technetium-tc-99m-exametazime and Bipolar-Disorder

Trapeziometacarpal osteoarthritis is associated with more pain and restrictions than other hand osteoarthritis due to the functional importance of the thumb. While the effectiveness of surgical and pharmacological interventions has been widely examined, there is a lack of specific evidence about conservative non-pharmacological trapeziometacarpal osteoarthritis therapies. The objective of this systematic review was to provide evidence-based knowledge on the effectiveness of physiotherapy and occupational therapy on pain, function and quality of life.. A literature search of Medline, CINAHL, PEDro, OTseeker, EMB Dare Cochrane Database of Systematic Reviews and Cochrane CENTRAL was performed. Randomized and quasi-randomized controlled trials and corresponding systematic reviews, observational studies, pragmatic studies and case-control studies were included. The risk of bias was assessed.. Physical and occupational therapy-related interventions, especially multimodal interventions, seem to be effective to treat pain in patients with trapeziometacarpal osteoarthritis. Pre-fabricated neoprene splints and custom-made thermoplastic splints may reduce pain equally. Single interventions seem not to be effective. Significant evidence for effectiveness on function and quality of life could not be found.. The sole Na. The SUV. Genetic variants of

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Topics: Bipolar Disorder; Brain; C9orf72 Protein; Frontotemporal Dementia; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Mutation; Proteins; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Single photon emission computed tomography (SPECT) with 99mTc-HMPAO was used to compare regional cerebral blood flow (rCBF) in patients with bipolar disorder and in healthy controls. The sample of this study consisted of 16 euthymic bipolar patients who met the DSM-IV criteria and 10 healthy control subjects. The mean regional cerebral blood flow values of the bipolar euthymic patients were significantly lower than those of the controls in the bilateral medial-basal temporal, occipital; medial frontal; parietal regions and in the cingulate gyrus; the hypoperfusion in the cingulate had the highest significant P value (.001, Bonferroni correction). No significant differences in rCBF emerged between right and left-brain regions. The most important findings of the current study are the presence of regional cerebral perfusion alterations, particularly in the cingulate gyrus in the euthymic bipolar patients. Our results imply that underlying brain dysfunction may be independent from manic or depressive episodes in bipolar disorder. Because of the small number of subjects, however, this finding should be viewed as preliminary.

Topics: Adult; Affect; Bipolar Disorder; Brain; Brain Mapping; Case-Control Studies; Cerebrovascular Circulation; Female; Humans; Male; Radiopharmaceuticals; Reference Values; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients.. Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO. Forty-three outpatients out of 85 fulfilling RDC diagnostic criteria for bipolar disorder and six healthy subjects were included in the study. SPECT and neuropsychological assessments were performed in 30 patients in manic (n = 7), hypomanic (n = 8), depressed (n = 12) or euthymic (n = 3) states. All assessments were carried out before starting treatment.. Several corrected correlations between neuropsychological function and cerebral blood flow (CBF) were identified: executive function (WCST) and striatal, frontal, temporal, cerebellum, parietal and cingulate CBF; memory (WMS, WAIS-Digits) and striatal, frontal, temporal and parietal CBF; attentional tasks (Stroop) and striatal, temporo-medial and parietal CBF; verbal learning (CVLT) and frontal, posterior temporal, cingulate and occipital CBF; psychomotor disturbances (TMT) and anterior temporal CBF; poorer intelligence performance scores (WAIS-Vocabulary) and cerebellum and parietal CBF.. This study confirms the presence of functional disturbances in fronto-subcortical structures, the cerebellum and limbic system in bipolar patients.

