• Progress in Medical Physics
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• v.14 no.2
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• pp.141-148
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• 2003

The purpose of this study is to evaluate the distribution of clusters and blood flow rate in ADHD SPECT brain blood flow images of children using statistical parametric mapping (SPM99). We studied 64 ADHD children (4-15 y, $8.03{\pm}2.57$ y. male/female:52/12) and compared them with a control group of 12 children (6-l7 y, $9.42{\pm}3.37$ y, male/female:8/4). We injected blood flow tracer $^{99m}Tc$-ethylcysteinate dimer (ECD) as a rCBF agent and took blood flow images after 30 min. by SPECT camera. In the case of hyperperfusion of rCBF in the ADHD group, we found 3 clusters clearly separated at the cingulate gyrus, Rt.cerebral occipital lobe and Lt.cerebellar post. lobe, on probability level 0.05 (P<0.05). Thirty-six ADHD patients with average hyperfusion rates between 18.72-19.30% in each cluster had more increase in blood flow than the average perfusion rate at the Rt. cerebral occipital lobe. These levels were influenced by P-value. In the case of hypoperfusion in the ADHD children, 4 decreased clusters on Lt. and Rt. cerebral frontal lobe, Lt. cerebral claustrum and Rt. cerebral, sup. temporal gyrus at P<0.01 can be seen. The average hypoperfusion rates for the ADHD children were 18.41-18.69% in each cluster, which showed more hypopefusion than the average perfusion rate at the Lt. Cerebrum inf. Frontal gyrus. The perfusion rates and the number of patients were not affected by P-value. The result of this study shows significant hyperpefusion clusters at the probability level of P:0.05 and hypoperfusion clusters at P:0.01. The number of ADHD patients in each clusters and the perfusion rate were not affected by P-value.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.31-41
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• 2004

Attention deficit hyperactivity disorder(ADHD)is one of the most common psychiatric disorders in childhood, especially school age children and persisting into adult. ADHD is affected 7.6% in our children, Korea. and persisting into $15{\sim}20%$ in adult. And it is characterized by hyperactivity, inattention and impulsivity. Brain imaging is one of way to diagnosis for ADHD. Brain imaging studies may be provide information two types - structural and functional imaging. Structural and functional images of the brain play an important role in management of neurologic and psyciatric disorders. Brain SPECT, with perfusion imaging radiopharmaceuticals is one of the appropriate test to diagnosis of neurologic and psychiatric diseases. Ther are a few studies about separated analysis between boys and girls ADHD SPECT brain images. Selection of Probability level(P-value) is very important to determind the abnormalities when analysis a data by SPM. SPM is a statistical method used for image analysis and determine statistical different between two groups-normal and ADHD. Commonly used P-value is P<0.05 in statistical analysis. The purpose of this study is to evaluation of blood flow clusters distribution, between boys and girls ADHD. The number of normal boys are 8(6-7y, average : $9.6{\pm}3.9y$) and 51(4-11y, average : $9.0{\pm}2.4$) ADHD patients, and normal girls are 4(6-12y, average : $9{\pm}2.4y$) and 13(2-13y, average $10{\pm}3.5y$) ADHD patiens. Blood flow tracer $^{99m}Tc-ethylcysteinate$ dimer(ECD) injected as rCBF agent and take blood flow images after 30 min. during sleeping by SPECT camera. The anatomical region of hyperperfusion of rCBF in boys ADHD group is posterior cingulate gyrus and hyperperfusion rate is 15.39-15.77% according to p-value. And girls ADHD group appears at posterior cerebellum, Lt. cerbral limbic lobe and Lt. Rt. cerebral temporal lobe. These areas hyperperfusion rate are 24.68-31.25%. Hypoperfusion areas in boys ADHD,s brain are Lt. cerebral insular gyrus, Lt. Rt. frontal lobe and mid-prefrontal lobe, these areas decresed blood flow as 15.21-15.64%. Girls ADHD decreased blood flow regions are Lt. cerebral insular gyrus, Lt. cerebral frontal and temporal lobe, Lt. Rt. lentiform nucleus and Lt. parietal lobe. And hypoperfusion rate is 30.57-30.85% in girls ADHD. The girls ADHD group's perfusion rate is more variable than boys. The studies about rCBF in ADHD, should be separate with boys and girls.

