RESUMO
We report an 83-year-old woman with atypical senile dementia with Fahr-type calcification. Brain computed tomography demonstrated asymmetrical calcification predominant in the basal ganglia on the right side and pronounced diffuse cortical atrophy in the frontotemporal areas. The patient was clinically diagnosed with diffuse neurofibrillary tangles with calcification. Brain single photon emission computed tomography findings revealed that cerebral blood flow was reduced on the right side, as compared with the left side, in widespread areas. Hemispheric asymmetry in both calcification and cerebral blood flow suggests a relationship between calcification and vascular changes.
Assuntos
Doença de Alzheimer/diagnóstico , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Calcinose/diagnóstico , Circulação Cerebrovascular , Emaranhados Neurofibrilares/patologia , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Encéfalo/diagnóstico por imagem , Calcinose/complicações , Feminino , Humanos , Emaranhados Neurofibrilares/diagnóstico por imagem , Tomógrafos Computadorizados , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
The subgenual anterior cingulate cortex (Cg25) has been reported to be a node of mood-regulatory networks. Using a responder and a non-responder of repetitive transcranial magnetic stimulation (rTMS) for depression, we examined pre/post-treatment cerebral blood flow (CBF) in the Cg25 and treatment-related CBF changes in cortical/subcortical regions. In the responder, pre-treatment Cg25 perfusion was higher and was decreased after treatment, in addition, CBF was increased in the frontal and parietal regions and decreased in the hippocampus and basal ganglia. Our results suggest that rTMS treatment response may be related to pre-treatment Cg25 activity and modulation of the Cg25 and mood-regulatory networks.
Assuntos
Circulação Cerebrovascular/fisiologia , Transtorno Depressivo Maior/patologia , Transtorno Depressivo Maior/terapia , Giro do Cíngulo/irrigação sanguínea , Transtorno Depressivo Maior/diagnóstico por imagem , Feminino , Lateralidade Funcional , Giro do Cíngulo/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Tempo , Tomografia Computadorizada de Emissão de Fóton Único , Estimulação Magnética Transcraniana/métodos , Resultado do TratamentoRESUMO
The Clock-Drawing Test (CDT) is widely used in clinical practice for the screening of dementia. However, neural activity during real clock drawing has not been investigated due to motion artifacts. In the present study, we examined brain activity during real clock drawing using multichannel near-infrared spectroscopy (NIRS). We measured hemoglobin concentration changes in the prefrontal and temporal surface areas during clock drawing using 52-channel NIRS. Data obtained from 37 right-handed healthy volunteers were analyzed. We found significant increases in oxy-Hb in more than 96.2% of the channels (false-discovery rate corrected, p < .025). The time required for CDT performance showed a negative correlation with changes in oxy-Hb in the prefrontal region (r = -.529, p = .002). The mean value for oxy-Hb changes was higher in the left hemisphere in 20 subjects (54%) and in the right hemisphere in 17 subjects (46%). The NIRS/CDT combination is acceptable as a clinical tool, as the method has the advantages of direct measurement of cortical activation with high temporal resolution. Our results confirm the aspects of the CDT involving the frontal-lobe battery.
Assuntos
Neuroimagem/psicologia , Testes Psicológicos/estatística & dados numéricos , Desempenho Psicomotor/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho/estatística & dados numéricos , Adulto , Dominância Cerebral/fisiologia , Feminino , Humanos , Masculino , Neuroimagem/métodos , Neuroimagem/estatística & dados numéricos , Oxiemoglobinas/metabolismo , Córtex Pré-Frontal/metabolismo , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Lobo Temporal/metabolismoRESUMO
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.
Assuntos
Mapeamento Encefálico , Córtex Cerebral/irrigação sanguínea , Alucinações/fisiopatologia , Música , Audiometria/métodos , Córtex Cerebral/diagnóstico por imagem , Feminino , Alucinações/diagnóstico por imagem , Alucinações/patologia , Humanos , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional/fisiologia , Tomografia Computadorizada de Emissão de Fóton Único/métodosRESUMO
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.