amine-oxime (HMPAO). The charachteristics, clinical usage and imitation of these two radiolabeled agents are discussed. The advantage of [sup 123]I-IMP is that it has high first-pass extraction and long retention in brain tissue, hence it can be used to measure the absolute values of regional cerebral blood flow (rCBF). When the kinetics of [sup 123]I-IMP is assumed to be freely diffusible in the brain, its behavior is considered by 2-compartment model, especially which is assumed by the microsphere model in the early period after the i.v. injection of [sup 123]I-IMP. Comparing the rCBF measured by [sup 123]I-IMP with that by [sup 133]Xe inhalation SPECT method, we have to consider PaCO[sub 2] when both SPECT studies are performed, because PaCO[sub 2] is one of the big factors which make effects on the alteration of rCBF. [sup 123]I-IMP has an interesting character of the redistribution phenomenon which represrent the degree of ischemia in the cerebrovascular diseases. Distribution volume an important datum obtained by the SPECT study with [sup 123]I-IMP, which represent the degree of retention, i.e. binding potential of [sup 123]I-IMP in the brain tissue. I introduced the usage of the distribution volume of [sup 123]I-IMP, which was constructed in the rate constant square method, in the differential diagnosis of Parkinson's disease and progressive supranuclear palsy (PSP). The clinical usage of [sup 99m] Tc-HMPAT was mentioned, the advantage of which is the rapid fixation in the brain tissue and the distribution does not change for long time after the i.v. injection. Hence [sup 99m]Tc-HMPAO is used for the diagnosis of epileptic foci and certain loading tests such as balloon occlusion test, postural test and acetazolamide loading test. (author).

  6. Advances in regional cerebral blood flow measurement and patho-physiological analysis by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo (Niigata Univ. (Japan). School of Medicine)

    1994-04-01

    Recently, two kinds of radiopharmaceuticals have been developed to represent the biodistribution of regional blood flow, which are N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and [sup 99m]Tc-hexamethylpropylene-amine-oxime (HMPAO). The charachteristics, clinical usage and imitation of these two radiolabeled agents are discussed. The advantage of [sup 123]I-IMP is that it has high first-pass extraction and long retention in brain tissue, hence it can be used to measure the absolute values of regional cerebral blood flow (rCBF). When the kinetics of [sup 123]I-IMP is assumed to be freely diffusible in the brain, its behavior is considered by 2-compartment model, especially which is assumed by the microsphere model in the early period after the i.v. injection of [sup 123]I-IMP. Comparing the rCBF measured by [sup 123]I-IMP with that by [sup 133]Xe inhalation SPECT method, we have to consider PaCO[sub 2] when both SPECT studies are performed, because PaCO[sub 2] is one of the big factors which make effects on the alteration of rCBF. [sup 123]I-IMP has an interesting character of the redistribution phenomenon which represrent the degree of ischemia in the cerebrovascular diseases. Distribution volume an important datum obtained by the SPECT study with [sup 123]I-IMP, which represent the degree of retention, i.e. binding potential of [sup 123]I-IMP in the brain tissue. I introduced the usage of the distribution volume of [sup 123]I-IMP, which was constructed in the rate constant square method, in the differential diagnosis of Parkinson's disease and progressive supranuclear palsy (PSP). The clinical usage of [sup 99m] Tc-HMPAT was mentioned, the advantage of which is the rapid fixation in the brain tissue and the distribution does not change for long time after the i.v. injection. Hence [sup 99m]Tc-HMPAO is used for the diagnosis of epileptic foci and certain loading tests such as balloon occlusion test, postural test and acetazolamide loading test. (author).

  7. Regional cerebral blood flow in epileptic foci using [I-123] IMP-SPECT

    International Nuclear Information System (INIS)

    Konishi, Tohru

    1989-01-01

    Fifty-six epileptic patients, whose ages ranged from 6 months to 16 years (a mean age, 8 years and 2 months), were examined by single photon emission computed tomography (SPECT) with [I-123] N-isopropyl p-iodoamphetamine (IMP). Of these patients, 44 had partial seizures (PS) and 12 had generalized seizures (GS). SPECT revealed abnormality of regional cerebral blood flow (rCBF) in 24 PS patients (54.5%), being correlated with EEG abnormality. Among the 24 patients, 22 had a decreased rCBF and 2 others had an increased rCBF. According to the PS type, rCBF abnormality in the foci was less frequently observed for benign age-related partial epilepsy (2/9) than for the other types of partial epilepsy (22/35). Among 35 patients with the other types of partial epilepsy, SPECT showed foci in the frontal (12), central (3), parietal (4), temporal (6), and occipital (6) regions, and diffuse spike-wave or the lack of paroaxysmals (4). The EEG foci was of the left hemisphere in 12 patients, and of the right hemisphere in 18 patients. Higher incidence of rCBF abnormality was associated with the temporal, partietal, and frontal foci than with the occipital foci. There was no correlation between the incidence of rCBF abnormlaity and the frequency of seizure activities on EEG. Complex partial seizures had a tendency to be associated with rCBF abnormality. In comparing IMP uptake in evaluable 17 patients with a decreased rCBF, a mean %CBF in foci compared to that in the contralateral area was 91.9%. All of the 12 GS patients showed no focal reduction of rCBF around the cortex. Patients with tonic-clonic seizure and myoclonic seizure had almost normal IMP images. The IMP images of organic lesions were a marked reduction of rCBF. IMP-SPECT may also be suitable for evaluating the underlying organic and secondary involving disorders with epilepsy. (N.K.)

  8. Cluster headache: transcranial Doppler ultrasound and regional cerebral blood flow studies

    International Nuclear Information System (INIS)

    Dahl, A.; Russell, D.; Nyberg-Hansen, R.; Rootwelt, K.

    1990-01-01

    Transcranial Doppler and rCBF examinations were carried out in 25 cluster headache patients. Spontaneous glyceryl trinitrate (nitroglycerin) provoked attacks were accompanied by a bilateral decrease in middle cerebral artery blood flow velocities. This decrease was more pronounced on the symptomatic side, but the difference did not reach statistical significance. Mean hemispheric blood flow and rCBF were within normal limits during provoked attacks and similar to those found when patients were attack-free. During cluster periods middle cerebral artery velocities were significantly higher on the symptomatic side. Glyceryl trinitrate caused a bilateral middle cerebral artery velocity decrease which was significantly greater on the symptomatic side. Attacks provoked by glyceryl trinitrate appeared to begin when the vasodilatory effect of this substance was received. 17 refs., 2 figs., 5 tabs

  9. A simple technique to measure regional cerebral blood flow during intravascular ballon clamping

    International Nuclear Information System (INIS)

    Furuhata, Shigeru; Kubo, Atsushi; Kawase, Takeshi; Ibata, Yukio; Toya, Shigeo

    1988-01-01

    A case of giant internal carotid ophthalmic aneurysm was presented. In order to clarify whether the patient could tolerate carotid occlusion, a ballon clamping test was performed before surgery. The cerebral blood flow was measured using early imaging by single photon emission computed tomography (SPECT) with N-isopropyl-(iodine-123)-p-iodoamphetamine ( 123 I-IMP). When the ballon clamping test was performed the tracer was injected, and scanning was performed 35 minutes after removing the catheter. This tracer enabled a 'memory of blood flow' during temporary ischemia to determine the character of quick diffusion and slow wash out, that could not be performed by other methods of cerebral blood flow measurement. SPECT with 123 I-IMP can simplify the measurement of cerebral blood flow during the balloon clamping test. (author)

  10. Lexical factors and cerebral regions influencing verbal fluency performance in MCI.

    Science.gov (United States)

    Clark, D G; Wadley, V G; Kapur, P; DeRamus, T P; Singletary, B; Nicholas, A P; Blanton, P D; Lokken, K; Deshpande, H; Marson, D; Deutsch, G

    2014-02-01

    nouns score in the left inferior frontal gyrus, but for letter A, letter S, and a composite FAS score in the right inferior frontal gyrus. These regressions also revealed a lateralized association of the left subcortical nuclei with all letter fluency scores and fruits and vegetables fluency, and an association of the right lower temporal ROI with letter A, FAS, and verb fluency. Gray matter volume in several bihemispheric ROIs (left dorsal frontal, right lower temporal, right occipital, and bilateral mesial temporal) mediated the relationship between cognitive impairment and fluency for fruits and vegetables. Gray matter volume in the right lower temporal ROI mediated the relationship between cognitive impairment and five fluency raw scores (animals, fruits and vegetables, tools, verbs, and the composite nouns score). Semantic memory exerts the strongest influence on word adjacency in letter fluency as well as semantic verbal fluency tasks. Orthography is a stronger influence than pronunciation. All types of fluency task raw scores (letter, noun, and verb) correlate with cerebral regions known to support verbal or nonverbal semantic memory. The findings emphasize the contribution of right hemisphere regions to fluency task performance, particularly for verb and letter fluency. The relationship between diagnosis and semantic fluency performance is mediated by semantic similarity of words and by gray matter volume in the right lower temporal region. Published by Elsevier Ltd.

  11. Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET

    DEFF Research Database (Denmark)

    IIda, H.; Law, I.; Pakkenberg, B.

    2000-01-01

    Limited spatial resolution of positron emission tomography (PET) can cause significant underestimation in the observed regional radioactivity concentration (so-called partial volume effect or PVE) resulting in systematic errors in estimating quantitative physiologic parameters. The authors have...... formulated four mathematical models that describe the dynamic behavior of a freely diffusible tracer (H215O) in a region of interest (ROI) incorporating estimates of regional tissue flow that are independent of PVE. The current study was intended to evaluate the feasibility of these models and to establish...... a methodology to accurately quantify regional cerebral blood flow (CBF) corrected for PVE in cortical gray matter regions. Five monkeys were studied with PET after IV H2(15)O two times (n = 3) or three times (n = 2) in a row. Two ROIs were drawn on structural magnetic resonance imaging (MRI) scans and projected...

  12. Relationship between white matter lesions and regional cerebral blood flow changes during longitudinal follow up in Alzheimer's disease.

    Science.gov (United States)

    Hanaoka, Takuya; Kimura, Noriyuki; Aso, Yasuhiro; Takemaru, Makoto; Kimura, Yuki; Ishibashi, Masato; Matsubara, Etsuro

    2016-07-01

    The aim of the present study was to evaluate the relationship between baseline white matter lesions (WML) and changes in regional cerebral blood flow during longitudinal follow up of patients with Alzheimer's disease (AD). A total of 38 patients with AD were included in the study (16 men, 22 women; mean age 77.8 years). All patients were evaluated using the Mini-Mental State Examination and brain perfusion single-photon emission computed tomography at baseline with an approximately 2-year follow up. The patients were divided into two subgroups according to the presence of WML on magnetic resonance imaging. Single-photon emission computed tomography data were analyzed using a voxel-by-voxel group analysis with Statistical Parametric Mapping 8 and region of interest analysis using FineSRT. Changes in Mini-Mental State Examination scores and regional cerebral blood flow were analyzed using the Wilcoxon signed-rank test. Mean Mini-Mental State Examination scores in AD patients with WML significantly decreased from 19.4 ± 4.8 to 15.5 ± 6.5 (P = 0.003). Statistical Parametric Mapping 8 and FineSRT analysis showed more severe and widespread regional cerebral blood flow reduction, mainly in the frontal and mesial temporal regions in AD patients with WML compared with those without WML. Baseline WML could predict a rapid progression of cognitive and brain functional impairment during longitudinal follow up in AD. Geriatr Gerontol Int 2016; 16: 836-842. © 2015 Japan Geriatrics Society.

  13. Regional cerebral blood flow pattern in normal young and aged volunteers: a 99mTc-HMPAO SPET study

    International Nuclear Information System (INIS)

    Catafau, A.M.; Lomena, J.; Pavia, J.; Parellada, E.; Bernardo, M.; Setoain, J.; Tolosa, E.

    1996-01-01

    The aim of this study was to investigate the normal pattern of regional cerebral blood flow (rCBF) distribution in normal young and aged volunteers using technetium-99m hexamethylpropylene amine oxime ( 99m -Tc-HMPAO) as a tracer. The region brain perfusion of young and aged subjects was compared, especially regarding rCBF differences due to age and gender, and interhemispheric rCBF asymmetries. Sixty-eight right-handed normal volunteers -40 young (mean age 29.5±6.3 years) and 28 aged (mean age 71.2±4.3 years) - were included in the study. rCBF was estimated on the basis of a semiquantitative approach by means of a left-right index and two region/reference ratios, using the cerebellum and the whole brain activity as references. A good correlation between these two region/reference ratios was found (P<0.005 in all cerebral regions). The highest rCBF ratios corresponded to the cerebellum, followed by the occipital lobe. The remaining cortical regions (temporal, parietal, frontal and basal ganglia) showed slightly lower values. The white matter showed rCBF ratios substantially lower than the grey matter. In neighter young nor aged subjects were significant rCBF differences between the genders found in any of the two region/reference indices employed. Aged sugjects showed significantly lower rCBF ratios than young subjects in the left frontal lobe and in the posterior region of the left temporal lobe. In both young and aged subjects, lower perfusion was found in the left hemisphere, except for the white matter region in both age groups and the frontal lobe in the young subjects. Aged subjects presented a slightly higher interhemispheric asymmetry in the frontal lobe. However, interhemispheric asymmetry was minimal (-1.01% to 3.14%). Consequently, a symmetrical rCBF distribution can be assumed between homologous regions, independent of age. (orig.)

  14. Post-Traumatic Narcolepsy Associated with Thalamic/Hypothalamic Injury

    Directory of Open Access Journals (Sweden)

    Kikyoung Yi

    2015-12-01

    Full Text Available The hypothalamus is an important structure that regulates sleep via hypocretin neurotransmission. Central nervous system disorders such as tumors and vascular legions involving the hypothalamus can cause secondary narcolepsy. In addition, brain trauma can contribute to post-traumatic narcolepsy despite lack of any definite brain lesion. Here, we present a case of a 37-year-old man suffering from a hypothalamus-to-thalamus hemorrhage after a traffic accident. After this trauma, he suffered from excessive daytime sleepiness and was diagnosed with post-traumatic narcolepsy by polysomnography and multiple sleep latency tests. He was positive for human leukocyte antigen (HLA-DQB1*03:01 and HLA-DQB1*06:01 antigens.

  15. Comorbidity of narcolepsy and schizophrenia in an adolescent patient

    Directory of Open Access Journals (Sweden)

    Mu-Hong Chen

    2014-11-01

    Full Text Available A 13-year-old boy suffered from hypersomnia, fragmented nighttime sleep, and cataplexy since age 10 years, and then developed prominent psychotic symptoms (i.e., auditory and visual hallucination, hallucinatory behavior, delusions of reference, and misidentification that occurred persistently during the wakeful and consciously clear period when he was aged 12 years. The child underwent additional medical evaluation and testing, and comorbidity of narcolepsy and schizophrenia was diagnosed. The child's psychotic symptoms and narcolepsy improved significantly upon treatment with methylphenidate 30 mg, olanzapine 25 mg, and haloperidol 10 mg. In this case, the child's symptomology of narcolepsy and schizophrenia and the dilemma of the use of antipsychotics and psychostimulants are representative examples of the diagnostic and therapeutic challenges in adolescent psychiatry.

  16. Characteristics of rapid eye movement sleep behavior disorder in narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul Jørgen; Frandsen, Rune Asger Vestergaard; Knudsen, Stine

    2013-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with Parkinsonian disorders, but is also reported in narcolepsy. Most patients...... of hypocretin deficiency. Thus, hypocretin deficiency is linked to the two major disturbances of REM sleep motor regulation in narcolepsy: RBD and cataplexy. Moreover, it is likely that hypocretin deficiency independently predicts periodic limb movements in REM and NREM sleep, probably via involvement...... of the dopaminergic system. This supports the hypothesis that an impaired hypocretin system causes general instability of motor regulation during wakefulness, REM and NREM sleep in human narcolepsy. We propose that hypocretin neurons are centrally involved in motor tone control during wakefulness and sleep in humans...

  17. The European Narcolepsy Network (EU-NN) database

    DEFF Research Database (Denmark)

    Khatami, Ramin; Luca, Gianina; Baumann, Christian R

    2016-01-01

    Narcolepsy with cataplexy is a rare disease with an estimated prevalence of 0.02% in European populations. Narcolepsy shares many features of rare disorders, in particular the lack of awareness of the disease with serious consequences for healthcare supply. Similar to other rare diseases, only a ......, identification of post-marketing medication side-effects, and will contribute to improve clinical trial designs and provide facilities to further develop phase III trials....... Narcolepsy Network is introduced. The database structure, standardization of data acquisition and quality control procedures are described, and an overview provided of the first 1079 patients from 18 European specialized centres. Due to its standardization this continuously increasing data pool is most...

