ro-16-0154 and Cerebral-Hemorrhage

Whereas SPECT images obtained 180 minutes after administration of I-iomazenil (IMZ) (late images) are proportional to the distribution of central benzodiazepine receptor-binding potential, SPECT images obtained within 30 minutes after I-IMZ administration (early images) correlate with regional brain perfusion. The aim of the present study was to determine whether crossed cerebellar tracer uptake on acute-stage I-IMZ SPECT imaging predicts 3-month functional outcome in patients with nonfatal hypertensive putaminal or thalamic hemorrhage.. Forty-six patients underwent early and late SPECT imaging with I-IMZ within 7 days after the onset of hemorrhage. A region of interest was automatically placed in the bilateral cerebellar hemispheres using a 3-dimensional stereotaxic region-of-interest template, and the ratio of the value in the cerebellar hemisphere contralateral to the affected side to that in the ipsilateral cerebellar hemisphere (ARcbl) was calculated in each patient. Each patient's physical function was measured using the modified Rankin scale (mRS) score 3 months after onset.. The ARcbl on early (ρ = -0.511, P = 0.0003) and late (ρ = -0.714, P < 0.0001) images correlated with the mRS 3 months after the onset of hemorrhage. Multivariate analysis showed that only a low ARcbl in late images was significantly associated with a poor functional outcome (mRS score ≥3 at 3 months after onset) (95% confidence interval, 0.001-0.003; P = 0.0212).. Crossed cerebellar tracer uptake on acute-stage I-IMZ SPECT imaging predicts 3-month functional outcome in patients with nonfatal hypertensive putaminal or thalamic hemorrhage.

Topics: Aged; Cerebral Hemorrhage; Female; Flumazenil; Humans; Male; Middle Aged; Putamen; Radiopharmaceuticals; Thalamus; Tomography, Emission-Computed, Single-Photon

[123I]Iomazenil is a single-photon emission computed tomography (SPECT) tracer that selectively binds to central benzodiazepine receptor in the neuron membrane. With this ligand, we studied the central benzodiazepine receptor distribution in the cortex remote from subcortical hematoma in intracerebral hemorrhage patients.. Four patients with unilateral putaminal hemorrhage and one patient with right thalamic hemorrhage were studied (mean +/- 1 SD age, 50.0 +/- 8.8 years). The initial volume of hematoma ranged from 4.3 to 31.0 mL (mean +/- 1 SD, 17.5 +/- 12.3 mL). SPECT images obtained 3 hours after intravenous administration of [123I]iomazenil (167 MBq/750 ng) were analyzed. In three patients, perfusion was evaluated with [123I]IMP. On SPECT images, the radioactivity ratio of the ipsilateral to the contralateral cerebral cortex (I/C ratio) or of the contralateral to the ipsilateral cerebellar hemisphere (C/I ratio) was measured.. The I/C ratio for iomazenil was significantly decreased compared with unity in the temporal lobe (0.84 +/- 0.08, P < .01) and the parietal lobe (0.87 +/- 0.10, P < .05), but the C/I ratio in the cerebellum (1.00 +/- 0.03) was not. The C/I ratio for perfusion in the cerebellar cortex (0.83 +/- 0.04, P < .01) was significantly decreased compared with that in normal subjects.. Central benzodiazepine receptor-[123I]iomazenil binding was decreased in the ipsilateral cerebral cortex remote from the subcortical hematoma. This preliminary result may facilitate further study of the potential damage of the cortical neurons remote from subcortical hematoma.

Topics: Cerebral Cortex; Cerebral Hemorrhage; Female; Flumazenil; Humans; Iodine Radioisotopes; Male; Middle Aged; Receptors, GABA-A; Tomography, Emission-Computed, Single-Photon