RESUMO
We report a 48-year-old patient with neuro-Behcet's disease who presented with the combination of severe memory impairment and frontal/executive dysfunction. The clinical feature mimicked that of diencephalic amnesic syndrome. The MRI and SPECT findings supported the notion that the thalamus and related subcortical-frontal connection was responsible for this patient's problem.
Assuntos
Amnésia/etiologia , Amnésia/psicologia , Síndrome de Behçet/psicologia , Lobo Frontal/patologia , Amnésia/diagnóstico por imagem , Atenção/fisiologia , Síndrome de Behçet/diagnóstico por imagem , Encéfalo/patologia , Cisteína/análogos & derivados , Função Executiva/fisiologia , Lobo Frontal/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Teste de Sequência AlfanuméricaRESUMO
BACKGROUND: Heavy alcohol intake induces both structural and functional changes in the central nervous system. Recent research developments converged on the idea that even in patients with alcohol dependence without apparent structural brain changes, some cognitive impairment exists, and associated functional change could be visualized by neuroimaging techniques. However, these data were from old (more than 50 years) patients using working memory and response inhibition tasks. Whether young abstinent patients show aberrant signs of brain activation is a matter of interest, specifically by the long-term memory retrieval task. METHODS: Subjects were 9 young patients with alcohol dependence with long-term abstinent (8 males and 1 female) and age- and education-matched 9 healthy controls (7 males and 2 females). We used a modified false recognition task in a functional MRI study. RESULTS: The young patients with alcohol dependence showed reduced activation in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC), left pulvinar in the thalamus, and in the right ventral striatum, although behavioral performances and regional patterns of brain activation were similar between patients and controls. CONCLUSIONS: Long-term memory retrieval induced altered activations in prefrontal lobes, ACC, thalamus, and ventral striatum in young patients with alcohol dependence. These findings were correspondent to deficits of goal directed behavior, monitoring the erroneous responses, memory function, and drug-seeking behavior. Furthermore, these reduced activations can be considered as latent "lesions," suggesting subclinical pathology in alcoholic brains.