  18. Antibodies Against Hypocretin Receptor 2 Are Rare in Narcolepsy.

    Science.gov (United States)

    Giannoccaro, Maria Pia; Waters, Patrick; Pizza, Fabio; Liguori, Rocco; Plazzi, Giuseppe; Vincent, Angela

    2017-02-01

    Recently, antibodies to the hypocretin receptor 2 (HCRTR2-Abs) were reported in a high proportion of narcolepsy patients who developed the disease following Pandemrix® vaccination. We tested a group of narcolepsy patients for the HCRTR2-Abs using a newly established cell-based assay. Sera from 50 narcolepsy type 1 (NT1) and 11 narcolepsy type 2 (NT2) patients, 22 patients with other sleep disorders, 15 healthy controls, and 93 disease controls were studied. Cerebrospinal fluid (CSFs) from three narcoleptic patients were subsequently included. Human embryonic kidney cells were transiently transfected with human HCRTR2, incubated with patients' sera for 1 hr at 1:20 dilution and then fixed. Binding of antibodies was detected by fluorescently labeled secondary antibodies to human immunoglobulin G (IgG) and the different IgG subclasses. A nonlinear visual scoring system was used from 0 to 4; samples scoring ≥1 were considered positive. Only 3 (5%) of 61 patients showed a score ≥1, one with IgG1- and two with IgG3-antibodies, but titers were low (1:40-1:100). CSFs from these patients were negative. The three positive patients included one NT1 case with associated psychotic features, one NT2 patient, and an NT1 patient with normal hypocretin CSF levels. Low levels of IgG1 or IgG3 antibodies against HCRTR2 were found in 3 of 61 patients with narcolepsy, although only 1 presented with full-blown NT1. HCRTR2-Abs are not common in narcolepsy unrelated to vaccination. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. The Socioeconomic and Demographic Features of Children with Cerebral Palsi Applied to our Centre from Southern Eastern Anatolian Region

    Directory of Open Access Journals (Sweden)

    Sedat Nacitarhan

    2005-01-01

    Full Text Available Cerebral palsy is a general term which is used to describe a group of disorders that define muscle control impairment due to lesion in the developing brain. The aim of the present study was to indicate the common features of the children with cerebral palsy and their families in South Eastern region of Turkey, the most underdeveloped community in our country. In addition, the rate of marriage between the relatives (consanguineous marriage is higher in this region than the other regions.A total of 258 children with a diagnosis of cerebral palsy were enrolled to our study. These children were born in South Eastern Anatolian region and live here throughout their childhood. Their families were also living in this region. The members of the families were interviewed with the questionnaire to obtain information. Statistical analysis of the results was performed with Graphpad Prism Ver 3.00.68.99 percent of the patients in our study were men, and 31.01 percent were women. They were between the ages of 10-375 months, average was 75.43±59.15 months. Rate of people, who was not under any social security guarantee, was 15.5%. 50.3% of mothers were not literate. Families’ income was 8.5% good, 42.6% poor. In families, there was 33.3% rate of relationship between partners (consanguineous marriage. In 15.5% of families, there was another retarded child. 55 percent of mothers were never been under health check in pregnancy period. Retarded child was usually from first delivery (26.3%. 3.1% of our patients had twin pregnancy. Only 59,6% of the whole births were given at the hospital or by the help of a midwife. Children were suckled along 6.4±6.4 months. Only 8,5% of the children were being educated.Finally, we concluded that reducing convertible risk factors caused by the low education level of our region, underdeveloped socioeconomic conditions and some traditions (e.g. consanguineous marriage and delivery in house instead of health organization has

  20. Regional distribution of cerebral white matter lesions years after preeclampsia and eclampsia

    NARCIS (Netherlands)

    Wiegman, Marjon J.; Zeeman, Gerda G.; Aukes, Annet M.; Bolte, Antoinette C.; Faas, Marijke M.; Aarnoudse, Jan G.; de Groot, Jan C.

    OBJECTIVE: To assess the distribution of cerebral white matter lesions in women who had eclampsia, preeclampsia, or normotensive pregnancies. The pathophysiology of these lesions, more often seen in formerly eclamptic and preeclamptic women, is unclear but may be related to a predisposition for

  1. Effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Juhler, Marianne; Wetterslev, Jørn

    2014-01-01

    BACKGROUND: One of the main causes of mortality and morbidity following subarachnoid hemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, no effective treatment of vasospasm exists to date. ...

  2. The effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Wetterslev, Jørn; Stavngaard, Trine

    2012-01-01

    One of the main causes of mortality and morbidity following subarachnoid haemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, to date no effective treatment of vasospasm exists. Prostacycli...

  3. Narcolepsy: Association with H1N1 Infection and Vaccination

    Directory of Open Access Journals (Sweden)

    Ji Hyun Song

    2016-12-01

    Full Text Available Epidemiological studies have demonstrated an association between H1N1 influenza infection and vaccinations. This article reviews the various studies, and suggests the biological mechanisms explaining why and how H1N1 influenza infection or vaccine stimulates the autoimmune response, thereby resulting in narcolepsy. Among the vaccines, the effect of Pandemrix was scrutinized more than other vaccines, due to its higher association with an increase of narcolepsy onset. The consequences of using other vaccines which contain same or different adjuvants as Pandemrix, were also analyzed.

  4. QUANTITATIVE CHANGES IN REGIONAL CEREBRAL BLOOD FLOW INDUCED BY COLD, HEAT AND ISCHEMIC PAIN: A CONTINUOUS ARTERIAL SPIN LABELING STUDY

    Science.gov (United States)

    Frölich, Michael A.; Deshpande, Hrishikesh; Ness, Timothy; Deutsch, Georg

    2012-01-01

    Background The development of arterial spin labeling methods, has allowed measuring regional cerebral blood flow (rCBF) quantitatively and to show the pattern of cerebral activity associated with any state such as a sustained pain state or changes due to a neurotropic drug. Methods We studied the differential effects of three pain conditions in ten healthy subjects on a 3T scanner during resting baseline, heat, cold and ischemic pain using continuous arterial spin labeling. Results Cold pain showed the greatest absolute rCBF increases in left anterior cingulate cortex, left amygdala, left angular gyrus, and Brodmann Area 6, and a significant rCBF decrease in the cerebellum. Changes in rCBF were characteristic of the type of pain condition: cold and heat pain showed increases, while the ischemic condition showed a reduction in mean absolute gray matter flow compared to rest. An association of subjects’ pain tolerance and cerebral blood flow was noted. Conclusions The observation that quantitative rCBF changes are characteristic of the pain task employed and that there is a consistent rCBF change in Brodman area 6, an area responsible for the integration of a motor response to pain, should provide extremely useful information in the quest to develop an imaging biomarker of pain. Conceivably, response in BA6 may serve as an objective measure of analgesic efficacy. PMID:22913924

  5. Quantitative changes in regional cerebral blood flow induced by cold, heat and ischemic pain: a continuous arterial spin labeling study.

    Science.gov (United States)

    Frölich, Michael A; Deshpande, Hrishikesh; Ness, Timothy; Deutsch, Georg

    2012-10-01

    The development of arterial spin labeling methods has allowed measuring regional cerebral blood flow (rCBF) quantitatively and to show the pattern of cerebral activity associated with any state such as a sustained pain state or changes due to a neurotropic drug. The authors studied the differential effects of three pain conditions in 10 healthy subjects on a 3 Tesla scanner during resting baseline, heat, cold, and ischemic pain using continuous arterial spin labeling. Cold pain showed the greatest absolute rCBF increases in left anterior cingulate cortex, left amygdala, left angular gyrus, and Brodmann area 6, and a significant rCBF decrease in the cerebellum. Changes in rCBF were characteristic of the type of pain condition: cold and heat pain showed increases, whereas the ischemic condition showed a reduction in mean absolute gray matter flow compared with rest. An association of subjects' pain tolerance and cerebral blood flow was noted. The observation that quantitative rCBF changes are characteristic of the pain task used and that there is a consistent rCBF change in Brodman area 6, an area responsible for the integration of a motor response to pain, should provide extremely useful information in the quest to develop an imaging biomarker of pain. Conceivably, response in BA6 may serve as an objective measure of analgesic efficacy.

  6. Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study.

    Science.gov (United States)

    Tuna, Ayca Tas; Akkoyun, Ibrahim; Darcin, Sevtap; Palabiyik, Onur

    2016-01-01

    Laparoscopic surgery has become a popular surgical tool when compared to traditional open surgery. There are limited data on pediatric patients regarding whether pneumoperitoneum affects cerebral oxygenation although end-tidal CO2 concentration remains normal. Therefore, this study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children. The study comprised forty children who were scheduled for laparoscopic (Group L, n=20) or open (Group O, n=20) appendectomy. Hemodynamic variables, right and left regional cerebral oxygen saturation (RrSO2 and LrSO2), fraction of inspired oxygen, end-tidal carbon dioxide pressure (PETCO2), peak inspiratory pressure (Ppeak), respiratory minute volume, inspiratory and end-tidal concentrations of sevoflurane and body temperature were recorded. All parameters were recorded after anesthesia induction and before start of surgery (T0, baseline), 15min after start of surgery (T1), 30min after start of surgery (T2), 45min after start of surgery (T3), 60min after start of surgery (T4) and end of the surgery (T5). There were progressive decreases in both RrSO2 and LrSO2 levels in both groups, which were not statistically significant at T1, T2, T3, T4. The RrSO2 levels of Group L at T5 were significantly lower than that of Group O. One patient in Group L had an rSO2 value <80% of the baseline value. Carbon dioxide insufflation during pneumoperitoneum in pediatric patients may not affect cerebral oxygenation under laparoscopic surgery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. [Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study].

    Science.gov (United States)

    Tuna, Ayca Tas; Akkoyun, Ibrahim; Darcin, Sevtap; Palabiyik, Onur

    2016-01-01

    Laparoscopic surgery has become a popular surgical tool when compared to traditional open surgery. There are limited data on pediatric patients regarding whether pneumoperitoneum affects cerebral oxygenation although end-tidal CO2 concentration remains normal. Therefore, this study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children. The study comprised forty children who were scheduled for laparoscopic (Group L, n=20) or open (Group O, n=20) appendectomy. Hemodynamic variables, right and left regional cerebral oxygen saturation (RrSO2 and LrSO2), fraction of inspired oxygen, end-tidal carbon dioxide pressure (PETCO2), peak inspiratory pressure (Ppeak), respiratory minute volume, inspiratory and end-tidal concentrations of sevoflurane and body temperature were recorded. All parameters were recorded after anesthesia induction and before start of surgery (T0, baseline), 15min after start of surgery (T1), 30min after start of surgery (T2), 45min after start of surgery (T3), 60min after start of surgery (T4) and end of the surgery (T5). There were progressive decreases in both RrSO2 and LrSO2 levels in both groups, which were not statistically significant at T1, T2, T3, T4. The RrSO2 levels of Group L at T5 were significantly lower than that of Group O. One patient in Group L had an rSO2 value <80% of the baseline value. Carbon dioxide insufflation during pneumoperitoneum in pediatric patients may not affect cerebral oxygenation under laparoscopic surgery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. The role of regional nerve block anesthesia for carotid endarterectomy: an experimental comparison with previous series with the use of general anesthesia and barbiturates for cerebral protection.

    Science.gov (United States)

    Agrifoglio, G; Agus, G B; Bonalumi, F; Costantini, A; Carlesi, R

    1987-01-01

    A retrospective analysis was performed on a consecutive series of 60 cases divided into two groups given carotid endarterectomy (C.E.) for atherosclerotic disease. In the first group general anesthesia and barbiturate cerebral protection were employed; in group two, loco-regional anesthesia. Indications and risk factors were similar in the two groups; the surgical procedure was identical. The differences in the results are reported and factors contributing to cerebral protection or reduction in the risk of stroke are analyzed. The analysis indicates that loco-regional anesthesia for C.E. is a reliable method for detecting cerebral ischemia and guaranteeing cerebral protection by means of a temporary shunt when strictly necessary.

  9. Regional cerebral blood flow in Parkinson's disease measured with N-isopropyl-p-[123I]iodoamphetamine (IMP) SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Nishihara, Mamiko; Hayashi, Hiroko; Higuchi, Shoichi; Sakai, Kunio; Ishikawa, Atsushi; Ibayashi, Katsuhiko.

    1992-01-01

    N-isopropyl-p-[ 123 I]iodoamphetamine (IMP) SPECT studies were performed on 21 patients (13 females; 45-73 yrs) with idiopathic Parkinson's disease (PD) and 10 age-matched normal controls (39-69 yrs). Regional cerebral blood flow (rCBF) was quantitatively measured by the arterial blood sampling method. When compared with normal controls, global CBF, and rCBF in the frontal cortex and in the basal ganglia were reduced 22.1% (p 123 I-IMP SPECT imaging is useful for evaluation and follow-up of patients with PD. (author)

  10. Measurement of regional cerebral blood flow by xenon-enhanced computed tomography

    International Nuclear Information System (INIS)

    Nakagomi, Tadayoshi; Yoshimasu, Norio; Kim, Shi-in; Takano, Koichi; Segawa, Hiromu.

    1982-01-01

    Serial CT scanning was carried out during and after inhalation of 50% non-radioactive xenon in humans. Our results of this research was as follows; 1) In normal subjects, blood flow in gray matter was 82 +- 11 and that in white matter 24 +- 5 ml/100 gm/min. 2) The blood flow of the brain tumors was close to that of gray matter, whereas blood flow of edematous white matter surrounding the tumor was decreased. 3) The blood flow in cerebral infarctions was always decreased. Effect of STA-MCA bypass was also evaluated. 4) In cerebral arterio-venous malformations, the blood flow in the white matter surrounding nidus was not decreased. This method appeared to have several advantages over conventional isotope method and to provide useful clinical and research informations. (author)

  11. Cerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, J; Borgeat, A; Trachsel, T; Cobo Del Prado, I; De Andrés, J; Bühler, P

    2014-02-01

    Ischemic brain damage has been reported in healthy patients after beach chair position for surgery due to cerebral hypoperfusion. Near-infrared spectroscopy has been described as a non-invasive, continuous method to monitor cerebral oxygen saturation. However, its impact on neurobehavioral outcome comparing different anesthesia regimens has been poorly described. In this prospective, assessor-blinded study, 90 patients undergoing shoulder surgery in beach chair position following general (G-group, n=45) or regional anesthesia (R-group; n=45) were enrolled to assess the prevalence of cerebral desaturation events comparing anesthesia regimens and their impact on neurobehavioral and neurological outcome. Anesthesiologists were blinded to regional cerebral oxygen saturation values. Baseline data assessed the day before surgery included neurological and neurobehavioral tests, which were repeated the day after surgery. The baseline data for regional cerebral oxygen saturation/bispectral index and invasive blood pressure both at heart and auditory meatus levels were taken prior to anesthesia, 5 min after induction of anesthesia, 5 min after beach chair positioning, after skin incision and thereafter all 20 min until discharge. Patients in the R-group showed significantly less cerebral desaturation events (psurgery (pshoulder surgery in beach chair position influencing neurobehavioral test results at 24h. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  12. Sleep-Wake Differences in Relative Regional Cerebral Metabolic Rate for Glucose among Patients with Insomnia Compared with Good Sleepers

    Science.gov (United States)

    Kay, Daniel B.; Karim, Helmet T.; Soehner, Adriane M.; Hasler, Brant P.; Wilckens, Kristine A.; James, Jeffrey A.; Aizenstein, Howard J.; Price, Julie C.; Rosario, Bedda L.; Kupfer, David J.; Germain, Anne; Hall, Martica H.; Franzen, Peter L.; Nofzinger, Eric A.; Buysse, Daniel J.

    2016-01-01

    Study Objectives: The neurobiological mechanisms of insomnia may involve altered patterns of activation across sleep-wake states in brain regions associated with cognition, self-referential processes, affect, and sleep-wake promotion. The objective of this study was to compare relative regional cerebral metabolic rate for glucose (rCMRglc) in these brain regions across wake and nonrapid eye movement (NREM) sleep states in patients with primary insomnia (PI) and good sleeper controls (GS). Methods: Participants included 44 PI and 40 GS matched for age (mean = 37 y old, range 21–60), sex, and race. We conducted [18F]fluoro-2-deoxy-d-glucose positron emission tomography scans in PI and GS during both morning wakefulness and NREM sleep at night. Repeated measures analysis of variance was used to test for group (PI vs. GS) by state (wake vs. NREM sleep) interactions in relative rCMRglc. Results: Significant group-by-state interactions in relative rCMRglc were found in the precuneus/posterior cingulate cortex, left middle frontal gyrus, left inferior/superior parietal lobules, left lingual/fusiform/occipital gyri, and right lingual gyrus. All clusters were significant at Pcorrected sleep and wakefulness. Significant group-by-state interactions in relative rCMRglc suggest that insomnia is associated with impaired disengagement of brain regions involved in cognition (left frontoparietal), self-referential processes (precuneus/posterior cingulate), and affect (left middle frontal, fusiform/lingual gyri) during NREM sleep, or alternatively, to impaired engagement of these regions during wakefulness. Citation: Kay DB, Karim HT, Soehner AM, Hasler BP, Wilckens KA, James JA, Aizenstein HJ, Price JC, Rosario BL, Kupfer DJ, Germain A, Hall MH, Franzen PL, Nofzinger EA, Buysse DJ. Sleep-wake differences in relative regional cerebral metabolic rate for glucose among patients with insomnia compared with good sleepers. SLEEP 2016;39(10):1779–1794. PMID:27568812

  13. Hypocretin (orexin) biology and the pathophysiology of narcolepsy with cataplexy.

    Science.gov (United States)

    Liblau, Roland S; Vassalli, Anne; Seifinejad, Ali; Tafti, Mehdi

    2015-03-01

    The discovery of hypocretins (orexins) and their causal implication in narcolepsy is the most important advance in sleep research and sleep medicine since the discovery of rapid eye movement sleep. Narcolepsy with cataplexy is caused by hypocretin deficiency owing to destruction of most of the hypocretin-producing neurons in the hypothalamus. Ablation of hypocretin or hypocretin receptors also leads to narcolepsy phenotypes in animal models. Although the exact mechanism of hypocretin deficiency is unknown, evidence from the past 20 years strongly favours an immune-mediated or autoimmune attack, targeting specifically hypocretin neurons in genetically predisposed individuals. These neurons form an extensive network of projections throughout the brain and show activity linked to motivational behaviours. The hypothesis that a targeted immune-mediated or autoimmune attack causes the specific degeneration of hypocretin neurons arose mainly through the discovery of genetic associations, first with the HLA-DQB1*06:02 allele and then with the T-cell receptor α locus. Guided by these genetic findings and now awaiting experimental testing are models of the possible immune mechanisms by which a specific and localised brain cell population could become targeted by T-cell subsets. Great hopes for the identification of new targets for therapeutic intervention in narcolepsy also reside in the development of patient-derived induced pluripotent stem cell systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Positive effects of massage therapy on a patient with narcolepsy.