• The Korean Journal of Physiology and Pharmacology
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• v.10 no.4
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• pp.167-172
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• 2006

In the present study, we developed a simple method to predict the neuronal cell death in the mouse hippocampus and striatum following transient global forebrain ischemia by evaluating both cerebral blood flow and the plasticity of the posterior communicating artery (PcomA). Male C57BL/6 mice were anesthetized with halothane and subjected to bilateral occlusion of the common carotid artery (BCCAO) for 30 min. The regional cerebral blood flow (rCBF) was measured by laser Doppler flowmetry. The plasticity of PcomA was visualized by intravascular perfusion of India ink solution. When animals had the residual cortical microperfusion less than 15% as well as the smaller PcomA whose diameter was less than one third compared with that of basilar artery, neuronal damage in the hippocampal subfields including CA1, CA2, and CA4, and in the striatum was consistently observed. Especially, when mice met these two criteria, marked neuronal damage was observed in CA2 subfield of the hippocampus. In contrast, after transient BCCAO, neuronal damage was consistently produced in the striatum, dependent more on the degree of rCBF reduction than on the plasticity of PcomA. The present study provided simple and highly reproducible criteria to induce the neuronal cell death in the vulnerable mice brain areas including the hippocampus and striatum after transient global forebrain ischemia.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.130-137
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• 2010

Objectives: So far it has been reported that acupuncture increases cerebral blood supply and stimulates the functional activity of brain nerve cells. Previous studies have demonstrated that frequently used electro-acupuncture (EA) therapies for stroke increased regional cerebral blood flow (rCBF) in normal volunteers. Though ST 36-ST 41 EA is another prevailing therapy for stroke, there had been no report about its effect on rCBF. This study was to evaluate the effect of ST 36-ST 41 EA on rCBF in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc$-ECD brain SPECT scans were performed on 10 normal volunteers (5 males, 5 female, mean age $23.6{\pm}0.5$ years). On the other study day, 7 days after the resting examination, 15 minutesEA were applied at ST 36 and ST 41 on the right side of the subjects. Immediately after ST36-ST41 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by SPM with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: EA applied at the right ST36-ST41 significantly increased rCBF in the right inferior parietal lobule (Brodmann area [BA] 40), right retrosubicular area (BA 48), left inferior parietal lobule (BA 40), left middle temporal gyrus (BA 21), left fusiform gyrus (BA 37), left inferior parietal lobule (BA 39), left inferior temporal gyrus (BA 20), and left somatosensory association cortex (BA 7). However, right ST36-ST41 EA significantly decreased rCBF in the right parahippocampal gyrus (BA 35), right cerebellum, left frontopolar area (BA 10), left orbitofrontal area (BA 11), left dorsolateral prefrontal cortex (BA 9), and left dorsal anterior cingulate cortex (BA 32). Conclusions: These results demonstrate that rightST36-ST41 EA increased rCBF prominently in both inferior parietal lobule (BA 40) and right retrosubicular area (BA 48), which suggest that there be correlation between specific EA and corresponding rCBF.

• Progress in Medical Physics
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• v.18 no.3
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• pp.149-160
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• 2007

Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.237-243
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• 1999

We conducted this study to find the optimal correction factor(${\alpha}$) of Lassen's linearization algorithm which has been applied for correction of flow-limited uptake at a high flow range in $^{99m}Tc$ d,l-hexamethylpropy leneamine oxime(HMPAO) and $^{99m}Tc$ ethyl cysteinate dimer(ECD). Ten patients with chronic cerebral infarction were involved in this study. We obtained the corrected $^{99m}Tc$ HMPAO and $^{99m}Tc$-ECD brain SPECT(single photon emission computed tomography) using the algorithm with ${\alpha}$ values that varied from 0.1 to 10 and compared the results with regional cerebral blood flow determined by positron emission tomography (PET-rCBF). The multi-modal volume registration by maximization of mutual information was used for matching between PET-rCBF and SPECT images. The highest correlation coefficient between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain uptake and PET-rCBF was revealed at ${\alpha}$ 1.4 and 2.1, respectively. We concluded that the ${\alpha}$ values of Lassen's linearization algorithm for $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain SPECT images were 1.4 and 2.1, respectively to indicate cerebral blood flow with comparison of PET-rCBF.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.64-71
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• 2016

Objectives: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). Methods: A total of 26 children with ADHD (21 boys, mean age: $9.2{\pm}2.05$ years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. Results: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). Conclusion: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.891-897
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• 2007

