RESUMEN
A 52-year-old woman with musical hallucinations was examined using brain single photon emission computed tomography (SPECT) with 99mTc-ECD. Changes in regional cerebral blood flow (rCBF) after carbamazepine treatment were assessed using a three-dimensional stereotaxic ROI template. Following treatment, rCBF was decreased in the subcortical structures and increased in the global cortical regions. From our findings, we propose that rCBF values in subcortical structures represent abnormalities similar to those reported in previous reports or other psychiatric disorders, while those in cortical regions suggest background brain dysfunctions that result in generation of musical hallucinations.
Asunto(s)
Mapeo Encefálico , Corteza Cerebral/irrigación sanguínea , Alucinaciones/fisiopatología , Música , Audiometría/métodos , Corteza Cerebral/diagnóstico por imagen , Femenino , Alucinaciones/diagnóstico por imagen , Alucinaciones/patología , Humanos , Persona de Mediana Edad , Flujo Sanguíneo Regional/fisiología , Tomografía Computarizada de Emisión de Fotón Único/métodosRESUMEN
We report the case of a patient with Fahr disease presenting with schizophrenia-like psychosis for whom a technetium Tc99 methyl cysteinate dimmer brain study was used to evaluate regional blood flow. A brain single photon-emission CT study showed increased cerebral blood flow to the bilateral temporal lobes. Such perfusion abnormalities may reflect psychotic symptoms, including auditory hallucinations and delusions, which suggests a disruption of the cortico-subcortical neural circuits in psychosis.
Asunto(s)
Circulación Cerebrovascular/fisiología , Trastornos Psicóticos/fisiopatología , Esquizofrenia/fisiopatología , Telencéfalo/irrigación sanguínea , Adulto , Enfermedades de los Ganglios Basales/diagnóstico , Enfermedades de los Ganglios Basales/fisiopatología , Calcinosis/diagnóstico , Calcinosis/fisiopatología , Femenino , Humanos , Imagen por Resonancia Magnética , Trastornos Psicóticos/diagnóstico , Flujo Sanguíneo Regional/fisiología , Esquizofrenia/diagnóstico , Tecnecio , Telencéfalo/diagnóstico por imagen , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/fisiopatología , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: The issue of hikikomori (prolonged social withdrawal) among Japanese youth has attracted attention from international experts. In previous research, the unique cultural and social factors of Japanese society have been the focus; however, in order to resolve the problem of hikikomori, individual mental health problems must be included. AIM: We examined the psychiatric background of individuals with hikikomori. METHODS: We recruited 337 individuals with hikikomori; 183 subjects who utilized the centres were designated as the help-seeking group. We examined the multi-axial psychiatric diagnosis based on the DSM-IV-TR, treatment policies and treatment outcomes. We also examined 154 subjects who did not utilize the centers (non-help-seeking group). RESULTS: Most of the subjects in the utilization group were classified into one of the diagnostic categories. Forty-nine (33.3%) subjects were diagnosed with schizophrenia, mood disorders or anxiety disorders, and this group needed pharmacotherapy. Other subjects were diagnosed with personality disorders or pervasive developmental disorders, and they mainly needed psycho-social support. The Global Assessment of Functioning (GAF) scores of the non-help-seeking group were significantly lower than the GAF scores of those who used treatments. CONCLUSION: Most hikikomori cases can be diagnosed using current diagnostic criteria. Individuals with hikikomori are much worse if they do not seek help.