technetium-tc-99m-bicisate and Nervous-System-Diseases

The non-criteria neuropsychiatric manifestations of antiphospholipid syndrome include headache, dizziness, vertigo, seizure, depression and psychosis. There were still no objective methods qualified to detect the early central nervous system involvement in non-criteria antiphospholipid syndrome. We evaluated the effectiveness of Tc-99m ECD SPECT in assessing circulatory insufficiency in the brains of patients with antiphospholipid antibodies and neuropsychiatric symptoms but without thromboembolism.. Patients with a history of positive antiphospholipid antibodies and neuropsychiatric symptoms composed the case group; patients without antiphospholipid antibody served as the control group. Subjects with a history of thromboembolism or autoantibodies to extractable nuclear antigens were excluded. All patients received Tc-99m ECD SPECT studies and were classified by the number of positive antiphospholipid antibodies they carried. The heterogeneity of brain perfusion was defined as the coefficient of variation of the SPECT signals. Analysis of variance (ANOVA) was applied to evaluate the differences between the groups.. Total 60 adult patients were included in this study. There were 54 patients in the case group and 6 patients in the control group. The mean age was 38.3 ± 11.5 years. There were 52 women and 8 men. There was no significant difference in the mean brain perfusion between groups (P = 0.69). However, Tc-99m ECD SPECT demonstrated significant heterogeneity of brain perfusion in relation to the number of antiphospholipid antibodies (P = 0.01).. This is the first study demonstrating that Tc-99m ECD SPECT can early detect the increased heterogeneity of brain circulation in non-criteria antiphospholipid antibody carriers.

Topics: Adult; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Brain; Central Nervous System; Cerebrovascular Circulation; Cysteine; Female; Humans; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Organotechnetium Compounds; Retrospective Studies; Thromboembolism; Tomography, Emission-Computed, Single-Photon

This case report describes the successful response to electroconvulsive therapy (ECT) in a patient with an unusual presentation of catatonia, whose onset occurred in the context of an extremely severe form of refractory obsessive-compulsive disorder (OCD). We correlated the clinical improvement in catatonic and OCD symptoms with specific changes in brain function as shown by regional cerebral blood flow scans, neurological soft signs examination, and neuropsychological testing. All assessments were conducted before and after the ECT course. The results strongly suggest that a right hemisphere dysfunction was the neural correlate of our patient's symptoms, and that ECT, by reverting this abnormality, may serve as an effective therapeutic approach for refractory catatonic OCD.

Topics: Behavior; Brain; Catatonia; Cerebrovascular Circulation; Cysteine; Electroconvulsive Therapy; Electroencephalography; Female; Humans; Nervous System Diseases; Neurologic Examination; Neuropsychological Tests; Obsessive-Compulsive Disorder; Organotechnetium Compounds; Psychiatric Status Rating Scales; Psychophysiology; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Young Adult

Technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect abnormal regional cerebral blood flow (rCBF) in 32 female patients with primary Sjögren's syndrome (PSS) showing definite neuropsychiatric symptoms/signs and normal brain magnetic resonance imaging (MRI) findings. It demonstrated hypoperfusion brain lesions in 18 (56.3%) of the patients, most frequently in the parietal lobes, and appears to be a sensitive tool for this clinical application.

Topics: Adult; Brain; Cerebrovascular Circulation; Cerebrovascular Disorders; Cysteine; Female; Humans; Mental Disorders; Middle Aged; Nervous System Diseases; Organotechnetium Compounds; Radiopharmaceuticals; Sjogren's Syndrome; Tomography, Emission-Computed, Single-Photon