technetium-tc-99m-exametazime and Down-Syndrome

In recent years, it has been possible for patients with Down syndrome to live longer with advanced medical treatment and social support. As a result, the problems of these patients, such as thyroid diseases, leukemia, and Alzheimer disease, would be encountered more frequently. In this study, we aimed to perform the brain perfusion of children with Down syndrome by technetium 99m hexamethylpropylene amine oxime (99mTc-HMPAO) single-photon emission computed tomography (SPECT) and to determine the relationship between brain perfusion and epilepsy, thyroid function tests, congenital heart disease, and level of mental and motor development. Thirty patients with Down syndrome, aged between 1 and 15 years, were included in our study. Demographic data, the existence of epilepsy and congenital heart defects, the level of mental and motor development, serum levels of thyroid hormones, and autoantibodies were determined. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI). Cerebral SPECT was performed in all cases to evaluate the brain perfusion pattern. According to the visual evaluation of cerebral SPECT results, hypoperfusion was detected in 11 cases (37%). Patients with cerebral hypoperfusion (group 1) and patients with normal cerebral perfusion (group 2) were compared. There was no difference between group 1 and group 2 in terms of demographic data, congenital heart defects, IQ levels, thyroid hormones, and autoantibodies, but the incidence of epilepsy was significantly higher in group 1 (P<.001). When motor and mental development levels were compared, it was found that cases in group 1 were significantly more retarded in personal-social and fine motor skills (P<.05). The present study showed that cerebral hypoperfusion in children with Down syndrome is mostly related to epilepsy and the other coexisting conditions, congenital heart disease and hypothyroidism. Patients with cerebral hypoperfusion also have more retarded developmental levels, especially in personal-social and fine motor skills.

Topics: Adolescent; Cerebrovascular Circulation; Child; Child Development; Child, Preschool; Down Syndrome; Epilepsy; Female; Heart Defects, Congenital; Humans; Hypothyroidism; Infant; Intelligence; Male; Motor Skills; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Down's syndrome (DS) is characterized by moderate mental retardation and a variety of abnormalities involving multiple organ systems. There is a high incidence of Alzheimer's disease (AD) type dementia beyond the age of 35. In this study, single photon emission computed tomography (SPECT) brain perfusion imaging of young Down's syndrome patients was performed to define the perfusion pattern. Tc-99m HMPAO brain perfusion SPECT was performed on 17 young DS patients, aged 3-24 years (mean: 10.9+/-5.9 years). None of the patients had dementia symptoms. Brain perfusion scans were acquired 15 min after i.v. injection of 12 MBq/kg of Tc-99m HMPAO using a single head rotating gamma camera. Images were analyzed visually and semiquantitatively by defining side-to-side asymmetry index. Nine DS cases showed normal brain perfusion. Eight of the 17 cases revealed mostly unilateral parieto-temporal, parieto-occipital and frontal hypoperfusions. The side-to-side asymmetry indices for these visually interpreted regional brain perfusion abnormalities ranged from 6 to 15%. These findings revealing mostly unilateral parieto-temporal and frontal hypoperfusions may not be considered as predictive patterns of dementia related Alzheimer type perfusion deficits in DS. However, such findings may connect to other functional imaging studies related to the higher cortical dysfunction in mental retardation.

Topics: Adolescent; Adult; Cerebrovascular Circulation; Child; Child, Preschool; Down Syndrome; Female; Humans; Male; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Twenty-six people with Down's syndrome (DS) were investigated using 99Tc(m)-hexamethylpropylene amine oxime (99Tc(m)-HMPAO) and single photon emission tomography (SPET). Dementia was diagnosed using a structured carer interview giving a deterioration score and by studying the case notes. Five subjects were clinically demented, 7 showed mild deterioration and 14 no deterioration. Increased deterioration correlated with advancing age (correlation coefficient 0.5425; P<0.02), but there was no significant difference between older (>40 years) and younger (<40 years) patients. Only one of the subjects with dementia had a regional cerebral blood flow (rCBF) abnormality that was of the dementia of Alzheimer type. Three subjects with mild deterioration and three with no deterioration had abnormal SPET scans. There was no association between the SPET abnormality and clinical dementia or with evidence of deterioration.

Topics: Adult; Age Factors; Brain; Dementia; Down Syndrome; Female; Humans; Intellectual Disability; Male; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

A 52-year-old patient with mosaic Down's syndrome exhibiting clinical features of early dementia who underwent high resolution SPECT neuroimaging is reported. While a CT scan of the brain showed no abnormality, cranial SPECT confirmed the presence of marked cortical blood flow deficits.

Topics: Alzheimer Disease; Brain; Down Syndrome; Humans; Male; Middle Aged; Mosaicism; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Fourteen young patients with Down's syndrome (nine males, five females, age range 8-30 years) were studied. 99Tcm-hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) was performed to evaluate regional cerebral blood flow (rCBF). Two experienced nuclear medicine physicians analysed the results of the SPECT by visual interpretation. The SPECT in all 14 patients with Down's syndrome invariably showed significantly unilateral perfusion defects in the temporal-parietal-occipital region, occasionally combined with small perfusion defects over other discrete cerebral areas. In this preliminary study, 99Tcm-HMPAO brain SPECT in the patients with Down's syndrome were abnormal. Patterns of rCBF in Down's syndrome were similar to the usual images of rCBF in Alzheimer's disease reported in the literature. Our findings provide new evidence of the similarities between Down's syndrome and Alzheimer's disease.

Topics: Adolescent; Adult; Alzheimer Disease; Cerebrovascular Circulation; Child; Down Syndrome; Female; Humans; Male; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Alzheimer's disease often occurs in patients with Down's syndrome. SPECT scanning with I-123 IMP and Tc-99m HMPAO identifies decreased cerebral perfusion and metabolism in these patients at lower cost. In this case, SPECT scanning revealed changes in Alzheimer's disease in a Down's syndrome patient.

Topics: Alzheimer Disease; Amphetamines; Brain; Down Syndrome; Humans; Iodine Radioisotopes; Iofetamine; Male; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon