Pharmacotherapy response and regional cerebral blood flow characteristics in patients with obsessive-compulsive disorder.

OBJECTIVE: To analyze the correlation between the pharmacotherapy response and the characteristics of the pre-treatment regional cerebral blood flow (rCBF) in patients with obsessive-compulsive disorder (OCD). METHODS: Single-photon emission-computed tomography (SPECT) was used to determine the pre-treatment rCBF in 30 OCD patients and 30 normal controls. Based on their clinical remission response, the subjects were divided into two groups: selective serotonin reuptake inhibitors (SSRIs) and SSRIs plus quetiapine. The subjects with clinical remission response were identified after treatment for a period of 24 weeks, and the rCBF imaging data were processed using statistical parametric mapping (SPM) software with two-sample Z-tests. RESULTS: Nineteen OCD patients who achieved clinical remission were included in the study. Increased rCBF in forebrain regions, including the frontal lobe, cingulate gyrus, hypothalamus, and basal ganglia, was found in 11 responders to SSRIs compared to normal control patients. The eight SSRI plus quetiapine responders exhibited a decrease in rCBF within posterior brain regions, including the parietal lobe, cerebellar vermis, and occipital lobe, and an increase in rCBF in the frontal lobe, thalamus, basal ganglia, and cerebellum tonsil compared to normal control patients. CONCLUSIONS: The characteristics of increased rCBF in forebrain regions and decreased rCBF in posterior brain regions before treatment of OCD patients was a potentially predictor of treatment response to guide treatment options.

[Change characteristics of regional cerebral blood flow and curative efficacy in patients with obsessive-compulsive disorder].

OBJECTIVE: To explore the change characteristics of regional cerebral blood flow (rCBF) and its correlation with curative efficacy in patients with obsessive-compulsive disorder (OCD). METHODS: The images of rCBF and computed tomography (CT) were acquired from 30 OCD and 30 normal controls by single photon emission computed tomography (SPECT) and CT. The tomographic data of rCBF were normalized, smoothed and statistically processed with the statistical parametric mapping (SPM) software with two-sample Z-test. And the OCD grade was evaluated with the Y-BOCS at pre- and post-medication. RESULTS: The abnormal results of CT were not found. The SPM Z-test showed that the sections of higher rCBF in the OCD patients were predominantly located in basal ganglia and occipital lobe compared with the normal controls (P < 0.001). The scores of Y-BOCS in 30 patients were markedly lower at post-medication than those at pre-medication (24 ± 7 vs 11 ± 6, P < 0.001). At post-medication, the scores of Y-BOCS with higher rCBF in basal ganglia and occipital lobe were higher than those in basal ganglia or occipital lobe (P < 0.05). CONCLUSION: The OCD patients have higher rCBF in basal ganglia and occipital lobe. The curative efficacy of OCD with higher rCBF in basal ganglia and occipital lobe is worse than that in basal ganglia or occipital lobe.

Neurocognitive dysfunction and regional cerebral blood flow in medically naïve patients with obsessive-compulsive disorder.

Previous research characterizes obsessive compulsive disorder (OCD) as a complex neurobehavioral disorder that may have multiple etiologies ( den Braber et al., 2008 ). This study analyzed neurocognitive function and change in regional cerebral blood flow (rCBF) to characterize OCD. Neurocognitive function and rCBF were examined in medically naïve patients with OCD and contrasted with controls. Results of this study indicated that the neurocognitive functions impaired in OCD are memory, attention, and executive function, which are primarily associated with the frontal and occipital lobes. Dysfunction in the basal ganglia and occipital lobes were associated with OCD and may be an etiological factor in the disorder.

Evaluation of headache and regional cerebral flood flow in patients with migraine.

PURPOSE OF THE REPORT: The aim of this study is to observe the abnormalities of regional cerebral blood flow (rCBF) in migraine patients and to evaluate its relation to the severity of the headache in patients with migraine. PATIENTS AND METHODS: The rCBF imaging was done on 19 patients with migraine and 15 normal controls using single-photon emission computed tomography (SPECT). The abnormal character of cerebral perfusion function was analyzed with Statistical Parametric Mapping (SPM) software, and the headache grade of patients was evaluated with the headache severity measuring scale. RESULTS: The results of SPM analysis demonstrated a decreased rCBF on both sides of the frontal and temporal lobes, left parietal lobe, and right occipital lobe (P < 0.001), and increased rCBF focus on the left prefrontal lobe and right temporal lobe (P < 0.001). The headache scores in migraineurs were correlated to the rCBF on the bilateral temporal lobes and right frontal lobe (P < 0.001). CONCLUSIONS: The migraineurs had lower rCBF at the frontal and temporal lobes, and the lower rCBF was correlated to the degree of headache.