    Science.gov (United States)

    Hill, Robyn; Baskwill, Amanda

    2013-01-01

    The purpose of this case report was to investigate the effects of massage therapy on the sleep patterns of a woman with narcolepsy. The 23-year-old woman's primary symptoms included excessive daytime sleepiness and periodic leg movements (PLM), which were associated with her diagnoses of both narcolepsy and cataplexy. Five 45-minute massage therapy treatments were administered over a five-week period. The patient's sleep patterns were recorded each week before the treatment. A final measurement was recorded in the sixth week. The sleep patterns were monitored using the Leeds Sleep Evaluation Questionnaire, which included ten visual analogue scales. The results of this case report included an improvement in getting to sleep by 148%, an improvement in quality of sleep by 1100%, an improvement in awake following sleep by 121%, and an improvement in behaviour following wakening by 28% using the Leeds Sleep Evaluation Questionnaire. This case report suggests that massage therapy had a positive effect on this patient with narcolepsy. Further research is needed to investigate the effects of massage therapy on narcolepsy and sleep patterns.

  15. Unravelling narcolepsy : from pathophysiology to measuring treatment effects

    NARCIS (Netherlands)

    Heide, van der A.

    2017-01-01

    Narcolepsy is a disorder of the regulation of sleep and wakefulness, with as its major features excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, sleep paralysis and disturbed nocturnal sleep. The first part of this thesis concernes an overview of the pathophysiology,

  16. The study of regional cerebral glucose metabolic change in human being normal aging process by using PET scanner

    International Nuclear Information System (INIS)

    Si Mingjue; Huang Gang

    2008-01-01

    Objective: With the technique development, PET has been more and more applied in brain function research. The aim of this study was to investigate the tendency of regional cerebral glucose metabolism changes in human being normal aging process by using 18 F-fluorodeoxyglucose (FDG) PET/CT and statistical parametric mapping (SPM) software. Methods: 18 F-FDG PET/CT brain imaging data acquired from 252 healthy normal subjects (age ranging: 21 to 88 years old) were divided into 6 groups according to their age: 21-30, 31-40, 41-50, 51-60, 61-70, 71-88. All 5 groups with age ≥31 years old were compared to the control group of 21-30 years old, and pixel-by-pixel t-statistic analysis was applied using the SPM2. The hypo-metabolic areas were identified by MNI space utility (MSU) software and the voxel value of each brain areas were calculated (P 60 years old showed significant metabolic decreases with aging mainly involved bilateral frontal lobe (pre-motto cortex, dorsolateral prefrontal cortex, frontal pole), temporal lobe (temporal pole), insula, anterior cingulate cortex and cerebellum. The most significant metabolic decrease area with aging was the frontal lobe , followed by the anterior cingulate cortex, temporal lobe, insula and cerebellum at predominance right hemisphere (P<0.0001). Parietal lobe, parahippocampal gyrus, basal ganglia and thalamus remain metabolically unchanged with advancing aging. Conclusions: Cerebral metabolic function decrease with normal aging shows an inconstant and unsymmetrical process. The regional cerebral metabolic decrease much more significantly in older than 60 years old healthy volunteers, mainly involving bilateral frontal lobe, temporal lobe, insula, anterior cingulate cortex and cerebellum at right predominance hemisphere. (authors)

  17. Evaluation of regional cerebral blood flow changes in normal aging using 99mTc-ECD SPECT and Patlak method

    International Nuclear Information System (INIS)

    Mizuno, Shinji; Nandate, Yuka; Enya, Mayumi; Manabe, Tomoko; Goto, Hiroo; Hoshi, Hiroaki; Takahashi, Yukitoshi; Kato, Zenichiro; Kondo, Naomi

    1998-01-01

    Changes in regional cerebral blood flow (rCBF) were studied using 99m Tc-ECD SPECT and Patlak method in 47 subjects, aged 1 to 79 years (mean 28.5 years). No abnormal finding was found on MR imaging in the subjects. We obtained mean cerebral blood flow (mCBF) by means of Patlak method. rCBF was measured by positioning regions of interest (ROIs) in frontal lobe, parietal lobe, temporal lobe, occipital lobe, cerebellum and thalamus. The correlation coefficient between ages and mCBF was r=-0.897 (p<0.0001). mCBF of children was significantly higher (p<0.05), compared with adults. By dispersion analysis according to the groups of ages, significantly higher rCBF values were available in the frontal, parietal, temporal and occipital lobes during childhood than adulthood (p<0.05), but there were almost no significant differences of rCBF during childhood than adulthood in cerebellum and thalamus. (author)

  18. Gender Differences in Cerebral Regional Homogeneity of Adult Healthy Volunteers: A Resting-State fMRI Study

    Directory of Open Access Journals (Sweden)

    Chunsheng Xu

    2015-01-01

    Full Text Available Objective. We sought to use the regional homogeneity (ReHo approach as an index in the resting-state functional MRI to investigate the gender differences of spontaneous brain activity within cerebral cortex and resting-state networks (RSNs in young adult healthy volunteers. Methods. One hundred and twelve healthy volunteers (56 males, 56 females participated in the resting-state fMRI scan. The ReHo mappings in the cerebral cortex and twelve RSNs of the male and female groups were compared. Results. We found statistically significant gender differences in the primary visual network (PVN (P<0.004, with Bonferroni correction and left attention network (LAtN, default mode network (DMN, sensorimotor network (SMN, executive network (EN, and dorsal medial prefrontal network (DMPFC as well (P<0.05, uncorrected. The male group showed higher ReHo in the left precuneus, while the female group showed higher ReHo in the right middle cingulate gyrus, fusiform gyrus, left inferior parietal lobule, precentral gyrus, supramarginal gyrus, and postcentral gyrus. Conclusions. Our results suggested that men and women had regional specific differences during the resting-state. The findings may improve our understanding of the gender differences in behavior and cognition from the perspective of resting-state brain function.

  19. Human hypocretin-deficient narcolepsy - aberrant food choice due to impaired taste?

    Directory of Open Access Journals (Sweden)

    Giselle de Martin Truzzi

    Full Text Available Authors demonstrate that patients with narcolepsy type 1 (N1 have more tendency of eat salty snacks after satiety than health volunteers. A few mechanisms to explain the weight gain have been discussed in narcolepsy. The hypocretin-1 deficiency can influence the olfactory system. The olfactory system should be modulated through hypocretin-1 via connections from the hypothalamic to other brain regions. Likewise, hypocretin-1 can be synthesized locally in our olfactory mucosa with possible private role modulating the olfactory. In experimental studies, different kinds of smell influence the preference for type of diet. Olfactory and taste sensations help control of appetite and regulate the quantity and quality of foods that will be chosen. N1 patients have lower levels of hypocretin-1 and consequent inferior olfactory threshold, less olfactory discrimination, and these findings improved after nasal hypocretin-1 administration. It is possible that the hyposmia influenced the quality and quantity of food by narcoleptic patients. We suggest that a complementary analysis of olfactory function should be done concomitant with food preferences to compare narcoleptic patients with and without hypocretin-1 deficiency.

  20. HLA-DPB1 and HLA class I confer risk of and protection from narcolepsy

    DEFF Research Database (Denmark)

    Ollila, Hanna M; Ravel, Jean-Marie; Han, Fang

    2015-01-01

    Type 1 narcolepsy, a disorder caused by a lack of hypocretin (orexin), is so strongly associated with human leukocyte antigen (HLA) class II HLA-DQA1(∗)01:02-DQB1(∗)06:02 (DQ0602) that very few non-DQ0602 cases have been reported. A known triggering factor for narcolepsy is pandemic 2009 influenza......-class-II-independent associations with HLA-A(∗)11:01 (OR = 1.32 [1.13-1.54], p = 4.92 × 10(-4)), HLA-B(∗)35:03 (OR = 1.96 [1.41-2.70], p = 5.14 × 10(-5)), and HLA-B(∗)51:01 (OR = 1.49 [1.25-1.78], p = 1.09 × 10(-5)) were also seen across ethnic groups in the HLA class I region. These effects might reflect modulation...... of autoimmunity or indirect effects of HLA class I and HLA-DP alleles on response to viral infections such as that of influenza....

  1. Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy

    Science.gov (United States)

    Ivanenko, Anna

    2009-01-01

    Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

  2. Regional cerebral blood flow in mood disorders. I. Comparison of major depressives and normal controls at rest

    International Nuclear Information System (INIS)

    Sackeim, H.A.; Prohovnik, I.; Moeller, J.R.; Brown, R.P.; Apter, S.; Prudic, J.; Devanand, D.P.; Mukherjee, S.

    1990-01-01

    We measured regional cerebral blood flow with the xenon 133 inhalation technique in 41 patients with major depressive disorder and 40 matched, normal controls during an eyes-closed, resting condition. The depressed group had a marked reduction in global cortical blood flow. To examine topographic abnormalities, traditional multivariate analyses were applied, as well as a new scaled subprofile model developed to identify abnormal functional neural networks in clinical samples. Both approaches indicated that the depressed sample had an abnormality in topographic distribution of blood flow, in addition to the global deficit. The scaled subprofile model identified the topographic abnormality as being due to flow reduction in the depressed patients in selective frontal, central, superior temporal, and anterior parietal regions. This pattern may reflect dysfunction in the parallel distributed cortical network involving frontal and temporoparietal polymodal association areas. The extent of this topographic abnormality, as revealed by the scaled subprofile model, was associated with both patient age and severity of depressive symptoms

  3. Measurement of regional cerebral blood flow with the Xenon-133 inhalation procedure in patients with cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, A.

    1985-10-01

    Measurement of regional cerebral blood flow with inhalation of Xenon-133 and recording of regional clearance curves by stationary external detectors permits repeated estimation of bilateral cortical blood flow in resting position and after different activating procedures. Measurements can be performed on an outpatient basis, measurements in critical ill patients are possible as well. Compared to Xenon-133 single photon emission computerized tomography smaller doses can be used. Compared to Iodine-123 amphetamie SPECT actual flow calculation without arterial puncture is possible. Drawbacks of the technique are the two-dimensional imaging, unsufficient indication of the look through phenomenon and non-perfused tissue with zero-flow. However, measurement of rCBF with this technique are helpful in individual diagnosis of the following diseases: transient ischemic attacks with prolonged ischemia, communicating hydrocephalus with normal intracranial pressure, follow up studies in hemodilution, evaluation of patients with polyarterial vascular disease in respect to neurosurgical or vasculosurgical intervention, subarachnoid hemorrhage and head trauma. (orig.).

  4. Noninvasive regional cerebral blood flow measurements at pre- and post-acetazolamide test using 99mTc-ECD

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Nakano, Seigo; Tanaka, Masaaki.

    1996-01-01

    A technique for serial noninvasive cerebral blood flow measurements at pre- and post-acetazolamide (Diamox) test was newly developed using 99m Tc-ECD without blood sampling. Baseline mean cerebral blood flow (mCBF) was measured from graphical analysis of time activity curves for brain and aortic arch obtained from radionuclide angiography by injection of 370-555 MBq 99m Tc-ECD. The first SPECT study was performed immediately after intravenous administration of 1 g of Diamox, then baseline regional cerebral blood flow (rCBF) was calculated using Lassen's correction algorithm. Immediately after the stop of the first SPECT study, additional 555-740 MBq of 99m Tc-ECD was administered, thereafter the second SPECT study was started. Post-Diamox SPECT images were obtained by subtraction of the first baseline images from the second images. Using Lassen's algorithm, post-Diamox mCBF was estimated from the baseline mCBF, the baseline mean SPECT counts, and post-Diamox mean SPECT counts corrected for administered dose and imaging time. Post-Diamox rCBF was obtained from the post-Diamox mCBF and the post-Diamox mean SPECT counts using Lassen's algorithm. Coefficient variation was shown 2.7% and 3.5%: mCBF and rCBF, respectively in test-retest results in six patients without Diamox administration. Nine demented patients without vascular disorders showed significant mCBF increase of 35.7% on the average by post-Diamox. In conclusion, this simplified method is practically useful for measuring CBF at pre- and post-Diamox test within short period of time without any blood sample. (author)

  5. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo

    1998-01-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ) were measured using the steady-state 15 O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson's disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean±SD, 51.8±3.7) and the duration of the illness ranged from 10 to 48 months (mean±SD, 28.8±15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson's Disease Rating Scale decreased from 35.1 (SD±11.3) to 25.7 (SD±11.6). The cognitive function assessed by Hasegawa's dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO 2 decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO 2 significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson's disease. (author)

  6. Health-related stigma as a determinant of functioning in young adults with narcolepsy.

    Directory of Open Access Journals (Sweden)

    Mary C Kapella

    Full Text Available Symptoms of narcolepsy tend to arise during adolescence or young adulthood, a formative time in human development during which people are usually completing their education and launching a career. Little is known about the impact of narcolepsy on the social aspects of health-related quality of life in young adults. The purpose of this study was to examine relationships between health-related stigma, mood (anxiety and depression and daytime functioning in young adults with narcolepsy compared to those without narcolepsy. Young adults (age 18-35 with narcolepsy (N = 122 and without narcolepsy (N = 93 were mailed a packet that included questionnaires and a self-addressed postage paid envelope. The questionnaire included demographic information and a composite of instruments including the SF 36, Functional Outcomes of Sleep Questionnaire (FOSQ, Fife Stigma Scale (FSS, Epworth Sleepiness Scale (ESS and Hospital Anxiety and Depression Scale (HADS. Variable associations were assessed using descriptive statistics, ANOVA, Mann-Whitney U Test, correlations, stepwise multiple regression and path analysis. Young adults with narcolepsy perceived significantly more stigma and lower mood and health-related quality of life than young adults without narcolepsy (p<0.01. Health-related stigma was directly and indirectly associated with lower functioning through depressed mood. Fifty-two percent of the variance in functioning was explained by the final model in the young adults with narcolepsy. Health-related stigma in young adults with narcolepsy is at a level consistent with other chronic medical illnesses. Health-related stigma may be an important determinant of functioning in young adults with narcolepsy. Future work is indicated toward further characterizing stigma and developing interventions that address various domains of stigma in people with narcolepsy.

  7. Health-related stigma as a determinant of functioning in young adults with narcolepsy.

    Science.gov (United States)

    Kapella, Mary C; Berger, Barbara E; Vern, Boris A; Vispute, Sachin; Prasad, Bharati; Carley, David W

    2015-01-01

    Symptoms of narcolepsy tend to arise during adolescence or young adulthood, a formative time in human development during which people are usually completing their education and launching a career. Little is known about the impact of narcolepsy on the social aspects of health-related quality of life in young adults. The purpose of this study was to examine relationships between health-related stigma, mood (anxiety and depression) and daytime functioning in young adults with narcolepsy compared to those without narcolepsy. Young adults (age 18-35) with narcolepsy (N = 122) and without narcolepsy (N = 93) were mailed a packet that included questionnaires and a self-addressed postage paid envelope. The questionnaire included demographic information and a composite of instruments including the SF 36, Functional Outcomes of Sleep Questionnaire (FOSQ), Fife Stigma Scale (FSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HADS). Variable associations were assessed using descriptive statistics, ANOVA, Mann-Whitney U Test, correlations, stepwise multiple regression and path analysis. Young adults with narcolepsy perceived significantly more stigma and lower mood and health-related quality of life than young adults without narcolepsy (p<0.01). Health-related stigma was directly and indirectly associated with lower functioning through depressed mood. Fifty-two percent of the variance in functioning was explained by the final model in the young adults with narcolepsy. Health-related stigma in young adults with narcolepsy is at a level consistent with other chronic medical illnesses. Health-related stigma may be an important determinant of functioning in young adults with narcolepsy. Future work is indicated toward further characterizing stigma and developing interventions that address various domains of stigma in people with narcolepsy.