This experimental Study was designed to investigate the mechanism of Acanthopanacis Cortex Roots(ACR) 50% ethyl alcohol extract on the improvement of regional cerebral blood flow and cytokines production in cerebral ischemic rats. And was designed to investigate whether ACR inhibits lactate dehydrogenase(LDH) activity in neuronal cells The results were as follows; ACR significantly inhibited LDH activity in neuronal cells. These results suggest that ACR prevents the neuronal death. rCBF was significantly and stably increased by ACR(10 mg/kg, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after middle cerebral arterial occlusion, experimental group was significantly decreased $IL-1{\beta}$ and $TNF-{\alpha}$ production, and significantly increased IL-10 production compared with control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after reperfusion, experimental group was significantly decreased $IL-1{\beta}$ and $TNF-{\alpha}$ production, and significantly increased IL-10 production compared with control group. According to above results, the author suggest that ACR had an anti-ischemic effect through the improvement of cerebral hemodynamics, and inhibitive effect on the brain damage by inhibited $IL-1{\beta}$ and $TNF-{\alpha}$ production, and accelerated IL-10 production.

• Investigative Magnetic Resonance Imaging
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• v.8 no.1
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• pp.17-23
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• 2004

Purpose : To evaluate changes in total cerebral blood flow (tCBF) with aging, parenchymal volume changes and vascular abnormalities, using 2 dimensional (D) phase-contrast magnetic resonance imaging (PC MRI). Materials and Methods : Routine brain MRI including T2 weighted image, time-of-flight (TOF) MR Angiography (MRA) and 2D PC MRI were performed in 73 individuals, including 12 volunteers. Normal subjects (12 volunteers, and 21 individuals with normal MRI and normal MRA) were classified into groups according to age (18-29, 30-49 and 50-66 years). For the group with abnormalities in brain MRIs, cerebral parenchymal volume changes were scored according to the T2 weighted images, and atherosclerotic changes were scored according to the MRA findings. Abnormal groups were classified into 4 groups: (i) mild reduction in volume, (ii) marked reduction in volume by parenchymal volume and atherosclerotic changes, and (iii) increased volume and (iv) Moya-moya disease. Volumetric flow was measured at the internal carotid artery (ICA) and vertebral artery bilaterally using the velocity-flow diagrams from PC MRI, and combined 4 vessel flows and tCBF were compared among all the groups. Results : The age-specific distribution of tCBFs in normal subjects were as follows: $12.0{\pm}2.1ml/sec$ in 18-29 years group, $11.8{\pm}1.9ml/sec$ in 30-49 years group, $10.9{\pm}2.2ml/sec$ in 50-66 years group. The distribution of tCBFs in the different subsets of the abnormal population were as follows: $9.5{\pm}2.5ml/sec$ in the group with mild reduction in volume, $7.6{\pm}2.0ml/sec$ in the group with marked reduction in volume, and $7.3{\pm}1.2ml/sec$ and $7.0{\pm}1.1ml/sec$ in the increased parenchymal volume and Moya-moya disease groups respectively. Conclusion : Total cerebral blood flow decreases with increasing age with a concomitant reduction in parenchymal volumes and increasing atherosclerotic changes. It is also reduced in the presence of increased parenchymal volume and Moya-moya disease.2D PC MRI can be used as a tool to evaluate tCBF with aging and in the presence of various conditions that can affect parenchymal volume and cerebral vasculature.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.46-54
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• 2001

Objective : To study correlation of the brain areas with acupoints used in the treatment of cerebrovascular diseases to evaluate the hypothesis that selecting acupoints on the left side to treat disorders on the right side and vice versa is known as the crossing combination of acupoints. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 5 normal male volunteers (age range from 27 to 30 years) using acupuncture at acupoint, LI4 located in the left hand. In the control study, needle location was chosen on a non-meridian focus 1cm posterior to the right fibular head. All images were spatially normalized and the differences between rest and acupuncture stimulation were statistically analyzed using SPM(R) for Windows(R). Results : Acupuncture applied at LI4 located in the left hand increased rCBF in the right hemisphere, that is, the right parietal lobe(angular gyrus) and a part of the right middle posterior temporal gyrus and the right inferior occipital lobe. In the control stimulation, no significant rCBF increase was observed. Conclusion : The results demonstrated a correlation between stimulation at acupoint with increase in rCBF to the controlateral hemisphere.