Limits...
Brain perfusion single photon emission computed tomography in major psychiatric disorders: From basics to clinical practice.

Santra A, Kumar R - Indian J Nucl Med (2014)

Bottom Line: Brain single photon emission computed tomography (SPECT) is a well-established and reliable method to assess brain function through measurement of regional cerebral blood flow (rCBF).It can be used to define a patient's pathophysiological status when neurological or psychiatric symptoms cannot be explained by anatomical neuroimaging findings.It can be utilized to evaluate the involvement of brain regions in a particular patient, to individualize treatment on basis of SPECT findings, to monitor the treatment response and modify treatment, if necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Brain imaging Centre, Dakshi Diagnostics, Lucknow, Uttar Pradesh, India.

ABSTRACT
Brain single photon emission computed tomography (SPECT) is a well-established and reliable method to assess brain function through measurement of regional cerebral blood flow (rCBF). It can be used to define a patient's pathophysiological status when neurological or psychiatric symptoms cannot be explained by anatomical neuroimaging findings. Though there is ample evidence validating brain SPECT as a technique to track human behavior and correlating psychiatric disorders with dysfunction of specific brain regions, only few psychiatrists have adopted brain SPECT in routine clinical practice. It can be utilized to evaluate the involvement of brain regions in a particular patient, to individualize treatment on basis of SPECT findings, to monitor the treatment response and modify treatment, if necessary. In this article, we have reviewed the available studies in this regard from existing literature and tried to present the evidence for establishing the clinical role of brain SPECT in major psychiatric illnesses.

No MeSH data available.


Related in: MedlinePlus

An 18-year-old male with severe anxiety neurosis revealed hyperactive prefrontal cortices and basal ganglia in technetium-99m-hexamethylpropyleneamineoxime brain perfusion single photon emission computed tomography images. (a) Transverse view, (b) sagittal view, (c) right lateral view of three-dimensional Talairach cortical perfusion report, (d) extracted basal ganglia and thalamus by “Neurogam” processing, (e) color scale for (c and d)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4228583&req=5

Figure 6: An 18-year-old male with severe anxiety neurosis revealed hyperactive prefrontal cortices and basal ganglia in technetium-99m-hexamethylpropyleneamineoxime brain perfusion single photon emission computed tomography images. (a) Transverse view, (b) sagittal view, (c) right lateral view of three-dimensional Talairach cortical perfusion report, (d) extracted basal ganglia and thalamus by “Neurogam” processing, (e) color scale for (c and d)

Mentions: Anxiety and depression are extremely common public health problems in today's world. The loss to our society from these illnesses is staggering: Individual pain, family strife, school and relationship failure, lost work productivity, and death. People actively seek out a cure for anxiety and depression, and are put on prescription medications that can harm them in other ways. Loss of interest or pleasure is the key symptom of depression. Other symptoms include feelings of hopelessness, worthlessness, and emotional pain; reduced energy and motivation; trouble sleeping; decreased appetite; and weight loss.[56] Brain SPECT with perfusion agents in patients free of medication has shown hypoperfusion of the following areas: The prefrontal area and temporal lobes, cingulate gyrus, and left caudate nucleus.[575859] There is evidence of prefrontal, limbic, and paralimbic hypoperfusion in both unipolar and bipolar depression;[60] and the lateral frontal area involvement in acute depression in the elderly.[61] Hypofrontality was shown to be associated with severe negative symptoms[62] [Figure 5]. In many occasions, both anxiety and depression coexist. Increased activity in the basal ganglia and frontal lobe may be seen in patients with anxiety [Figure 6]. Severity of depression is inversely correlated with rCBF in left cingulate cortex, lentiform nucleus, and parahippocampal gyrus, and directly correlated with right posterolateral parietal cortex. Anxiety directly correlated with right anterolateral OFC, while cognitive performance correlated with right posteromedial OFC and left lentiform nucleus.[6364] Cognitive decline in postmenopausal women is also associated with hypofrontality.[65] In major depressive disorders, sadness is related to decrease activity in dorsolateral prefrontal and dorsal cingulated cortex, with increased activity in ventromedial prefrontal and ventral cingulated cortex; whereas anxiety is associated with left AC cortex.[66] Whole brain blood flow also correlated positively with anxiety.[67] When recurrent depressions progressed to melancholies, involvement of left posterior parieto-temporal region is seen in addition to hypofrontality.[68] Findings of brain SPECT in anxiety depression disorders from different studies are summarized in Table 4.


Brain perfusion single photon emission computed tomography in major psychiatric disorders: From basics to clinical practice.

Santra A, Kumar R - Indian J Nucl Med (2014)

An 18-year-old male with severe anxiety neurosis revealed hyperactive prefrontal cortices and basal ganglia in technetium-99m-hexamethylpropyleneamineoxime brain perfusion single photon emission computed tomography images. (a) Transverse view, (b) sagittal view, (c) right lateral view of three-dimensional Talairach cortical perfusion report, (d) extracted basal ganglia and thalamus by “Neurogam” processing, (e) color scale for (c and d)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228583&req=5

Figure 6: An 18-year-old male with severe anxiety neurosis revealed hyperactive prefrontal cortices and basal ganglia in technetium-99m-hexamethylpropyleneamineoxime brain perfusion single photon emission computed tomography images. (a) Transverse view, (b) sagittal view, (c) right lateral view of three-dimensional Talairach cortical perfusion report, (d) extracted basal ganglia and thalamus by “Neurogam” processing, (e) color scale for (c and d)
Mentions: Anxiety and depression are extremely common public health problems in today's world. The loss to our society from these illnesses is staggering: Individual pain, family strife, school and relationship failure, lost work productivity, and death. People actively seek out a cure for anxiety and depression, and are put on prescription medications that can harm them in other ways. Loss of interest or pleasure is the key symptom of depression. Other symptoms include feelings of hopelessness, worthlessness, and emotional pain; reduced energy and motivation; trouble sleeping; decreased appetite; and weight loss.[56] Brain SPECT with perfusion agents in patients free of medication has shown hypoperfusion of the following areas: The prefrontal area and temporal lobes, cingulate gyrus, and left caudate nucleus.[575859] There is evidence of prefrontal, limbic, and paralimbic hypoperfusion in both unipolar and bipolar depression;[60] and the lateral frontal area involvement in acute depression in the elderly.[61] Hypofrontality was shown to be associated with severe negative symptoms[62] [Figure 5]. In many occasions, both anxiety and depression coexist. Increased activity in the basal ganglia and frontal lobe may be seen in patients with anxiety [Figure 6]. Severity of depression is inversely correlated with rCBF in left cingulate cortex, lentiform nucleus, and parahippocampal gyrus, and directly correlated with right posterolateral parietal cortex. Anxiety directly correlated with right anterolateral OFC, while cognitive performance correlated with right posteromedial OFC and left lentiform nucleus.[6364] Cognitive decline in postmenopausal women is also associated with hypofrontality.[65] In major depressive disorders, sadness is related to decrease activity in dorsolateral prefrontal and dorsal cingulated cortex, with increased activity in ventromedial prefrontal and ventral cingulated cortex; whereas anxiety is associated with left AC cortex.[66] Whole brain blood flow also correlated positively with anxiety.[67] When recurrent depressions progressed to melancholies, involvement of left posterior parieto-temporal region is seen in addition to hypofrontality.[68] Findings of brain SPECT in anxiety depression disorders from different studies are summarized in Table 4.

Bottom Line: Brain single photon emission computed tomography (SPECT) is a well-established and reliable method to assess brain function through measurement of regional cerebral blood flow (rCBF).It can be used to define a patient's pathophysiological status when neurological or psychiatric symptoms cannot be explained by anatomical neuroimaging findings.It can be utilized to evaluate the involvement of brain regions in a particular patient, to individualize treatment on basis of SPECT findings, to monitor the treatment response and modify treatment, if necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Brain imaging Centre, Dakshi Diagnostics, Lucknow, Uttar Pradesh, India.

ABSTRACT
Brain single photon emission computed tomography (SPECT) is a well-established and reliable method to assess brain function through measurement of regional cerebral blood flow (rCBF). It can be used to define a patient's pathophysiological status when neurological or psychiatric symptoms cannot be explained by anatomical neuroimaging findings. Though there is ample evidence validating brain SPECT as a technique to track human behavior and correlating psychiatric disorders with dysfunction of specific brain regions, only few psychiatrists have adopted brain SPECT in routine clinical practice. It can be utilized to evaluate the involvement of brain regions in a particular patient, to individualize treatment on basis of SPECT findings, to monitor the treatment response and modify treatment, if necessary. In this article, we have reviewed the available studies in this regard from existing literature and tried to present the evidence for establishing the clinical role of brain SPECT in major psychiatric illnesses.

No MeSH data available.


Related in: MedlinePlus