  8. A quantitative study of regional cerebral blood flow in childhood using {sup 123}I-IMP-SPECT. With emphasis on age-related changes

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Ayame; Kishi, Kazuko; Sejima, Hitoshi; Haneda, Noriyuki; Uchida, Nobue; Sugimura, Kazuro; Ito, Masatoshi; Shiraishi, Hideyuki [Shimane Medical Univ., Izumo (Japan)

    1996-11-01

    Single photon emission computed tomography (SPECT), using N-isopropyl-p-={sup 123}I= iodoamphetamine ({sup 123}I-IMP) was used for quantitative analysis of regional cerebral blood flow (rCBF) on 26 individuals between 0 and 19 years of age. The rCBF showed age-related changes; it was low in early infancy, increased in late infancy through early childhood, and decreased and remained constant after puberty. The rCBF through cerebral cortex varied more greatly than through thalamus and cerebellum, and seemed to depend more closely on age. In the case of 4 months of age rCBF was very low at the frontal region and was very high at the occipital region. In more older cases, rCBF in the cerebral cortex was higher than in the thalamus. In childhood, rCBF was very inconsistent and showed a great inter-individual variance. (author)

  9. A quantitative study of regional cerebral blood flow in childhood using 123I-IMP-SPECT. With emphasis on age-related changes

    International Nuclear Information System (INIS)

    Kobayashi, Ayame; Kishi, Kazuko; Sejima, Hitoshi; Haneda, Noriyuki; Uchida, Nobue; Sugimura, Kazuro; Ito, Masatoshi; Shiraishi, Hideyuki

    1996-01-01

    Single photon emission computed tomography (SPECT), using N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP) was used for quantitative analysis of regional cerebral blood flow (rCBF) on 26 individuals between 0 and 19 years of age. The rCBF showed age-related changes; it was low in early infancy, increased in late infancy through early childhood, and decreased and remained constant after puberty. The rCBF through cerebral cortex varied more greatly than through thalamus and cerebellum, and seemed to depend more closely on age. In the case of 4 months of age rCBF was very low at the frontal region and was very high at the occipital region. In more older cases, rCBF in the cerebral cortex was higher than in the thalamus. In childhood, rCBF was very inconsistent and showed a great inter-individual variance. (author)

  10. Correlated regions of cerebral blood flow with clinical parameters in Parkinson's disease. Comparison using 'Anatomy' and 'Talairach Daemon' software

    International Nuclear Information System (INIS)

    Yoon, Hyun Jin; Cheon, Sang Myung; Jeong, Young Jin; Kang, Do Young

    2012-01-01

    We assign the anatomical names of functional activation regions in the brain, based on the probabilistic cyto-architectonic atlas by Anatomy 1.7 from an analysis of correlations between regional cerebral blood flow (rCBF) and clinical parameters of the non-demented Parkinson's disease (PD) patients by statistical parametric mapping (SPM) 8. We evaluated Anatomy 1.7 of SPM toolbox compared to 'Talairach Daemon' (TD) Client 2.4.2 software. One hundred and thirty-six patients (mean age 60.0±9.09 years; 73 women and 63 men) with non-demented PD were selected. Tc-99m-HMPAO brain single-photon emission computed tomography (SPECT) scans were performed on the patients using a two-head gamma-camera. We analyzed the brain image of PD patients by SPM8 and found the anatomical names of correlated regions of rCBF perfusion with the clinical parameters using TD Client 2.4.2 and Anatomy 1.7. The SPM8 provided a correlation coefficient between clinical parameters and cerebral hypoperfusion by a simple regression method. To the clinical parameters were added age, duration of disease, education period, Hoehn and Yahr (H and Y) stage and Korean mini-mental state examination (K-MMSE) score. Age was correlated with cerebral perfusion in the Brodmann area (BA) 6 and BA 3b assigned by Anatomy 1.7 and BA 6 and pyramis in gray matter by TD Client 2.4.2 with p<0.001 uncorrected. Also, assigned significant correlated regions were found in the left and right lobules VI (Hem) with duration of disease, in left and right lobules VIIa crus I (Hem) with education, in left insula (Ig2), left and right lobules VI (Hem) with H and Y, and in BA 4a and 6 with K-MMSE score with p<0.05 uncorrected by Anatomy 1.7, respectively. Most areas of correlation were overlapped by two different anatomical labeling methods, but some correlation areas were found with different names. Age was the most significantly correlated clinical parameter with rCBF. TD Client found the exact anatomical name by the peak

  11. Effectiveness of treatment with donepezil hydrochloride and changes in regional cerebral blood flow in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Yoshida, Tsunetaka; Ha-Kawa, S.; Yoshimura, Masafumi; Nobuhara, Kenji; Kinoshita, Toshihiko; Sawada, Satoshi

    2007-01-01

    The objective of this study was to elucidate the relationship between the effects of donepezil hydrochloride (donepezil) and cerebral blood flow, and to evaluate the usefulness of cerebral blood flow imaging in assessing and predicting treatment effectiveness. The subjects were 29 outpatients (12 men and 17 women; age 50-82 years; mean age 69.2 years), who had received a diagnosis of Alzheimer's disease (AD). Efficacy was evaluated before donepezil administration; after 1 month, 3 months, and 6 months of drug administration; and at 1 year after completion of administration using the Japanese version of the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog), as a measure of cognitive function. The ADAS-cog has been frequently used to evaluate cognitive function in AD patients. Patients whose ADAS-cog scores improved by 3 or more points during the observation period were classified as responders, and those with no improvement were classified as nonresponders. 123 I-iofetamine (IMP) was used for single photon emission computed tomography cerebral blood flow scintigraphy. On the basis of ADAS-cog score improvement, 22 of the 29 patients were responders (7 men and 15 women; age 50-82 years; mean age 69.0 years) and seven were nonresponders (5 men and 2 women; age 61-80 years; mean age 70.0 years). The results indicate that a difference in cerebral blood flow responsiveness after 1 month of treatment distinguishes responders from nonresponders. After 1 month, blood flow was significantly decreased in all regions of nonresponders, whereas significant increases in blood flow were seen in the anterior frontal lobe and parietal lobe of responders. At that time point, blood flow in the basal ganglion differed significantly between the two groups, indicating that this difference in responsiveness after 1 month of treatment may distinguish responders from nonresponders. In cognitive function testing, the group that exhibited a complete response showed

  12. Influence of the depth of sedation on regional cerebral oxygen saturation monitoring in neurosurgery of supratentorial gliomas

    Directory of Open Access Journals (Sweden)

    ZHANG Kai⁃ying

    2012-12-01

    Full Text Available Objective To investigate the influence on regional cerebral oxygen saturation (rScO2 of sedation depth during anesthesia induction and maintenance in supratentorial glioma resections. Methods Thirty patients with Ⅰ - Ⅱ supratentorial glioma (graded by American Society of Anesthesiologists underwent elective supratentorial glioma resection were included in this study. Rocuronium, sufentanil and propofol were used for anesthesia induction. After trachea cannula, total intravenous anesthesia (TIVA was maintained with plasma concentration of propofol 2.80-3.20 μg/ml and remifentanil 0.10-0.20 μg/(kg·min. Thirty groups of rScO2, bispectral index (BIS, mean arterial pressure (MAP and heart rate (HR were recorded continuously till the incision. Results During anesthesia induction, BIS decreased along with the infusion of anesthetics, and there was significant negative correlation between BIS and rScO2 (r = ⁃0.803, P = 0.001. During anesthesia maintenance, rScO2 and BIS were not significantly related (r = 0.147, P = 0.396. Conclusion The rScO2 monitoring can reflect the influence of sedation depth on cerebral oxygen delivery and consumption balance during supratentorial glioma resection under TIVA.

  13. Investigation of regional cerebral blood flow in alcoholic Korsakoff`s syndrome with {sup 123}I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Makoto; Nomura, Soichiro [Tachikawa Hospital, Tokyo (Japan); Kato, Motoichiro; Nakazawa, Tsuneyuki

    1995-05-01

    Regional cerebral blood flow (rCBF) was determined quantitatively by single photon emission computed tomography (SPECT) using N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) in 6 patients with alcoholic Korsakoff`s syndrome (A group). The findings were compared with concurrently available findings from 6 alcoholic patients with no evidence of cerebral disordres such as Korsakoff`s syndrome and dementia (B group) and 4 healthy persons (C group). In both A and B groups, diffuse decrease in blood flow was significantly observed in the entire brain, as compared with the C group; no significant difference in the decreased blood flow existed between the A and B groups. According to the WAIS results, the patients in the A group were classified as `typical Korsakoff`s syndrome` (full IQ of 90 or more) and as `serious Korsakoff`s syndrome` (full IQ of 89 or less). rCBF in the thalamus was significantly lower in the A group of patients with typical Korsakoff`s syndrome than the B group. These findings may reflect the variety of alcoholic Korsakoff`s syndrome. This may also have an implication for the possible classification of several types in this syndrome. (N.K.).

  14. Regional cerebral glucose metabolic rate in human sleep assessed by positron emission tomography

    International Nuclear Information System (INIS)

    Buchsbaum, M.S.; Wu, J.; Hazlett, E.; Sicotte, N.; Bunney, W.E. Jr.; Gillin, J.C.

    1989-01-01

    The cerebral metabolic rate of glucose was measured during nighttime sleep in 36 normal volunteers using positron emission tomography and fluorine-18-labeled 2-deoxyglucose (FDG). In comparison to waking controls, subjects given FDG during non-rapid eye movement (NREM) sleep showed about a 23% reduction in metabolic rate across the entire brain. This decrease was greater for the frontal than temporal or occipital lobes, and greater for basal ganglia and thalamus than cortex. Subjects in rapid eye movement (REM) sleep tended to have higher cortical metabolic rates than walking subjects. The cingulate gyrus was the only cortical structure to show a significant increase in glucose metabolic rate in REM sleep in comparison to waking. The basal ganglia were relatively more active on the right in REM sleep and symmetrical in NREM sleep

  15. Portable regional cerebral blood flow system based on IBM PC/AT and microprocessor electronics

    International Nuclear Information System (INIS)

    Mun, S.K.; Mun, I.K.; Petite, J.; Cohan, S.L.; Fahey, F.H.

    1986-01-01

    A portable 16-channel reginal cerebral blood flow (rCBF) measuring system has been developed using an IBM PC/AT and new microelectronics to improve processing speed and portability. The detector electronics were developed by Scan Detectronics A/S of Denmark. The counter module contains 18 16-bit counters, each programmable in four different modes. The rate meter has three independent microprocessor controllers for rate meter functions, window controller, and channel controller. The detector electronics and detection parameters can be fully controlled by the host PC/AT. The menu-driven system (Better Basic) assists the operator at each step. The collected data from 16 channels can be processed automatically or postprocessed using more flexible and sophisticated techniques within 20 minutes. The headgear holding 16 sodium iodide detectors is fabricated by modifying a motorcycle helmet

  16. Design and evaluation of radiotracers for determination of regional cerebral blood flow with PET

    International Nuclear Information System (INIS)

    Lambrecht, R.M.; Duncan, C.C.; Shiue, C.Y.

    1982-01-01

    The tracer kinetics of 4-Fluoro( 18 F)-, 4-Bromo( 82 Br)- and 4-Iodo( 125 I)-antipyrine and 15 O-water were compared in a cat or baboon animal model. First-pass cerebral extraction and clearance with alterations in PaCO 2 were measured for whole brain. The Renkin/Crone model was used to evaluate brain capillary permeability-surface area product for 4- 18 FAP in cats. Positron-emission-tomographic measurements required development of an instrument and technique for control of the arterial concentration of the radiotracer as a ramp function, so that tracer concentration changes due to radioactive decay or altered physiological processes could be accurately described with PET. Pharmacokinetic and tissue-distribution studies in cats were used to determine dosimetry for 4- 18 FAP. 4-Bromoantipyrine labeled with 78 Br (t = 6.5 m) is suggested as a tracer for determination of rCBF with PET

  17. Time dependency of local cerebral blood flow measurements caused by regional variations in tissue transit time

    International Nuclear Information System (INIS)

    Lear, J.L.; Kasliwal, R.; Feyerabend, A.

    1990-01-01

    Calculated values of local cerebral blood flow (LCBF) using the diffusible tracer model are assumed to be independent of time as long as experiments are brief enough to prevent tissue saturation. This paper investigates the effects of CTT variation on LCBF measurements. Using double-label quantitative digital autoradiography, we compared iodoantipyrine (IAP)-based LCBF measurements obtained with tracer infusions of different lengths of time. Lightly anesthetized rats were given simultaneous ramp infusions of C-14 IAP (45 seconds) and I-123 IAP (15 seconds) and immediately sacrificed. Two autoradiograms of each brain section, one representing I-123 and the other representing C-14, were produced, digitized, and converted into images of LCBF based on the 15- and 45-second infusion periods. The LCBF image pairs were compared on a pixel-by-pixel basis

  18. The effect of smoking on regional cerebral blood flow in the normal aged volunteers

    International Nuclear Information System (INIS)

    Yamashita, Kazuya; Kobayashi, Shotai; Yamaguchi, Shuhei; Kitani, Kohaku; Tsunematsu, Tokugoro

    1987-01-01

    They were divided into four groups of (1) 15 young smokers (mean age of 55 years), (2) 14 young non-smokers (mean age of 52 years), (3) 16 elderly smokers (mean age of 74 years), and (4) elderly non-smokers (mean age of 75 years). All subjects were healthy volunteers without any past history of cerebral and pulmonary diseases. The rCBF was measured by Xe 133 inhalation method using 16-ch-Novo-cerebrograph. Pulmonary functions such as FVC, FEV 1.0 %, %VC, FEV 1.0 , V 50 and V 25 were measured by Autospiror HI-498, and End-tidal partial pressures for carbon dioxide (PeCO 2 ) were monitored by capnograph (Normocap, Datex). The rCBF reduced significantly with advancing age. Although there was no significant difference in rCBF between young smokers and non-smokers, elderly smokers showed significantly lower rCBF than elderly non-smokers. There was no difference in vital capacity and FEV 1.0 % between smokers and non-smokers in both young and elderly people. Smokers group, however, showed significantly lower V 50 than non-smokers group. PeCO 2 in smokers was significantly lower than that in non-smokers. No significant differences were seen in hematocrit, antithrombin III, serum lipids, and blood pressure between two groups in the young and elderly. There was a significantly positive correlation between rCBF and PeCO 2 . Our finding showed smoking over a long period produces reductions in the cerebral blood flow. This was consistent with the reports by other researchers. In addition, the results of the present study suggested the possibility that the latent small airway disturbances resulting from long-term smoking also play a ole of leading to decreased PCO 2 and eventually cause reductions in rCBF. (author)

  19. Regional cerebral blod flow studied by xenon-133. Intra-arterial injection studies and inhalation studies using emission tomography

    DEFF Research Database (Denmark)

    Lassen, N A

    1980-01-01

    .) technique is insensitive both to hyperemia and ischemia yielding essentially only a mean flow value. A new rapidly moving single photon tomograph following D. Kuhl's principle is presented applicable to Xe-133. Preliminary clinical data show that this technique is able to detect ischemic areas both with Xe......A survey of the Xenon-133 techniques for measurement of regional cerebral blood flow, rCBF, in man is presented. The intra-arterial Xe-133 injection method is very sensitive for detecting even small hyperemic areas, but cannot "see" smaller ischemic areas. The Xe-133 inhalation (or i.v. inj......-133 intra-arterial injection and with Xe-133 inhalation. The practical and economic advantages of Xe-133 or Xe-127 tomography over positron tomography for rCBF are discussed....

  20. Regional cerebral blood flow during light sleep--a H(2)(15)O-PET study

    DEFF Research Database (Denmark)

    Kjaer, Troels W; Law, Ian; Wiltschiøtz, Gordon

    2002-01-01

    to other forms of altered awareness, for example, relaxation meditation than to deeper sleep stages. We are of the opinion that stage-1 sleep represents the dreaming state of wakefulness, while rapid eye movement (REM) sleep reflects the dreaming state of the unaware, sleeping brain.......This is the first report on the distribution of regional cerebral blood flow (rCBF) changes during stage-1 sleep or somnolence. Two hypotheses were tested: (A) that rCBF differed between the awake relaxed state and stage-1 sleep, (B) that hypnagogic hallucinations frequently experienced at sleep...... onset would be accompanied by measurable changes in rCBF using positron emission tomography (PET). Eight subjects were PET-scanned with (15)O-labeled water injection in three conditions: awake, stage-1 sleep with reportable experiences and stage-1 sleep without reportable experiences...

  1. The SPECT study on the regional cerebral blood flow of heroin addicts during cue-induced heroin craving

    International Nuclear Information System (INIS)

    Wang Zhengqing; Liu Qinglong; Wang Yuhua; Wang Jinmin; Wang Shuo; Zhao Geyuan

    2003-01-01

    Objective: To explore the character of the regional cerebral blood flow (rCBF) of heroin addicts during the exposure to the heroin-related cues. Methods: Twenty-five heroin dependent individuals undergoing detoxification for more than one month were enrolled in the present study. All subjects were exposed to the heroin-related cues for 15 min. The rCBF was measured in these patients before and after exposure to heroin-related cues. Result: The rCBF in the frontal, temporal cortex and amygdala was significantly increased during the exposure to heroin-related cues. Conclusion: The findings indicate that drug-related cues play a critical role in the relapse of drug dependence; and the frontal, temporal cortex and amygdala are involved in the relapsing process

  2. FDG-PET study of the bilateral subthalamic nucleus stimulation effects on the regional cerebral metabolism in advanced Parkinson disease

    International Nuclear Information System (INIS)

    Li, D.; Shen, J.; Zan, S.; Sun, B.; Zuo, C.; Guan, Y.; Zhao, Y.

    2006-01-01

    The aim of the study was to evaluate the changes in regional cerebral metabolic rate of glucose (rCMRGIu) induced by bilateral subthalamic nucleus (STN) stimulation in advanced Parkinson's disease (PD). 18 F-Fluorodeoxyglucose (FDG) PET data obtained before and one month after stimulation were analyzed with statistical parametric mapping (SPM). As a result of clinically effective bilateral STN stimulation, rCMRGIu increased in lateral globus pallidus (GP), upper brain stem, dorsolateral prefrontal cortex (DLPFC) and posterior parietal-occipital cortex, and decreased in the orbital frontal cortex and parahippocampus gyrus (p <0.001). We conclude that the alleviation of clinical symptoms in advanced PD by bilateral STN stimulation may be the result of activation of both ascending and descending pathways from STN and of restoration of the impaired higher-order cortex functions. (author)

  3. Effects of scatter correction on regional distribution of cerebral blood flow using I-123-IMP and SPECT

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Iida, Hidehiro; Kinoshita, Toshibumi; Hatazawa, Jun; Okudera, Toshio; Uemura, Kazuo

    1999-01-01

    The transmission dependent convolution subtraction method which is one of the methods for scatter correction of SPECT was applied to the assessment of CBF using SPECT and I-123-IMP. The effects of scatter correction on regional distribution of CBF were evaluated on a pixel by pixel basis by means of an anatomic standardization technique. SPECT scan was performed on six healthy men. Image reconstruction was carried out with and without the scatter correction. All reconstructed images were globally normalized for the radioactivity of each pixel, and transformed into a standard brain anatomy. After anatomic standardization, the average SPECT images were calculated for scatter corrected and uncorrected groups, and these groups were compared on pixel by pixel basis. In the scatter uncorrected group, a significant overestimation of CBF was observed in the deep cerebral white matter, pons, thalamus, putamen, hippocampal region and cingulate gyrus as compared with scatter corrected group. A significant underestimation was observed in all neocortical regions, especially in the occipital and parietal lobes, and the cerebellar cortex. The regional distribution of CBF obtained by scatter corrected SPECT was similar to that obtained by O-15 water PET. The scatter correction is needed for the assessment of CBF using SPECT. (author)

  4. The influence of social activity on regional cerebral blood flow and mental function in the normal aged volunteers

    International Nuclear Information System (INIS)

    Kobayashi, Shotai; Yamaguchi, Shuhei; Katsube, Tomoko; Kitani, Kohaku; Okada, Masanori

    1983-01-01

    The infuence of social activity on regional cerebral blood flow (rCBF) and mental function was studied by Xe133 inhalation method in normal aged volunteers. Subjects: The first group consisted of 33 aged volunteers living in nursing home and exposed to little social stimuli. There were 15 males (mean age of 77 years) and 18 females (77 years). The second group consisted of 49 aged community volunteers who were confirmed socially active. There were 25 males (76 years) and 24 females (72 years). All subjects were healthy persons without a past hitory of cerebral diseases and lung diseases. There were no difference in blood pressure and hematocrit between the two groups. Method: The rCBF was measured by 16-ch-Novo-cerebrograph. Verbal intelligence was evaluated by the Hasegawa Simple Intelligence Scale for Aged. Performance intelligence was evaluated with the Kohs' Block Design Test. Results: 1) The mean rCBF in group I showed significantly lower value than that of group II, especially in the frontotemporal region. The performance intelligence was decreased in group I. However, there were no significant difference in the verbal intelligence between the two groups. 2) The aging effect on rCBF and intelligences was more prominent in group II. 3) In males, hemispheric rCBF of group I decreased bilaterally associated with the decrease of both intelligences. While the left hemispheric rCBF in females was relatively preserved as well as the preservation of verbal intelligence. These results indicate that the social environmental factors may have significant influence to aging of the brain especially in the males. (author)

  5. The Familial Risk and HLA Susceptibility among Narcolepsy Patients in Hong Kong Chinese

    Science.gov (United States)

    Chen, Lei; Fong, S.Y.Y.; Lam, Ching W.; Tang, Nelson L.S.; Ng, Margaret H. L.; Li, Albert M.; Ho, C.K.W.; Cheng, Suk-Hang; Lau, Kin-Mang; Wing, Yun Kwok

    2007-01-01

    Study Objectives: To explore the familial aggregation and HLA susceptibility of narcolepsy in Hong Kong Chinese by objective sleep measurements and HLA typing. Design: Case control design Participants: Twelve narcoleptic probands, 34 first-degree relatives, and 30 healthy controls. Interventions: N/A Measurements and Results: Each subject underwent a standardized nocturnal polysomnogram (PSG), followed by a daytime multiple sleep latency test (MSLT). HLA typing was performed for all subjects. One relative (2.9%) was diagnosed as suffering from narcolepsy with cataplexy. Nearly 30% of the relatives fulfilled the criteria of narcolepsy spectrum disorder (shortened mean sleep latency [MSL] and/or the presence of sleep onset REM periods [SOREMPs]). When using the population data for comparison, the relative risk of narcolepsy in first-degree relatives was 85.3. The odds ratio of narcolepsy spectrum disorder in first-degree relatives was 5.8 (95% CI: 1.2 – 29.3) when compared to healthy controls. There existed 6 multiplex families, in which all 10 relatives with narcolepsy spectrum disorders, including all 3 relatives with multiple SOREMPs, were positive for HLA DQB1*0602. Conclusions: Our study demonstrated a definitive familial aggregation of narcolepsy, narcolepsy spectrum disorders, and possibly cataplexy in Hong Kong Chinese. This familial aggregation supported an inherited basis for narcolepsy spectrum. The tight co-segregation of HLA DQB1*0602 and narcolepsy spectrum disorders might suggest that HLA typing, especially DQB1*0602, at least partly confer the familial risk of narcolepsy. In addition, our study suggested that the subjective questionnaire measurements including Ullanlinna Narcolepsy Scale and Epworth Sleepiness Scale were unable to detect the presence of narcolepsy spectrum disorders among the relatives. A stringent objective measurement-based design for family studies is suggested for future study. Further studies are indicated for the determination

  6. Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management.

    Science.gov (United States)

    Sarıtaş, Aykut; Çinleti, Burcu Acar; Zincircioğlu, Çiler; Uzun, Uğur; Köse, Işıl; Şenoğlu, Nimet

    2018-04-09

    The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA. This study was performed on surviving adult comatose patients after CA treated with TTM. The average scores of rSO 2 was measured at 6h intervals for the first 2days and once a day for the following 3days with a NIRS device during TTM. The CPC scale was used to define the neurologic outcomes of patients. We compared the correlations of rSO 2 values between good (CPC 1-2) and poor (CPC 3-5) neurologic outcomes in CA patients. There was no statistically significant difference identified between the prognosis groups in terms of rSO 2 , CPR durations, hemoglobin values and admission body temperature (p>0.05). When the variation in rSO 2 values over time is investigated, though there was no significant difference between the good and poor prognosis groups, it appeared to fall in the first 6h in both prognosis groups. The median NT-proBNP and lactate values were observed to be higher in the poor prognosis group. There is no significant correlation between rSO 2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area. Copyright © 2018. Published by Elsevier Inc.

  7. Comparison of benzodiazepine receptor and regional cerebral blood flow imagings of epileptiform foci in hippocampal kindled rabbits

    International Nuclear Information System (INIS)

    Kurokawa, Kenzo

    1993-01-01

    To compare the benzodiazepine (Bz) receptor imaging and regional cerebral blood flow (rCBF) imaging in the detection of epileptic foci, the distribution pattern of the Bz receptor and rCBF in hippocampal kindled rabbits was examined by a double tracer autoradiography using ethyl 7-[ 125 I]-5,6-dihydro-5-methyl-6-oxo-4H-imidazo [1, 5-a][1,4] benzodiazepine-3-carboxylate ( 125 I-Ro 16-0154) and 99m Tc-hexamethyl-propyleneamine oxime ( 99m Tc-HMPAO). In visual and quantitative analyses, 125 I-Ro 16-0154 accumulation in brain slices extracted after the completion of the kindling was markedly and extensively decreased in the kindled CA1 region mimicking a primary epileptic focus. 125 I-Ro 16-0154 accumulation was moderately decreased in the ipsilateral temporal lobe, dentate gyrus, CA2, CA4, and bilateral CA3 regions, regarded as the propagated sites of seizure discharges. 99m Tc-HMPAO accumulation was found to be decreased in the ipsilateral CA1, frontal, temporal and dentate gyri. However, the decrease was much more slight and less extensive than that in 125 I-Ro 16-0154 accumulation. These results suggest that Bz receptor imaging is much more sensitive in the detection of epileptic foci than rCBF imaging, and therefore that Bz receptor imaging is useful in clinical epilepsy. (author)

  8. Types of traumatic brain injury and regional cerebral blood flow assessed by [sup 99m]Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi [Chiba Univ. (Japan). School of Medicine

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with [sup 99m]technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: (1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, (2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and (3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author).

  9. Correlation of regional cerebral blood flow and positive/negative symptoms in schizophrenic patients: covariate SPM analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ki Chun; Kim, J. S.; Kim, C. Y.; Lee, H. K.; Moon, D. H. [Ulsan University, Seoul (Korea, Republic of)

    2002-07-01

    We investigated the relations between rCBF and psychopathology in schizophrenic patients using a SPM99. Thirty-two patients(M/F:22/10, 25{+-}5,6yr) with active symptoms of schizophrenia and 15 age matched normal controls underwent Tc-99m ECD brain perfusion SPECT. Psychopathology of all patients were also assessed according to PANSS (positive and negative syndrome scale in schizophrenia). By covariate SPM analysis, specific areas where rCBF correlated with sum scores of positive/negative synptoms were identified. Regional CBF of schizophrenics was different in several cortical regions from normal controls. Sum scores of positive symptoms were positively correlated with rCBF of both rectal and inferior frontal gyri and right transverse temporal gyrus, and negatively correlated with rCBF of left lingual and right middle temporal gyri (p<0.01). Sum scores of negative symptoms were positively correlated with rCBF of both middle temporal gyri and negatively correlated with rCBF of right superior parietal lobule and medial frontal gyrus (p<0.01). Positive and negative symptoms of schizophrenia were correlated with rCBF change in different regions of cerebral association cortex.

  10. Correlation of regional cerebral blood flow and positive/negative symptoms in schizophrenic patients: covariate SPM analysis

    International Nuclear Information System (INIS)

    Lim, Ki Chun; Kim, J. S.; Kim, C. Y.; Lee, H. K.; Moon, D. H.

    2002-01-01

    We investigated the relations between rCBF and psychopathology in schizophrenic patients using a SPM99. Thirty-two patients(M/F:22/10, 25±5,6yr) with active symptoms of schizophrenia and 15 age matched normal controls underwent Tc-99m ECD brain perfusion SPECT. Psychopathology of all patients were also assessed according to PANSS (positive and negative syndrome scale in schizophrenia). By covariate SPM analysis, specific areas where rCBF correlated with sum scores of positive/negative synptoms were identified. Regional CBF of schizophrenics was different in several cortical regions from normal controls. Sum scores of positive symptoms were positively correlated with rCBF of both rectal and inferior frontal gyri and right transverse temporal gyrus, and negatively correlated with rCBF of left lingual and right middle temporal gyri (p<0.01). Sum scores of negative symptoms were positively correlated with rCBF of both middle temporal gyri and negatively correlated with rCBF of right superior parietal lobule and medial frontal gyrus (p<0.01). Positive and negative symptoms of schizophrenia were correlated with rCBF change in different regions of cerebral association cortex

  11. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT.

    Science.gov (United States)

    Yamakami, I; Yamaura, A; Isobe, K

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99mtechnetium-hexamethyl propyleneamine oxime. Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient.

  12. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99m technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author)

  13. Stimulus rate dependence of regional cerebral blood flow in human striate cortex, demonstrated by positron emission tomography

    International Nuclear Information System (INIS)

    Fox, P.T.; Raichle, M.E.

    1984-01-01

    The purpose of this investigation was to determine the relationship between the repetition rate of a simple sensory stimulus and regional cerebral blood flow (rCBF) in the human brain. Positron emission tomography (PET), using intravenously administered H 2 ( 15 )O as the diffusible blood-flow tracer, was employed for all CBF measurements. The use of H 2 ( 15 )O with PET allowed eight CBF measurements to be made in rapid sequence under multiple stimulation conditions without removing the subject from the tomograph. Nine normal volunteers each underwent a series of eight H2( 15 )O PET measurements of CBF. Initial and final scans were made during visual deprivation. The six intervening scans were made during visual activation with patterned-flash stimuli given in random order at 1.0-, 3.9-, 7.8-, 15.5-, 33.1-, and 61-Hz repetition rates. The region of greatest rCBF increase was determined. Within this region the rCBF was determined for every test condition and then expressed as the percentage change from the value of the initial unstimulated scan (rCBF% delta). In every subject, striate cortex rCBF% delta varied systematically with stimulus rate. Between 0 and 7.8 Hz, rCBF% delta was a linear function of stimulus repetition rate. The rCBF response peaked at 7.8 Hz and then declined. The rCBF% delta during visual stimulation was significantly greater than that during visual deprivation for every stimulus rate except 1.0 Hz. The anatomical localization of the region of peak rCBF response was determined for every subject to be the mesial occipital lobes along the calcarine fissure, primary visual cortex. Stimulus rate is a significant determinant of rCBF response in the visual cortex. Investigators of brain responses to selective activation procedures should be aware of the potential effects of stimulus rate on rCBF and other measurements of cerebral metabolism

  14. Rare missense mutations in P2RY11 in narcolepsy with cataplexy

    DEFF Research Database (Denmark)

    Degn, Matilda; Dauvilliers, Yves; Dreisig, Karin

    2017-01-01

    these are single nucleotide polymorphisms in the P2RY11-EIF3G locus. It is unknown how these genetic variants affect narcolepsy pathogenesis and whether the effect is directly related to P2Y11 signalling or EIF3G function. Exome sequencing in 18 families with at least two affected narcolepsy with cataplexy...

  15. Cerebrospinal fluid hypocretin 1 deficiency, overweight, and metabolic dysregulation in patients with narcolepsy.

    Science.gov (United States)

    Heier, Mona S; Jansson, Tine S; Gautvik, Kaare M

    2011-12-15

    The possible relationship between cerebrospinal fluid (CSF) hypocretin and leptin levels, overweight, and association to risk factors for diabetes 2 in narcolepsy with cataplexy were compared to patients with idiopathic hypersomnia and controls. 26 patients with narcolepsy, cataplexy, and hypocretin deficiency; 23 patients with narcolepsy, cataplexy, and normal hypocretin values; 11 patients with idiopathic hypersomnia; and 43 controls. Body mass index (BMI), serum leptin, and HbA1C were measured in patients and controls; and CSF hypocretin 1 and leptin measured in all patients. Female and male patients with narcolepsy and hypocretin deficiency had the highest mean BMI (27.8 and 26.2, respectively), not statistically different from patients with narcolepsy and normal hypocretin or controls, but statistically higher than the patients with idiopathic hypersomnia (p 30) was increased in both narcolepsy groups. Serum and CSF leptin levels correlated positively to BMI in patients and controls, but not to CSF hypocretin concentrations. HbA1C was within normal levels and similar in all groups. The study confirms a moderate tendency to obesity (BMI > 30) and overweight in patients with narcolepsy and cataplexy. Obesity was not correlated to hypocretin deficiency or reduced serum or CSF leptin concentrations. We suggest that overweight and possible metabolic changes previously reported in narcolepsy, may be caused by other mechanisms.

  16. Cerebrospinal fluid biomarkers of neurodegeneration are decreased or normal in narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul Jørgen; Pedersen, Lars Østergaard; Bahl, Justyna Maria Czarna

    2017-01-01

    OBJECTIVES: To investigate whether cerebrospinal fluid (CSF) biomarkers of neurodegeneration are altered in narcolepsy in order to evaluate whether the hypocretin deficiency and abnormal sleep-wake pattern in narcolepsy leads to neurodegeneration. METHODS: Twenty-one patients with central...... that hypocretin deficiency and an abnormal sleep-wake pattern alter the turnover of these proteins in CNS....

  17. Narcolepsy with hypocretin/orexin deficiency, infections and autoimmunity of the brain

    DEFF Research Database (Denmark)

    Kornum, Birgitte Rahbek; Faraco, Juliette; Mignot, Emmanuel

    2011-01-01

    The loss of hypothalamic hypocretin/orexin (hcrt) producing neurons causes narcolepsy with cataplexy. An autoimmune basis for the disease has long been suspected and recent results have greatly strengthened this hypothesis. Narcolepsy with hcrt deficiency is now known to be associated with a Huma...

  18. Common variants in P2RY11 are associated with narcolepsy

    DEFF Research Database (Denmark)

    Kornum, Birgitte R; Kawashima, Minae; Faraco, Juliette

    2011-01-01

    Growing evidence supports the hypothesis that narcolepsy with cataplexy is an autoimmune disease. We here report genome-wide association analyses for narcolepsy with replication and fine mapping across three ethnic groups (3,406 individuals of European ancestry, 2,414 Asians and 302 African Ameri...

  19. Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate

    Directory of Open Access Journals (Sweden)

    Tomi eSarkanen

    2014-08-01

    Full Text Available Aim: Hypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy.Method: We present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia.Results: Three out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone alleviated psychotic symptoms in two cases. Conclusion: Psychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia however the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.

  20. Complex Movement Disorders at Disease Onset in Childhood Narcolepsy with Cataplexy

    Science.gov (United States)

    Plazzi, Giuseppe; Pizza, Fabio; Palaia, Vincenzo; Franceschini, Christian; Poli, Francesca; Moghadam, Keivan K.; Cortelli, Pietro; Nobili, Lino; Bruni, Oliviero; Dauvilliers, Yves; Lin, Ling; Edwards, Mark J.; Mignot, Emmanuel; Bhatia, Kailash P.

    2011-01-01

    Narcolepsy with cataplexy is characterized by daytime sleepiness, cataplexy (sudden loss of bilateral muscle tone triggered by emotions), sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. Narcolepsy with cataplexy is most often associated with human leucocyte antigen-DQB1*0602 and is caused by the loss of…

  1. Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate.

    Science.gov (United States)

    Sarkanen, Tomi; Niemelä, Valter; Landtblom, Anne-Marie; Partinen, Markku

    2014-01-01

    Hypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy, and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB) treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy. We present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia. Three out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone) alleviated psychotic symptoms in two cases. Psychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia; however, the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.

  2. Effects of thyrotropin-releasing hormone on regional cerebral blood flow in man

    DEFF Research Database (Denmark)

    Oturai, P S; Friberg, L; Sam, I

    1992-01-01

    emission computerized tomograph and inhalation of 133Xe. Thyrotropin-releasing hormone caused a significant mean increase of 3.7% (range -8.8-22.7) in blood flow in a region consistent with the left thalamus compared to placebo (3.2% decrease). In 25 other regions no significant change was detected...

  3. The changes of regional cerebral blood flow: successful pain relief of intractable CRPS type II patients by motor cortex stimulation

    International Nuclear Information System (INIS)

    Jung, J. A.; Son, H. S.; Kim, S. H.; Jung, S. G

    2004-01-01

    Authors report the effectiveness of MCS in extraordinarily extended pain due to intractable CRPS type II and rCBF study result for mechanism of pain control by MCS. A 43-year-old male presented severe spontaneous burning pain in his left hand and forearm and allodynia over the left arm and left hemibody. Authors planned MCS as a neuromodulation therapy for this intractable peripheral neuropathic pain patient because further neurodestructive procedure did not work anymore and have a potential risk of further aggrevation of neuopathic pain. We performed baseline and stimulation brain perfusion SPECT using 20 mCi of Tc-99m ECD. The baseline CBD studies were done with stimulator 'off' state and stimulation studies were done after stimulator 'on' with satisfactory pain relief. For the stimulation study, the radioisotope was injected immediately after pain-relief and the images were taken about 50 minutes after injection of radioisotope. In resting rCBF in the patient was compared with normal control datas, we found significant increase in rCBF in the bilateral prefrontal cortex, right dorsolateral prefrontal cortex, right superior temporal gyrus, left temporooccipital area. When rCBF datas obtained after alleviation of pain with stimulator 'on' . there were significant increase in rCBF in bilateral prefrontal cortex and left temporoocipital area. After subtraction of ECD SPECT, we found significant increase in rCBF in the right premotor and supplementary motor cortex left sensorimotor cortex, right cingulated cortex, right posterior insular cortex, right anterior limb of internal capsule. left orbitofrontal cortex and right pyramidal tract in cerebral peduncle. Authors report exellent pain control by MCS in a case of severe CRPS type II with hemibody involvement and regional cerebral blood flow changes according to successful pain control

  4. The changes of regional cerebral blood flow: successful pain relief of intractable CRPS type II patients by motor cortex stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Jung, J. A.; Son, H. S.; Kim, S. H.; Jung, S. G [The Catholic University of Korea, Seoul (Korea, Republic of)

    2004-07-01

    Authors report the effectiveness of MCS in extraordinarily extended pain due to intractable CRPS type II and rCBF study result for mechanism of pain control by MCS. A 43-year-old male presented severe spontaneous burning pain in his left hand and forearm and allodynia over the left arm and left hemibody. Authors planned MCS as a neuromodulation therapy for this intractable peripheral neuropathic pain patient because further neurodestructive procedure did not work anymore and have a potential risk of further aggrevation of neuopathic pain. We performed baseline and stimulation brain perfusion SPECT using 20 mCi of Tc-99m ECD. The baseline CBD studies were done with stimulator 'off' state and stimulation studies were done after stimulator 'on' with satisfactory pain relief. For the stimulation study, the radioisotope was injected immediately after pain-relief and the images were taken about 50 minutes after injection of radioisotope. In resting rCBF in the patient was compared with normal control datas, we found significant increase in rCBF in the bilateral prefrontal cortex, right dorsolateral prefrontal cortex, right superior temporal gyrus, left temporooccipital area. When rCBF datas obtained after alleviation of pain with stimulator 'on' . there were significant increase in rCBF in bilateral prefrontal cortex and left temporoocipital area. After subtraction of ECD SPECT, we found significant increase in rCBF in the right premotor and supplementary motor cortex left sensorimotor cortex, right cingulated cortex, right posterior insular cortex, right anterior limb of internal capsule. left orbitofrontal cortex and right pyramidal tract in cerebral peduncle. Authors report exellent pain control by MCS in a case of severe CRPS type II with hemibody involvement and regional cerebral blood flow changes according to successful pain control.

  5. Regional differences of relationships between atrophy and glucose metabolism of cerebral cortex in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Toyama, H.; Uemura, K.; Kanekiyo, S.; Ishii, K.; Ishii, K.

    2002-01-01

    Aim: The purpose of this paper is to estimate a correlation between the extent of atrophy and the decline in the brain function measured with PET study among the patients with Alzheimer's disease by each brain lobe. Materials and Methods: Two groups, the normal controls (male: 8, female: 22 age: 62.4±4.9) and the patients with Alzheimer's disease (male: 6, female: 24, age: 65.9±7.2) participated in this study. The extent of atrophy was evaluated from the extracted gyrus on 2D-projection magnetic resonance imaging (MRI) and the cerebral cortical glucose metabolism was assessed on 2D-projection positron emission tomography (PET) image, and then a relationship between the cerebral atrophy and the function was evaluated by each brain lobe extracted automatically. 2D-projection of PET and MR images were made by means of the Mollweide method which keeps the area of the brain surface. In order to extract brain lobes from each subject automatically, the bitmap with different value by each brain lobe was made from a standard brain image and was automatically transformed to match each subject's brain image by using SPM99. A correlation image was generated between 2D-projection images of glucose metabolism and the area of the sulcus and the gyrus extracted from the correlation between MR and PET images clustered by K-means method. Results: The glucose metabolism of Alzheimer's disease was lower than that of normal control subjects at the frontal, parietal, and temporal lobes with the same extent of atrophy as that of the normal. There was high correlation between the area of gyrus and the glucose metabolism, and the correlation tendency of the Alzheimer's disease was steeper than that of the normal control at the parietal lobe. Conclusions: Combined analysis of regional morphology and function may be useful to distinguish pathological process such as early stage of Alzheimer's disease from normal physiological aging

  6. Regional cerebral blood flow in childhood autism: a SPET study with SPM evaluation.

    Science.gov (United States)

    Burroni, Luca; Orsi, Alessandra; Monti, Lucia; Hayek, Youssef; Rocchi, Raffaele; Vattimo, Angelo G

    2008-02-01

    To establish a link between rCBF assessed with Tc-ECD SPET and the clinical manifestation of the disease. We performed the study on 11 patients (five girls and six boys; mean age 11.2 years) displaying autistic behaviour and we compared their data with that of an age-matched reference group of eight normal children. A quantitative analysis of rCBF was performed calculating a perfusion index (PI) and an asymmetry index (AI) in each lobe. Images were analysed with statistical parametric mapping software, following the spatial normalization of SPET images for a standard brain. A statistically significant (P=0.003) global reduction of CBF was found in the group of autistic children (PI=1.07+/-0.07) when compared with the reference group (PI=1.25+/-0.12). Moreover, a significant difference was also observed for the right-to-left asymmetry of hemispheric perfusion between the control group and autistic patients (P=0.0085) with a right prevalence greater in autistic (2.90+/-1.68) with respect to normal children (1.12+/-0.49). Our data show a significant decrease of global cerebral perfusion in autistic children in comparison with their normal counterparts and the existence of left-hemispheric dysfunction, especially in the temporo-parietal areas devoted to language and the comprehension of music and sounds. We suggest that these abnormal areas are related to the cognitive impairment observed in autistic children, such as language deficits, impairment of cognitive development and object representation, and abnormal perception and responses to sensory stimuli. Tc-ECD SPET seems to be sensitive in revealing brain blood flow alterations and left-to-right asymmetries, when neuroradiological patterns are normal.

  7. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy

    DEFF Research Database (Denmark)

    Dauvilliers, Yves; Jennum, Poul; Plazzi, Giuseppe

    2013-01-01

    Narcolepsy is a rare disabling hypersomnia disorder that may include cataplexy, sleep paralysis, hypnagogic hallucinations, and sleep-onset rapid eye movement (REM) periods, but also disrupted nighttime sleep by nocturnal awakenings, and REM sleep behavior disorder (RBD). RBD is characterized...... by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with neurodegenerative disorders including Parkinsonisms, but is also reported in narcolepsy in up to 60% of patients. RBD in patients with narcolepsy is, however...... with narcolepsy often present dissociated sleep features including RSWA, increased density of phasic chin EMG and frequent shift from REM to NREM sleep, with or without associated clinical RBD. Most patients with narcolepsy with cataplexy lack the hypocretin neurons in the lateral hypothalamus. Tonic and phasic...

  8. Rapid eye movement sleep behaviour disorder in patients with narcolepsy is associated with hypocretin-1 deficiency

    DEFF Research Database (Denmark)

    Knudsen, Stine; Gammeltoft, Steen; Jennum, Poul J

    2010-01-01

    Rapid eye movement sleep behaviour disorder is characterized by dream-enacting behaviour and impaired motor inhibition during rapid eye movement sleep. Rapid eye movement sleep behaviour disorder is commonly associated with neurodegenerative disorders, but also reported in narcolepsy with cataplexy....... Most narcolepsy with cataplexy patients lack the sleep-wake, and rapid eye movement sleep, motor-regulating hypocretin neurons in the lateral hypothalamus. In contrast, rapid eye movement sleep behaviour disorder and hypocretin deficiency are rare in narcolepsy without cataplexy. We hypothesized...... that rapid eye movement sleep behaviour disorder coexists with cataplexy in narcolepsy due to hypocretin deficiency. In our study, rapid eye movement sleep behaviour disorder was diagnosed by the International Classification of Sleep Disorders (2nd edition) criteria in 63 narcolepsy patients with or without...

  9. Effective treatment of narcolepsy-like symptoms with high-frequency repetitive transcranial magnetic stimulation

    Science.gov (United States)

    Lai, Jian-bo; Han, Mao-mao; Xu, Yi; Hu, Shao-hua

    2017-01-01

    Abstract Rationale: Narcolepsy is a rare sleep disorder with disrupted sleep-architecture. Clinical management of narcolepsy lies dominantly on symptom-driven pharmacotherapy. The treatment role of repetitive transcranial magnetic stimulation (rTMS) for narcolepsy remains unexplored. Patient concerns: In this paper, we present a case of a 14-year-old young girl with excessive daytime sleepiness (EDS), cataplexy and hypnagogic hallucinations. Diagnoses: After excluding other possible medical conditions, this patient was primarily diagnosed with narcolepsy. Interventions: The patient received 25 sessions of high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC). Outcomes: The symptoms of EDS and cataplexy significantly improved after rTMS treatment. Meanwhile, her score in the Epworth sleep scale (ESS) also remarkably decreased. Lessons: This case indicates that rTMS may be selected as a safe and effective alternative strategy for treating narcolepsy-like symptoms. Well-designed researches are warranted in future investigations on this topic. PMID:29145290

  10. Regional cerebral perfusion measurements: a comparative study of xenon-enhanced CT and C15O2 build-up using dynamic PET

    International Nuclear Information System (INIS)

    St Lawrence, K.S.; Bews, J.; Dunscombe, P.B.

    1992-01-01

    Regional cerebral perfusion can be determined by monitoring the uptake of a diffusable tracer concurrently in cerebral tissue and arterial blood. Two techniques based on this methodology are xenon-enhanced computed tomography (Xe CT) and C 15 O 2 build-up using dynamic positron emission tomography (C 15 O 2 PET). Serial images are used by both Xe CT and C 15 O 2 PET to characterize the uptake of the tracer in cerebral tissue. The noise present in these images will reduce the precision of the perfusion measurements obtained by either technique. Using Monte Carlo type computer simulations, the precision of the two techniques as a function of image noise has been examined. On the basis of their results, they conclude that the precision of the Xe CT technique is comparable to the precision of C 15 O 2 PET when realistic clinical protocols are employed for both. (author)

  11. Regional cerebral blood flow in acute stage with ischemic cerebrovascular disease by xenon-133 inhalation and single photon emission computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hiroyuki; Iino, Katsuro; Kojima, Hisashi; Saito, Hitoshi; Suzuki, Mikio; Watanabe, Kazuo; Kato, Toshiro

    1987-05-01

    Single photon emission computed tomography (SPECT) with xenon-133 inhalation method was undertaken within 48 hr after the onset in 68 patients with ischemic cerebrovascular disease. The results for regional cerebral blood flow (rCBF) were compared with concurrently available computed tomography (CT) scans. In patients with cerebral infarction, SPECT detected ischemic lesions earlier than CT, with the detectability being 92 %. The area with a decreased blood flow, as seen on SPECT, was more extensive than the low density area on CT, with a concomitant decrease in blood flow in the contralateral cerebral hemisphere. Crossed cerebellar diaschisis was associated with stenosis of the internal carotid artery in 50 % (7/14), and with stenosis of the middle cerebral artery in 35 % (9/26). Abnormal SPECT findings were seen in 47 % (8/17) of the patients with transient ischemic attack (TIA). Five TIA patients had a decreased rCBF on SPECT, which was not provided by CT scans. On the contrary, small infarct lesions in the cerebral basal ganglia, as observed in 4 patients, was not detected by SPECT, but detected by CT. This may imply the limitations of SPECT in the detection of deep-seated lesions of the cerebrum. The results led to the conclusion that SPECT can be performed safely even in acute, seriously ill patients to know changes in rCBF because it is noninvasive and is capable of being repeated in a short time. (Namekawa, K.).

  12. Measurement of regional cerebral blood flow with single photon emission computed tomography in patients with aphasia

    International Nuclear Information System (INIS)

    Reischies, F.M.; Muellmann, A.; Hedde, J.P.; Freie Univ. Berlin; Christe, W.

    1984-01-01

    5 cases are demonstrated of patients with aphasia whose brain perfusion as measured regionally by SPECT using 133 Xe was correlated to the lesions seen in the CT study. Perfusion reductions exceeded the CT visible lesions, such as, that in cortical lesions perfusion in the region of basal ganglia is diminished and vice versa. The findings are discussed in relation to recent work on brain perfusion and metabolism. (orig.) [de

  13. Regional cerebral blood flow in Parkinson's disease measured with N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Nishihara, Mamiko; Hayashi, Hiroko; Higuchi, Shoichi; Sakai, Kunio [Niigata Univ. (Japan). School of Medicine; Ishikawa, Atsushi; Ibayashi, Katsuhiko

    1992-09-01

    N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT studies were performed on 21 patients (13 females; 45-73 yrs) with idiopathic Parkinson's disease (PD) and 10 age-matched normal controls (39-69 yrs). Regional cerebral blood flow (rCBF) was quantitatively measured by the arterial blood sampling method. When compared with normal controls, global CBF, and rCBF in the frontal cortex and in the basal ganglia were reduced 22.1% (p<0.01), 25.0% (p<0.05) and 25.6% (p<0.01), respectively. The reduction of rCBF in the basal ganglia was significantly correlated (p<0.05) with symptoms such as gait disturbance, frozen gait and motor disability score. However, no significant correlation was observed between the severity of dementia and any regional reduction of CBF, including the frontal or parietal cortices. These data show that the severity of dementia in PD may be related to other factors but not with CBF. Quantification of rCBF with [sup 123]I-IMP SPECT imaging is useful for evaluation and follow-up of patients with PD. (author).

  14. Regional Cerebral Blood Flow during Wakeful Rest in Older Subjects with Mild to Severe Obstructive Sleep Apnea.

    Science.gov (United States)

    Baril, Andrée-Ann; Gagnon, Katia; Arbour, Caroline; Soucy, Jean-Paul; Montplaisir, Jacques; Gagnon, Jean-François; Gosselin, Nadia

    2015-09-01

    To evaluate changes in regional cerebral blood flow (rCBF) during wakeful rest in older subjects with mild to severe obstructive sleep apnea (OSA) and healthy controls, and to identify markers of OSA severity that predict altered rCBF. High-resolution (99m)Tc-HMPAO SPECT imaging during wakeful rest. Research sleep laboratory affiliated with a University hospital. Fifty untreated OSA patients aged between 55 and 85 years, divided into mild, moderate, and severe OSA, and 20 age-matched healthy controls. N/A. Using statistical parametric mapping, rCBF was compared between groups and correlated with clinical, respiratory, and sleep variables. Whereas no rCBF change was observed in mild and moderate groups, participants with severe OSA had reduced rCBF compared to controls in the left parietal lobules, left precentral gyrus, bilateral postcentral gyri, and right precuneus. Reduced rCBF in these regions and in areas of the bilateral frontal and left temporal cortex was associated with more hypopneas, snoring, hypoxemia, and sleepiness. Higher apnea, microarousal, and body mass indexes were correlated to increased rCBF in the basal ganglia, insula, and limbic system. While older individuals with severe obstructive sleep apnea (OSA) had hypoperfusion in the sensorimotor and parietal areas, respiratory variables and subjective sleepiness were correlated with extended regions of hypoperfusion in the lateral cortex. Interestingly, OSA severity, sleep fragmentation, and obesity correlated with increased perfusion in subcortical and medial cortical regions. Anomalies with such a distribution could result in cognitive deficits and reflect impaired vascular regulation, altered neuronal integrity, and/or undergoing neurodegenerative processes. © 2015 Associated Professional Sleep Societies, LLC.

  15. Global and regional associations of smaller cerebral gray and white matter volumes with gait in older people.

    Directory of Open Access Journals (Sweden)

    Michele L Callisaya

    Full Text Available BACKGROUND: Gait impairments increase with advancing age and can lead to falls and loss of independence. Brain atrophy also occurs in older age and may contribute to gait decline. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people. METHODS: In a population-based study, participants aged >60 years without Parkinson's disease or brain infarcts underwent magnetic resonance imaging and gait measurements using a computerized walkway. Linear regression was used to study associations of total gray and white matter volumes with gait, adjusting for each other, age, sex, height and white matter hyperintensity volume. Other covariates considered in analyses included weight and vascular disease history. Voxel-based morphometry was used to study regional relationships of gray and white matter with gait. RESULTS: There were 305 participants, mean age 71.4 (6.9 years, 54% male, mean gait speed 1.16 (0.22 m/s. Smaller total gray matter volume was independently associated with poorer gait speed (p = 0.001 and step length (p<0.001, but not cadence. Smaller volumes of cortical and subcortical gray matter in bilateral regions important for motor control, vision, perception and memory were independently associated with slower gait speed and shorter steps. No global or regional associations were observed between white matter volume and gait independent of gray matter volume, white matter hyperintensity volume and other covariates. CONCLUSION: Smaller gray matter volume in bilaterally distributed brain networks serving motor control was associated with slower gait speed and step length, but not cadence.

  16. Regional cerebral blood flow measurement using N-isopropyl-p-[123I] iodoamphetamine and rotating gamma camera emission computed tomography

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Seki, Hiroyasu; Ishida, Hiroko

    1985-01-01

    Thirty-one regional cerebral blood flow (rCBF) measurements were performed on 26 patients with cerebrovascular accidents using N-Isopropyl-p-[ 123 I] Iodoamphetamine ( 123 I-IMP) and rotating gamma camera emission computed tomography (ECT). The equation for determining rCBF is as follows: F=100.R.Cb/(N.A), where F is rCBF in ml/100 g/min., R is the constant withdrawal rate of arterial blood in ml/min., Cb is the brain activity concentration in μCi/g, A is the total activity (5 min.) in the withdrawal arterial whole blood in μCi and N is the fraction of A that is true tracer activity (0.75). In determining Cb at 5 min. after injection, reconstructed counts from 35 min. to 59 min. were corrected to represent those from 4 min. to 5 min. with the use of time activity curve for the entire brain immediately after injection to 30 min. Reconstructed counts of central region in tomographic image were corrected 118% of the obtained values from the result of the countingrate ratio between peripheral and central regions of interests obtained from phantom study. Brain mean blood flow values were distributed from 11 to 39 ml/100 g/min. In 119 cortical regions obtained from 11 measurements in 9 patients, there was a significant correlation (r=0.41, p 123 I-IMP and rotating gamma camera ECT and those from 133 Xe inhalation method. rCBF measurement using 123 I-IMP and rotating gamma camera ECT is not only relatively noninvasive measurement for the entire brain but also three-dimensional evaluation. Besides, it is superior in spatial resolution and accuracy to conventional 133 Xe clearance method. (author)

  17. A comparative study of methods for automatic detection of rapid eye movement abnormal muscular activity in narcolepsy

    DEFF Research Database (Denmark)

    Olesen, Alexander Neergaard; Cesari, Matteo; Christensen, Julie Anja Engelhard

    2018-01-01

    atonia index (RAI), supra-threshold REM EMG activit ymetric (STREAM), and Frandsen method (FR) were calculated from polysomnography recordings of 20 healthy controls, 18 clinic controls (subjects suspected with narcolepsy but finally diagnosed without any sleep abnormality), 16 narcolepsy type 1 without...... REM sleep behavior disorder (RBD), 9 narcolepsy type 1 with RBD, and 18 narcolepsy type 2. Diagnostic value of metrics in differentiating between groups was quantified by area under the receiver operating characteristic curve (AUC). Correlations among the metrics and cerebrospinal fluid hypocretin-1...... in narcolepsy 1 compared to controls. This finding might play a supportive role in diagnosing narcolepsy and in discriminating narcolepsy subtypes. Moreover, the negative correlation between CSF-hcrt-1 level and REM muscular activity supported a role for hypocretin in the control of motor tone during REM sleep....

  18. Human regional cerebral blood flow during rapid-eye-movement sleep

    DEFF Research Database (Denmark)

    Madsen, P L; Holm, S; Vorstrup, S

    1991-01-01

    Owing to the coupling between CBF and neuronal activity, regional CBF is a reflection of neural activity in different brain regions. In this study we measured regional CBF during polysomnographically well-defined rapid-eye-movement (REM) sleep by the use of single photon emission computerized...... tomography and the new tracer 99mTc-dl-hexamethylpropyleneamine. Eleven healthy volunteers aged between 22 and 27 years were studied. CBF was measured on separate nights during REM sleep and during EEG-verified wakefulness. On awakening from REM sleep, all subjects reported visual dreams. During REM sleep...... dream experiences. On the other hand, the reduced involvement of the inferior frontal cortex observed during REM sleep might explain the poor temporal organization and bizarreness often experienced in dreams....

  19. Regional cerebral palmitate incorporation following transient bilateral carotid occlusion in awake gerbils

    Energy Technology Data Exchange (ETDEWEB)

    Tone, O.; Miller, J.C.; Bell, J.M.; Rapoport, S.I.

    1987-11-01

    (/sup 14/C)Palmitate was injected intravenously in awake gerbils at various times after 5 minutes of bilateral carotid artery occlusion or a sham operation. Regional rates of incorporation of plasma palmitate into the hippocampus and other regions of the anterior circulation were determined relative to the mean rate of incorporation into regions of the posterior circulation using quantitative autoradiography and a ratio method of analysis. One day after bilateral carotid occlusion, relative palmitate incorporation was elevated significantly by 16% in the CA4 pyramidal cell layer and by 20% in the dentate gyrus of the hippocampus compared with sham-operated gerbils. At 3 days, significant elevations of this magnitude were found in the CA3 and CA4 cell layers, whereas relative incorporation was reduced by 26% in the CA1 pyramidal cell layer. At 7 days, the only significant difference from control was a 15% elevated incorporation in the CA3 pyramidal cell layer. Histologic examination indicated substantial cell death in the CA1 pyramidal layer at 3 days, with extensive glial reaction and phagocytic invasion at 7 days. Our results suggest that the turnover of palmitate-containing lipids is reduced in the CA1 layer of the gerbil hippocampus but that lipid synthesis is stimulated in hippocampal regions (CA3, CA4, dentate gyrus) affected by but recovering from transient bilateral carotid occlusion.

  20. Regional cerebral palmitate incorporation following transient bilateral carotid occlusion in awake gerbils

    International Nuclear Information System (INIS)

    Tone, O.; Miller, J.C.; Bell, J.M.; Rapoport, S.I.

    1987-01-01

    [ 14 C]Palmitate was injected intravenously in awake gerbils at various times after 5 minutes of bilateral carotid artery occlusion or a sham operation. Regional rates of incorporation of plasma palmitate into the hippocampus and other regions of the anterior circulation were determined relative to the mean rate of incorporation into regions of the posterior circulation using quantitative autoradiography and a ratio method of analysis. One day after bilateral carotid occlusion, relative palmitate incorporation was elevated significantly by 16% in the CA4 pyramidal cell layer and by 20% in the dentate gyrus of the hippocampus compared with sham-operated gerbils. At 3 days, significant elevations of this magnitude were found in the CA3 and CA4 cell layers, whereas relative incorporation was reduced by 26% in the CA1 pyramidal cell layer. At 7 days, the only significant difference from control was a 15% elevated incorporation in the CA3 pyramidal cell layer. Histologic examination indicated substantial cell death in the CA1 pyramidal layer at 3 days, with extensive glial reaction and phagocytic invasion at 7 days. Our results suggest that the turnover of palmitate-containing lipids is reduced in the CA1 layer of the gerbil hippocampus but that lipid synthesis is stimulated in hippocampal regions (CA3, CA4, dentate gyrus) affected by but recovering from transient bilateral carotid occlusion

  1. Reduced regional cerebral blood flow in SPG4-linked hereditary spastic paraplegia

    DEFF Research Database (Denmark)

    Scheuer, Kristin H; Nielsen, Jørgen E; Krabbe, Katja

    2005-01-01

    flow (rCBF) as an indirect marker of regional neuronal activity. Eighteen SPG4 patients and 18 matched control subjects were studied. Resting state rCBF was measured using Positron Emission Tomography (PET) and the (15)O-labelled water bolus technique and relative group differences were explored using...

  2. Impact of cytokine in type 1 narcolepsy: Role of pandemic H1N1 vaccination ?

    Science.gov (United States)

    Lecendreux, Michel; Libri, Valentina; Jaussent, Isabelle; Mottez, Estelle; Lopez, Régis; Lavault, Sophie; Regnault, Armelle; Arnulf, Isabelle; Dauvilliers, Yves

    2015-06-01

    Recent advances in the identification of susceptibility genes and environmental exposures (pandemic influenza 2009 vaccination) provide strong support that narcolepsy type 1 is an immune-mediated disease. Considering the limited knowledge regarding the immune mechanisms involved in narcolepsy whether related to flu vaccination or not and the recent progresses in cytokine measurement technology, we assessed 30 cytokines, chemokines and growth factors using the Luminex technology in either peripheral (serum) or central (CSF) compartments in a large population of 90 children and adult patients with narcolepsy type 1 in comparison to 58 non-hypocretin deficient hypersomniacs and 41 healthy controls. Furthermore, we compared their levels in patients with narcolepsy whether exposed to pandemic flu vaccine or not, and analyzed the effect of age, duration of disease and symptom severity. Comparison for sera biomarkers between narcolepsy (n = 84, 54 males, median age: 15.5 years old) and healthy controls (n = 41, 13 males, median age: 20 years old) revealed an increased stimulation of the immune system with high release of several pro- and anti-inflammatory serum cytokines and growth factors with interferon-γ, CCL11, epidermal growth factor, and interleukin-2 receptor being independently associated with narcolepsy. Increased levels of interferon-γ, CCL11, and interleukin-12 were found when close to narcolepsy onset. After several adjustments, only one CSF biomarker differed between narcolepsy (n = 44, 26 males, median age: 15 years old) and non-hypocretin deficient hypersomnias (n = 57, 24 males, median age: 36 years old) with higher CCL 3 levels found in narcolepsy. Comparison for sera biomarkers between patients with narcolepsy who developed the disease post-pandemic flu vaccination (n = 36) to those without vaccination (n = 48) revealed an increased stimulation of the immune system with high release of three cytokines, regulated upon activation normal T-cell expressed

  3. Nova técnica: operação de Norwood com perfusão regional cerebral e coronariana New technique: Norwood operation with regional cerebral and coronary perfusion

    Directory of Open Access Journals (Sweden)

    Gláucio Furlanetto

    2009-12-01

    Full Text Available OBJETIVO: Avaliar o resultado imediato da operação de Norwood modificado com nova técnica de perfusão regional cerebral (PRCeA anterógrada associado a perfusão regional coronariana (PRCoR retrógrada em substituição à parada circulatória total com hipotermia profunda em crianças portadoras da Síndrome da Hipoplasia do Coração Esquerdo (SHCE com aorta ascendente extremamente hipoplásica (AH. MÉTODOS: No período de dezembro de 2006 a fevereiro de 2008, a operação de Norwood modificado com tubo entre o ventrículo direito e as artérias pulmonares ou shunt tipo Sano foi realizada em oito crianças portadoras de SHCE e aorta ascendente com diâmetro inferior a 3 mm, (quatro do sexo masculino e quatro do sexo feminino com idade média de 9,2 dias (variando de 1 a 29 dias e peso médio de 3,3 kg (variando de 2,7 a 3,8 kg. Utilizada CEC e hipotermia a 25ºC com duas cânulas venosas e anastomose de um enxerto de politetrafluoretileno com a artéria inominada utilizado como linha arterial e para PRCeA. A PRCoR foi realizada por meio de um desvio na linha arterial e colocação de um cateter na aorta ascendente. Foram analisados o resultado cirúrgico imediato e a presença de alterações neurológicas nesse período. RESULTADOS: O resultado cirúrgico imediato revelou mortalidade de 25% e ausência de comprometimento neurológico ao exame clínico. CONCLUSÃO: A operação de Norwood modificado pode ser realizada com PRCeA e PRCoR em crianças com SHCE e AH com resultado cirúrgico imediato satisfatório e ausência de complicações neurológicas.OBJECTIVE: To assess the immediate result of the modified Norwood procedure with new technique of anterograde regional cerebral perfusion (ARCeP and retrograde regional coronary perfusion (RRCoP in substitution of profound hypothermia and circulatory arrest in children with hypoplastic left heart syndrome (HLHS with extremely hypoplastic ascending aorta (HA. METHODS: In the period of

  4. Age and gender effects on normal regional cerebral blood flow studied using two different voxel-based statistical analyses

    International Nuclear Information System (INIS)

    Pirson, A.S.; George, J.; Krug, B.; Vander Borght, T.; Van Laere, K.; Jamart, J.; D'Asseler, Y.; Minoshima, S.

    2009-01-01

    Fully automated analysis programs have been applied more and more to aid for the reading of regional cerebral blood flow SPECT study. They are increasingly based on the comparison of the patient study with a normal database. In this study, we evaluate the ability of Three-Dimensional Stereotactic Surface Projection (3 D-S.S.P.) to isolate effects of age and gender in a previously studied normal population. The results were also compared with those obtained using Statistical Parametric Mapping (S.P.M.99). Methods Eighty-nine 99m Tc-E.C.D.-SPECT studies performed in carefully screened healthy volunteers (46 females, 43 males; age 20 - 81 years) were analysed using 3 D-S.S.P.. A multivariate analysis based on the general linear model was performed with regions as intra-subject factor, gender as inter-subject factor and age as co-variate. Results Both age and gender had a significant interaction effect with regional tracer uptake. An age-related decline (p < 0.001) was found in the anterior cingulate gyrus, left frontal association cortex and left insula. Bilateral occipital association and left primary visual cortical uptake showed a significant relative increase with age (p < 0.001). Concerning the gender effect, women showed higher uptake (p < 0.01) in the parietal and right sensorimotor cortices. An age by gender interaction (p < 0.01) was only found in the left medial frontal cortex. The results were consistent with those obtained with S.P.M.99. Conclusion 3 D-S.S.P. analysis of normal r.C.B.F. variability is consistent with the literature and other automated voxel-based techniques, which highlight the effects of both age and gender. (authors)

  5. Traumatic brain injury causes long-term behavioral changes related to region-specific increases of cerebral blood flow.