Topics: Adult; Bipolar Disorder; Brain; Cerebrovascular Circulation; Cognition Disorders; Female; Humans; Male; Memory Disorders; Psychomotor Disorders; Radiopharmaceuticals; Severity of Illness Index; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Wechsler Scales

Regional cerebral blood flow was studied in 17 bipolar I depressed patients (DSM-IV criteria) with single photon emission computed tomography (SPECT). Visual analysis of images revealed no abnormality in eight patients and abnormal findings in nine patients. In the nine patients with abnormal findings, all showed regional decreases of the uptake of (99m)Tc-D,L-hexamethylpropylene amine oxime (HMPAO, four in the frontal region, two in the basal ganglia, and three in both the frontal region and the basal ganglia). The patients with visible SPECT abnormalities had significantly higher scores on the Hamilton Rating Scale for Depression (HDRS).

Topics: Adult; Basal Ganglia; Bipolar Disorder; Brain; Diagnostic and Statistical Manual of Mental Disorders; Female; Frontal Lobe; Humans; Male; Middle Aged; Radiopharmaceuticals; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Adolescent; Adult; Alzheimer Disease; Bipolar Disorder; Cerebral Cortex; Cerebrovascular Circulation; Depressive Disorder; Diagnosis, Differential; Female; Humans; Male; Radiopharmaceuticals; Substance-Related Disorders; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Single photon emission tomography (SPECT) with 99mTc-HMPAO was used to compare regional cerebral blood flow (rCBF) in patients with unipolar and bipolar depression. The study group consisted of 10 unipolar depressed patients and seven bipolar depressed patients who met the DSM-III-R criteria for major depressive disorder (MDD). Nine physically and mentally healthy volunteers served as control subjects. SPECT images were obtained in the patients at two time points: (1) during the major depressive episode before patients had received medication; and (2) at the beginning of the remitted state while patients were receiving antidepressant medication. During the depressive episode, unmedicated unipolar depressed patients showed relatively increased left frontal rCBF compared both with the control subjects and the bipolar patients (P < 0.05). No significant differences in rCBF emerged between the bipolar patients and the control subjects. The data suggest that unipolar depressed patients, unlike bipolar patients, have relatively increased rCBF in the left frontal lobes during the depressive episode, but these differences tend to disappear during the period of remission.

Topics: Adult; Aged; Bipolar Disorder; Brain; Brain Mapping; Depressive Disorder, Major; Dominance, Cerebral; Female; Frontal Lobe; Humans; Male; Middle Aged; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Early manic relapse following lithium discontinuation offers an important opportunity to investigate the relationship between symptoms, effects of treatment and regional brain activation in bipolar affective disorder.. Fourteen stable bipolar patients on lithium were examined with neuropsychological measures, clinical ratings and single photon emission computed tomography (SPECT) before and after acute double-blind withdrawal of lithium. Brain perfusion maps were spatially transformed into standard stereotactic space and compared pixel-by-pixel. A parametric analysis was used to examine the change in brain perfusion on lithium withdrawal, and the relationship between symptom severity and brain perfusion separately both between and within subjects.. Lithium withdrawal was associated with an important redistribution of brain perfusion, with increases in inferior posterior regions and decreases in limbic areas, particularly anterior cingulate cortex. Seven of the 14 patients developed manic symptoms during the placebo phase, correlating with relative increases in perfusion of superior anterior cingulate and possibly left orbito-frontal cortex.. The important effect of lithium withdrawal on brain perfusion implies that after withdrawal of lithium, the brain develops an abnormal state of activity in limbic cortex. The structures involved did not co-localise with those apparently modulated by manic symptoms.

Topics: Antimanic Agents; Bipolar Disorder; Female; Humans; Lithium Carbonate; Male; Middle Aged; Organotechnetium Compounds; Oximes; Substance Withdrawal Syndrome; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Depression is a common psychiatric illness, and several reports have described cerebral blood flow (CBF) abnormalities on SPECT studies in affected patients. However, because region of interest analyses were used to determine significant CBF changes in these studies, there were methodological limitations. Therefore, we investigated CBF distribution abnormalities in depression on a pixel-by-pixel basis using SPECT and an anatomic standardization technique that has been commonly used for PET activation studies.. Eleven patients with unipolar depression, six patients with bipolar depression and nine age-matched normal control subjects underwent HMPAO brain SPECT studies. The radioactivities of SPECT images for each subject were globally normalized to 100 counts/pixel. Then, each SPECT image was transformed for standard brain anatomy using a computerized Human Brain Atlas system. For each group, the mean and variance images were calculated from the standardized anatomic SPECT images, and group comparisons were performed on a pixel-by-pixel basis.. Significant decreases in CBF in the prefrontal cortices, limbic systems and paralimbic areas were observed in both depression groups compared with the normal control group.. Decreases in CBF in these regions may be related to impaired attention as well as cognitive and emotional responses, which have been recognized as usual symptoms in depression. The anatomic standardization technique promises to be useful for group comparison analysis of brain SPECT on a pixel-by-pixel basis for individual neurological and psychiatric diseases.

Topics: Aged; Bipolar Disorder; Brain; Case-Control Studies; Cerebrovascular Circulation; Depressive Disorder; Female; Humans; Image Processing, Computer-Assisted; Limbic System; Male; Organotechnetium Compounds; Oximes; Prefrontal Cortex; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Functional imaging studies generally show decreased cerebral metabolism and perfusion in depressed patients relative to normal controls, although the location of the deficits varies. We used Tc99m HMPAO SPECT to compare cerebral blood flow in medication resistant, depressed patients and a normal control group. HMPAO uptake ratios (adjusted for age) were significantly lower in the depressed patients in the transaxial slices 4 cm and 6 cm above the orbitomeatal line (OML) on the left side. Examining individual regions of interest (corrected for age and multiple testing), we found significantly lower perfusion in the left superior temporal, right parietal and bilateral occipital regions in the patient group. These findings are in limited agreement with previous HMPAO SPECT studies. Methodological differences between studies, particularly variability in adjusting data for age, lead to a divergence in findings. Future research should seek to standardize protocols and data analysis in order to generate comparable results.

Topics: Adult; Affective Disorders, Psychotic; Aged; Antidepressive Agents; Bipolar Disorder; Brain Mapping; Cerebral Cortex; Depressive Disorder; Dominance, Cerebral; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Reference Values; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Six depressed patients with schizophrenia and 6 depressed patients with major depression were investigated before and during somatosensory stimulation (SS) with Tc-99m HMPAO SPECT. 8 controls were investigated only under resting conditions. The results can be summarized as follows: 1. Both psychiatric patient groups were hypofrontal (dorsolateral prefrontal cortex) compared to controls. 2. Hypofrontality was further enhanced by SS, significantly only in affective psychoses in the right inferior frontal lobe and in the right frontal hemisphere in total, in schizophrenia in the left dorsolateral prefrontal cortex. 3. Within the frontal lobes different regions were affected by SS in the two diagnostic groups. 4. In the right inferior parietal lobe SS response was significantly different in the two illnesses with schizophrenia showing a relative decrease, affective psychoses showing a relative increase of activity. 5. SS produced an increase of cerebral blood flow in subcortical regions (statistically significant contralateral to SS in thalamus and basal ganglia, ipsilateral to SS in cerebellum), a pattern which was common to all psychiatric patients. 6. Somatosensory cortex flow was not changed by SS. In conclusion, we could not fully confirm our hypotheses that similar blood flow abnormalities in different illnesses during SS are only caused by similarities in depressive psychopathology. Instead, depressed patients with schizophrenia were different from depressed patients with major depression in showing decreased activity in interrelating brain regions participating in an attentional network.

Topics: Adult; Amitriptyline; Bipolar Disorder; Brain; Brain Mapping; Depressive Disorder; Dominance, Cerebral; Energy Metabolism; Evoked Potentials, Somatosensory; Female; Frontal Lobe; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Sulpiride; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon