technetium-tc-99m-bicisate and Aphasia

To determine the prognostic value of brain perfusion single-photon emission computed tomography (SPECT) in patients with aphasia after a stroke.. Brain perfusion SPECT with 99mTc-ethyl cysteinate dimer (99mTc-ECD) was used in 16 right-handed patients with aphasia after a left-sided cerebrovascular accident (CVA) in the early chronic period after the onset of CVA. The region of interest (ROI) method was used to calculate the relative regional cerebral blood flow (rCBF) in each cerebral lobe, the thalamus, the putamen and the cerebellum as ratios to the count in the left cerebellar hemisphere. The Standard Language Test of Aphasia (SLTA) was performed twice, once at the same time as SPECT, a mean of 2.3 months after CVA onset (early SLTA), and again a mean of 17.0 months after CVA onset (late SLTA). In addition to the overall language function score, scores for taking dictation (Dictation), oral reading (Speaking) and comprehension (Comprehension) were calculated, and the correlations with each of the rCBF values were evaluated.. Left temporal CBF correlated with the late Dictation score; bilateral frontal, bilateral temporal and right parietal CBF correlated with the late Speaking score; and right frontal, left temporal and left occipital CBF correlated with the late Comprehension score.. Brain perfusion SPECT in the early chronic stage was shown to be useful for predicting recovery from aphasia, recovery of oral reading, ability to take dictation and comprehension.

Topics: Aged; Aged, 80 and over; Aphasia; Brain; Cerebrovascular Circulation; Cysteine; Female; Humans; Language Tests; Male; Middle Aged; Organotechnetium Compounds; Prognosis; Radiopharmaceuticals; Recovery of Function; Stroke; Tomography, Emission-Computed, Single-Photon

This study aimed to investigate the relationship between the change of language symptoms and the change of regional cerebral blood flow (rCBF) in the recovery process of two children with acquired aphasia caused by infarctions from Moyamoya disease with an onset age of 8years.. We compared the results for the Standard Language Test of Aphasia (SLTA) with rCBF changes in 7 language regions in the left hemisphere and their homologous regions in the right hemisphere at 4 time points from 3weeks for up to 5years after the onset of aphasia, while controlling for the effect of age.. In both cases, strong correlations were seen within a hemisphere between adjacent regions or regions that are connected by neuronal fibers, and between some language regions in the left hemisphere and their homologous regions in the right hemisphere. Conversely, there were differences between the two cases in the time course of rCBF changes during their recovery process.. Consistent with previous studies, the current study suggested that both hemispheres were involved in the long-term recovery of language symptoms in children with acquired aphasia. We suggest that the differences between both cases during their recovery process might be influenced by the brain states before aphasia, by which hemisphere was affected, and by the timing of the surgical revascularization procedure. However, the changes were observed in the data obtained for rCBF with strong correlations with the changes in language performance, so it is possible that rCBF could be used as a biomarker for language symptom changes.

Topics: Adolescent; Aphasia; Brain; Cerebrovascular Circulation; Child; Cysteine; Female; Humans; Magnetic Resonance Imaging; Organotechnetium Compounds; Recovery of Function; Severity of Illness Index; Tomography, Emission-Computed, Single-Photon

An early 60s-year-old man suffered reversible dysfunction of the blood-brain barrier (BBB) induced by repeated injection of contrast medium during coil embolization of intracranial unruptured aneurysm. He presented with convulsion during coil embolization, and neurological symptoms of aphasia and right hemiparesis continued for 5 days, and then improved completely. All transient radiological abnormalities were limited to the territory of the left internal carotid artery, where contrast medium was injected repeatedly. Repeated computed tomography, magnetic resonance imaging, single-photon emission computed tomography, and cerebrospinal fluid test findings indicated that temporary dysfunction of the BBB might have occurred. Dysfunction of the BBB in the anterior circulation induced by contrast medium is rare. Tolerance to toxicity of contrast medium may depend on the individual patient, and repeated injection of contrast medium may cause dysfunction of the BBB, leading to toxic dysfunction directly in the brain.

Topics: Aphasia; Blood-Brain Barrier; Carotid Artery, Internal; Cerebral Angiography; Contrast Media; Cysteine; Dose-Response Relationship, Drug; Embolization, Therapeutic; Humans; Injections, Intra-Arterial; Intracranial Aneurysm; Iopamidol; Magnetic Resonance Angiography; Male; Middle Aged; Organotechnetium Compounds; Paresis; Seizures; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The objective of this study was to clarify the influence of regional cerebral blood flow (rCBF) changes in language-relevant areas of the dominant hemisphere on rCBF in each region in the non-dominant hemisphere in post-stroke aphasic patients.. The study subjects were 27 aphasic patients who suffered their first symptomatic stroke in the left hemisphere. In each subject, we measured rCBF by means of 99mTc-ethylcysteinate dimmer single photon emission computed tomography (SPECT). The SPECT images were analyzed by the statistical imaging analysis programs easy Z-score Imaging System (eZIS) and voxel-based stereotactic extraction estimation (vbSEE). Segmented into Brodmann Area (BA) levels, Regions of Interest (ROIs) were set in language-relevant areas bilaterally, and changes in the relative rCBF as average negative and positive Z-values were computed fully automatically. To assess the relationship between rCBF changes of each ROIs in the left and right hemispheres, the Spearman ranked correlation analysis and stepwise multiple regression analysis were applied.. Globally, a negative and asymmetric influence of rCBF changes in the language-relevant areas of the dominant hemisphere on the right hemisphere was found. The rCBF decrease in left BA22 significantly influenced the rCBF increase in right BA39, BA40, BA44 and BA45.. The results suggested that the chronic increase in rCBF in the right language-relevant areas is due at least in part to reduction in the trancallosal inhibitory activity of the language-dominant left hemisphere caused by the stroke lesion itself and that these relationships are not always symmetric.

Topics: Aged; Aged, 80 and over; Aphasia; Automation; Brain Mapping; Cerebral Cortex; Cerebrovascular Circulation; Cysteine; Female; Functional Laterality; Humans; Language; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Regional Blood Flow; Signal Processing, Computer-Assisted; Software; Stroke; Tomography, Emission-Computed, Single-Photon

A 55-year-old right-handed male patient with atrial fibrillation was admitted to our hospital because of a sudden disturbance of consciousness and right hemiparesis. Neurological examinations revealed left conjugate deviation of the eyes, aphasia, right hemianopsia without macula sparing using a Goldmann perimeter, right hemianesthesia, and right hemiparesis. Magnetic resonance imaging showed low intensity areas (left posterior limb of internal capsule, left cerebral peduncle of middle brain, a part of left substantia nigra, left amygdala, ventral posterior lateral nucleus and ventral anterior nucleus of left thalamus, left lateral geniculate body, and left occipital lobe) in T1 weighted image, due to the infarct in the left anterior choroidal artery territory. Aphasia in this case was accompanied with non-fluent speech, good repetition, naming deficits, and perseveration. We suggest that aphasia with anterior choroidal artery syndrome cannot be classified using the conventional system, and emphasize the importance of accurate descriptions of the symptoms characteristic of aphasia with anterior choroidal artery.

Topics: Aphasia; Atrial Fibrillation; Cerebral Infarction; Choroid Plexus; Cysteine; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Tomography, Emission-Computed, Single-Photon