    Science.gov (United States)

    Pöttker, Bruno; Stöber, Franziska; Hummel, Regina; Angenstein, Frank; Radyushkin, Konstantin; Goldschmidt, Jürgen; Schäfer, Michael K E

    2017-12-01

    Traumatic brain injury (TBI) is a leading cause of disability and death and survivors often suffer from long-lasting motor impairment, cognitive deficits, anxiety disorders and epilepsy. Few experimental studies have investigated long-term sequelae after TBI and relations between behavioral changes and neural activity patterns remain elusive. We examined these issues in a murine model of TBI combining histology, behavioral analyses and single-photon emission computed tomography (SPECT) imaging of regional cerebral blood flow (CBF) as a proxy for neural activity. Adult C57Bl/6N mice were subjected to unilateral cortical impact injury and investigated at early (15-57 days after lesion, dal) and late (184-225 dal) post-traumatic time points. TBI caused pronounced tissue loss of the parietal cortex and subcortical structures and enduring neurological deficits. Marked perilesional astro- and microgliosis was found at 57 dal and declined at 225 dal. Motor and gait pattern deficits occurred at early time points after TBI and improved over the time. In contrast, impaired performance in the Morris water maze test and decreased anxiety-like behavior persisted together with an increased susceptibility to pentylenetetrazole-induced seizures suggesting alterations in neural activity patterns. Accordingly, SPECT imaging of CBF indicated asymmetric hemispheric baseline neural activity patterns. In the ipsilateral hemisphere, increased baseline neural activity was found in the amygdala. In the contralateral hemisphere, homotopic to the structural brain damage, the hippocampus and distinct cortex regions displayed increased baseline neural activity. Thus, regionally elevated CBF along with behavioral alterations indicate that increased neural activity is critically involved in the long-lasting consequences of TBI.

  6. Characteristic deterioration of ADAS-Jcog subscale scores and correlations with regional cerebral blood flow reductions in Alzheimer's disease.

    Science.gov (United States)

    Yoshii, Fumihito; Kawaguchi, Chikako; Kohara, Saori; Shimizu, Mie; Onaka, Hiroe; Ryo, Masafuchi; Takahashi, Wakoh

    2018-05-01

    The Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-Jcog) is composed of a number of subscale tasks. However, it is not clear which subscale tasks are most susceptible to impairment in Alzheimer's disease (AD) or what is the relationship between reduction in regional cerebral blood flow (rCBF) and decreased ADAS-Jcog scores. Subjects were 32 AD patients, aged 52-86 years. We examined the relationship between subscale tasks that showed marked score changes and brain regions that showed reduced rCBF over a 2-year period. rCBF was measured by single-photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimer ( 99m Tc-ECD), and the SPECT imaging data were analyzed with the easy Z-score imaging system (eZIS) and voxel-based stereotactic extraction estimation (vbSEE) methods. Total score of ADAS-Jcog deteriorated from 19.5 ± 7.0 to 35.7 ± 15.2 after 2 years. Subscale scores were significantly worse in all fields, particularly in orientation, word recall, remembering test instructions, commands, constructional praxis, and ideational praxis, in that order. Significant correlations were found between (1) word recall and commands and rCBF in the left middle temporal lobe, (2) naming objects/fingers and rCBF in the left temporal (middle, inferior) lobe, and (3) constructional and ideational praxis and rCBF in the right parietal (superior, inferior) lobe, temporal (superior, middle) lobe, angular gyrus, and cingulate gyrus. We identified the brain regions associated with specifically impaired subscales of ADAS-Jcog during progressive deterioration of AD over 2 years.

  7. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    Full Text Available Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD, a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation.CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM voxel-based morphometry (VBM. Pseudo-continuous arterial spin labeling (pcASL was used to produce cerebral blood flow (CBF images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables.In 30 men with CAD (mean age 65±7 years, VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001. Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak.Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.

  8. Regional cerebral blood flow and anxiety: a correlation study in neurologically normal patients

    International Nuclear Information System (INIS)

    Rodriguez, G.; Cogorno, P.; Gris, A.; Marenco, S.; Mesiti, C.; Nobili, F.; Rosadini, G.

    1989-01-01

    Regional CBF (rCBF) was evaluated by the 133 Xe inhalation method in 60 neurologically normal patients (30 men and 30 women) and hemispheric and regional values were correlated with anxiety measurements collected by a self-rating questionnaire before and after the examination. Statistically significant negative correlations between rCBF and anxiety measures were found. rCBF reduction for high anxiety levels is in line with results previously reported by others and could be related to lower performance levels for moderately high anxiety scores as those reported in the present population. This could perhaps be explained by rearrangement of flow from cortical zones to deeper areas of the brain, classically known to be implicated in the control of emotions. However, these results should be interpreted cautiously, since they were obtained in patients and not in normal subjects

  9. Regional cerebral glucose metabolism is normal in young adults with Down syndrome

    International Nuclear Information System (INIS)

    Schapiro, M.B.; Grady, C.L.; Kumar, A.; Herscovitch, P.; Haxby, J.V.; Moore, A.M.; White, B.; Friedland, R.P.; Rapoport, S.I.

    1990-01-01

    Regional CMRglc (rCMRglc) values were measured with [ 18 F]2-fluoro-2-deoxy-D-glucose ( 18 FDG) and positron emission tomography (PET), using a Scanditronix PC-1024-7B scanner, in 14 healthy, noninstitutionalized subjects with trisomy 21 (Down syndrome; DS) (mean age 30.0 years, range 25-38 years) and in 13 sex-matched, healthy volunteers (mean age 29.5 years, range 22-38 years). In the DS group, mean mental age on the Peabody Picture Vocabulary Test was 7.8 years and dementia was not present. Resting rCMRglc was determined with eyes covered and ears occluded in a quiet, darkened room. Global gray CMRglc equaled 8.76 +/- 0.76 mg/100 g/min (mean +/- SD) in the DS group as compared with 8.74 +/- 1.19 mg/100 g/min in the control group (p greater than 0.05). Gray matter regional measurements also did not differ between groups. The ratio of rCMRglc to global CMRglc, calculated to reduce the variance associated with absolute rCMRglc, and right/left ratios did not show any consistent differences. These results show that healthy young DS adults do not have alterations in regional or global brain glucose metabolism, as measured with 18FDG and PET, prior to an age at which the neuropathological changes in Alzheimer disease are reported to occur

  10. Monitoring of regional cerebral blood flow by single photon emission tomography of I123-N-isopropyl-iodoamphetamine in epileptics

    International Nuclear Information System (INIS)

    Magistretti, P.L.; Uren, R.F.; Parker, J.A.; Royal, H.D.; Front, D.; Kolodny, G.M.

    1983-01-01

    In some patients with epileptic disorders it is difficult to accurately localize the seizure focus especially in the case of deep lesions. In an attempt to provide better localization of such foci we have used single photon emission tomography (SPECT) of a new radiopharmaceutical I 123 -N-isopropyl-iodoamphetamine (IMP) to measure regional cerebral blood flow (RCBF) in the ictal and interictal phases. Eight patients were studied. The location of the seizure focus was determined by intraoperative corticography operative findings and pathology in 5 patients and by neuropsychological testing and long-term EEG monitoring in the other three. The SPECT scan accurately localized the seizure focus in all patients. This modality also allowed the functional state of the seizure focus to be assessed. In five of the thirteen studies there was increased RCBF at the seizure focus. On four of these occasions the patients reported symptoms typical of their seizures. In the asymptomatic patient the focally increased RCBF corresponded with a very active superficial epileptic focus on EEG. These preliminary results suggest that SPECT scans of RCBF, will have considerable utility in the management of epileptics. This is particularly the case as the necessary instrumentation is already available in many hospitals, thus minimizing the cost of widespread application

  11. Evaluation of reconstruction techniques in regional cerebral blood flow SPECT using trade-off plots: a Monte Carlo study.

    Science.gov (United States)

    Olsson, Anna; Arlig, Asa; Carlsson, Gudrun Alm; Gustafsson, Agnetha

    2007-09-01

    The image quality of single photon emission computed tomography (SPECT) depends on the reconstruction algorithm used. The purpose of the present study was to evaluate parameters in ordered subset expectation maximization (OSEM) and to compare systematically with filtered back-projection (FBP) for reconstruction of regional cerebral blood flow (rCBF) SPECT, incorporating attenuation and scatter correction. The evaluation was based on the trade-off between contrast recovery and statistical noise using different sizes of subsets, number of iterations and filter parameters. Monte Carlo simulated SPECT studies of a digital human brain phantom were used. The contrast recovery was calculated as measured contrast divided by true contrast. Statistical noise in the reconstructed images was calculated as the coefficient of variation in pixel values. A constant contrast level was reached above 195 equivalent maximum likelihood expectation maximization iterations. The choice of subset size was not crucial as long as there were > or = 2 projections per subset. The OSEM reconstruction was found to give 5-14% higher contrast recovery than FBP for all clinically relevant noise levels in rCBF SPECT. The Butterworth filter, power 6, achieved the highest stable contrast recovery level at all clinically relevant noise levels. The cut-off frequency should be chosen according to the noise level accepted in the image. Trade-off plots are shown to be a practical way of deciding the number of iterations and subset size for the OSEM reconstruction and can be used for other examination types in nuclear medicine.

  12. Analysis of depression and anxiety state and changes of regional cerebral blood flow in patients with Graves' disease

    International Nuclear Information System (INIS)

    Yu Jiangyuan; Li Yaming; Yin Yafu; Li Xuena; Han Chunqi; Li Deshun; Liu Hao; Li Na; Liang Chenrong; Sun Zhenqiu

    2006-01-01

    Objective: To explore the incidence of depression and anxiety state and the changes of regional cerebral blood flow (rCBF) in patients with Graves' disease (GD). Methods: Twenty-one GD patients underwent rCBF SPECT imaging, and their mental state was evaluated by Zung self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS) respectively. Results: Total scores obtained from SDS and SAS were both significantly greater in the GD group than that in the control group (t SDS =7.26, t SAS =5.35, P 3 , FT 4 and TSH levels. In SPECT imaging, GD group had decreased uptake of radioactivity in frontal lobs, temporal lobs, basal ganglia and thalamus mainly. There was also no significant correlation between the decrease of rCBF and SDS or SAS scores. Conclusions: The psychiatric symptoms in GD group are more significant than normal controls, rCBF of GD group decreases mainly in bilateral frontal lobes, temporal lobes, basal ganglia and thalamus. (authors)

  13. Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling.

    Science.gov (United States)

    Miranda, Maria J; Olofsson, Kern; Sidaros, Karam

    2006-09-01

    Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term-born neonates. Examinations were performed on unsedated infants at postmenstrual age of 39-40 wk in both groups. Due to motion, reliable data were obtained from 23 preterm and 6 term infants. Perfusion in the basal ganglia (39 and 30 mL/100 g/min for preterm and term neonates, respectively) was significantly higher (p neonates at term-equivalent age and in term neonates. Perfusion was significantly higher (p = 0.01) in the preterm group than in the term infants, indicating that RCP may be influenced by developmental and postnatal ages. This study demonstrates, for the first time, that noninvasive ASL at 3T may be used to measure RCP in healthy unsedated preterm and term neonates. ASL is, therefore, a viable tool that will allow serial studies of RCP in high-risk neonates.

  14. Striatal dopamine transporter, regional cerebral blood flow and glucose utilization in MPTP-induced parkinson disease mice model

    International Nuclear Information System (INIS)

    Gao Yunchao; Wu Chunying; Xiang Jingde; Lin Xiangtong; Zhu Huiqing

    2005-01-01

    Objective: To explore the variation of regional cerebral blood flow (rCBF), glucose utilization as well as the neurotoxic effect on dopaminergic neurons induced by neurotoxin 1-methy-4-phenyl-1,2,3,6-tetrahy-dropyridine (MPTP). Methods: Eight-week old male C57BL/6 mice were given a total dose of 0-80 mg/kg MPTP intraperitoneally. Ten days later the mice were sacrificed for tyrosine hydroxylase (TH)-immunopositive cell count- ing in substantia nigra using SP immunohistochemistry. Vivo autoradiography was employed to measure striatal do- pamine transporter (DAT) loss, rCBF and glucose utilization in striatum and thalamus. Results: The extents of DAT depletion and TH-immunopositive cell loss were positively correlated (r=0.998, P O.2), while glucose utilization was only slightly reduced in caudate/putamen and thalamus by 3.0% and 5.4% in 80 mg/kg MPTP-treated mice (P<0.05). Conclusion: Significant dose-dependent relationship was in presence of MPTP induced dopaminergic neurons loss, changes of rCBF in caudate/putamen and thalamus were not significant, while the glucose utilization was slightly decreased in higher dose group. (authors)

  15. Regional cerebral blood flow during rest and skilled hand movements by xenon-133 inhalation and emission computerized tomography

    International Nuclear Information System (INIS)

    Lauritzen, M.; Henriksen, L.; Lassen, N.A.

    1981-01-01

    Regional cerebral blood flow (CBF) was studied in 16 normal adult volunteers during rest and in 10 the study was repeated during skilled hand movements. A fast-rotating (''dynamic''), single-photon emission computerized tomograph (ECT) with four detector heads was used. Xenon-133 was inhaled over a 1-min period at a concentration of 10 mCi/L. The arrival and washout of the radioisotope was recorded during four 1-min periods. Two slices, 2 cm thick, 7 and 12 cm above the orbitomeatal line were obtained in every study. CBF averaged 60 ml/100 g/min (SD +/- 11) in the lower slice and 51 ml/100 g/min (SD +/- 13) in the upper slice. A symmetric pattern comparing right to left sides was found in both slices. Finger tapping and writing with the right hand increased CBF in specific areas of the upper slice: in the contralateral hand area by 35 +/- 15% (p less than 0.025), and in the supplementary motor area on both sides by 34 +/- 15%

  16. Regional cerebral metabolic alterations in dementia of the Alzheimer type: positron emission tomography with [18F]fluorodeoxyglucose

    International Nuclear Information System (INIS)

    Friedland, R.P.; Budinger, T.F.; Ganz, E.; Yano, Y.; Mathis, C.A.; Koss, B.; Ober, B.A.; Huesman, R.H.; Derenzo, S.E.

    1983-01-01

    Alzheimer disease is the most common cause of dementia in adults. Despite recent advances in our understanding of its anatomy and chemistry, we remain largely ignorant of its pathogenesis, physiology, diagnosis, and treatment. Dynamic positron emission tomography using [ 18 F]fluorodeoxyglucose (FDG) was performed on the Donner 280-crystal ring in 10 subjects with dementia of the Alzheimer type and six healthy age-matched controls. Ratios comparing mean counts per resolution element in frontal, temporoparietal, and entire cortex regions in brain sections 10 mm thick obtained 40-70 min following FDG injection showed relatively less FDG uptake in the temporoparietal cortex bilaterally in all the Alzheimer subjects (p less than 0.01). Left-right alterations were less prominent than the anteroposterior changes. This diminished uptake was due to lowered rates of FDG use and suggests that the metabolic effects of Alzheimer disease are most concentrated in the temporoparietal cortex. Positron emission tomography is a most powerful tool for the noninvasive in vivo assessment of cerebral pathophysiology in dementia

  17. Functional regional cerebral blood flow SPECT using 99mTc-HM-PAO by speech memory tasks

    International Nuclear Information System (INIS)

    Tohyama, Junko

    1993-01-01

    Using single photon emission computed tomography (SPECT) with Tc-99m HA-PAO, changes in regional cerebral blood flow (rCBF) by giving word memory and Miyake's tasks were determined for localizatin of speech memory function. Twice injection method of Tc-99m HM-PAO was used to obtain subtraction SPECT images; and positioning of the 1st and 2nd SPECT was determined by phantom study. To prevent artifacts and changes in rCBF as far as possible, the subjects were informed word fluency and Miyake's tasks sufficiently. When giving word fluency approach, an increase in rCBF was observed in both the operculum and the supratemporal convolution of dominant hemisphere. When giving Miyake's approach, it was observed predominantly in the supratemporal convolution of dominant hemisphere. Although it was also observed in the base of frontal lobe and operculum, there was no bilateral difference. An increased rCBF in the basal nucleus was more clearly observed by Miyake's than word fluency tasks without bilateral differences. There was no definitive increase in rCBF in the Papez's circuit responsible for memory and emotion by either word fluency or Miyake's tasks. In mentally mild disorder patients, an increased rCBF was observed in the same areas as those in normal subjects. In such patients having a decreased rCBF at rest, an increased rCBF was seen in the contralateral hemisphere and the surrounding areas of the lesions, suggesting compensatory mechanism. (N.K.) 65 refs

  18. Effects of premedication with oral hydroxyzine on patient motion during inhalation of 32% xenon for regional cerebral blood flow mapping

    International Nuclear Information System (INIS)

    Sesay, M.; Dousset, V.; Caille, J.M.; Maurette, P.; Tanaka, Akira

    2000-01-01

    Because of its anesthetic properties, inhalation of 30-35% Xenon is associated with uncontrolled patient motion in 3-15% of the cases. This constitutes a major setback to regional cerebral blood flow studies with Xenon-enhanced computed tomography (Xe-CT CBF). The present study attempted to determine the effects of oral premedication with hydroxyzine (H) in the control of motion. Patients scheduled for Xe-CT CBF, aged 20-55 years, were randomly allocated to 3 groups: H 50 mg (n=41), H 100 mg (n=36) or Placebo (n=43). The drugs were administered orally 90 minutes before Xenon inhalation. This consisted a gas mixture of 32% Xe and 25% oxygen. Motion was classifie