technetium-tc-99m-bicisate and Alcoholism

This study investigated regional cerebral flood flow (CBF) in chronic alcoholic patients, focusing primarily on the limbic system, including the hippocampus and the callosomarginal region, because of their susceptibility to damage in such patients. The degree of hippocampal atrophy in such patients was also examined. Regional CBF and the degree of parahippocampal gyrus atrophy were studied in 22 chronic alcoholic male patients with no neurological or psychological symptom (mean age, 59.3+/-4.1 years). Their findings were compared with those of 22 age-matched, male, normal controls (mean age, 59.7+/-3.9 years). Single-photon emission computed tomography was performed using the (99m)Tc-ethylcysteinate dimer ( (99m)Tc-ECD) Patlak Plot method, and the three-dimensional stereotaxic region of interest (ROI) template (3DSRT) and the fine stereotaxic ROI template (fine SRT) developed by Takeuchi et al were used to evaluate regional CBF, focusing primarily on the limbic system. These methods make it possible to precisely and objectively measure the details of regional CBF. The voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to determine the degree of parahippocampal gyrus atrophy in chronic alcoholic patients. VSRAD is a method developed by Hirata et al for evaluating the degree of atrophy of the parahippocampal gyrus. The results were analyzed using Z scores (>2 indicating significant atrophy). Blood flows in the callosomarginal region, pericallosal region, thalamus, hippocampus, parahippocampal gyrus, amygdaloid body, anterior cingulate gyrus, and middle cingulate gyrus were lower in the chronic alcoholic group than in the control group. Parahippocampal gyrus atrophy was not observed in the control group (average Z score, 0.62+/-0.29). In contrast, an atrophic tendency was observed in the chronic alcoholic group (average Z score, 1.88+/-0.44). Clinically intact, chronic alcoholic patients with no neurological or psychological symptom had decreased CBF in the limbic system and a tendency to parahippocampal gyrus atrophy.

Topics: Alcoholism; Atrophy; Cerebrovascular Circulation; Cysteine; Humans; Limbic System; Male; Middle Aged; Organotechnetium Compounds; Parahippocampal Gyrus; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

The depressant actions of ethanol in the brain is known. SPECT is non invasive method to measure the regional cerebral blood flow (rCBF) and to evaluate indirectly the brain metabolism. The aim of the study is to evaluate morphologic and functional status of CNS using 99mTc-ECD SPECT in chronic alcoholics.. Examined group consisted of 18 male alcoholic patients aged from 28 to 52 years (x = 42.1 +/- 5.4) treated at the Ward of Toxicology and Environmental Diseaes (Detoxification Unit). Only patients without prior head injury, CNS inflammatory changes, epilepsy, migraine, diabetes mellitus or other systemic injury were included. Alcohol dependence was diagnosed according to ICD-10 criteria. The intensity of withdrawal syndrome was measured using CIWA-A scale. The regional cerebral blood flow (rCBF) was measured using 99mTc-ECD SPECT with the double head E.CAM Siemens gamma camera. The reference group, necessary to obtain a normal values for the gamma camera applied, consisted of 31 healthy subjects (33.32 +/- 10.99 y).. The mean values of rCBF in all examined region of frontal and temporal lobes, and in basal ganglia bothsided were significantly lower in the group of alcoholic patients than in the control group. No significant difference between rCBF in occipital lobes except the occipital inferior region, and in parietal lobes except the parietal superior region. Symetrical hypoperfusion (rCBF-2SD) in the frontal lobes was stated in 11 (61.1%), in temporal lobes in 4 (22.2%), in parietal and occipital lobes in 3 (16.7%) of the patients examined. In 7 the patients examined rCBF disturbances in basal ganglia were found (bothsided in 4, leftsided in 2, and rightsided in 2 the patients). Focal rCBF changes in the parietal, frontal and temporal lobes localised mostly on the left hemisphere were stated in 27.8% of the alcoholics examined. In concusion, the metabolic disturbances and the brain morphological changes mostly in frontal and temporal lobes due to chronic alcoholism were detected in the pilot study. A further investigation on more numerous group of ethanol dependent patients and monitoring of the changes in alcoholics who maintain a long-term abstinence from alcohol is needed.

Topics: Adult; Alcoholism; Basal Ganglia; Brain; Cerebrovascular Circulation; Cysteine; Ethanol; Frontal Lobe; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Angiography; Radiopharmaceuticals; Regional Blood Flow; Substance Withdrawal Syndrome; Temporal Lobe; Tomography, Emission-Computed, Single-Photon