• Title/Summary/Keyword: regional cerebral blood flow

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Evaluation of Hemodynamic Failure with Acetazolamide Challenged $^{123}I-IMP$ Brain SEPCT and PET (PET과 Acetazolamide 부하 $^{123}I-IMP$ 뇌혈류 SPECT를 이용한 혈역학적 부전의 평가)

  • Chun, Kyung-Ah;Cho, In-Ho;Won, Kyu-Jang;Lee, Hyung-Woo;Hayashida, Kohei
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.94-102
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    • 2003
  • Purpose : Cerebral blood flow (CBF) reactivity to acetazolamide (ACZ) is useful to select patients with hemodynamic failure. However, it is still a matter of speculation that varying degrees of regional CBF increases after ACZ administration represent the severity or stage of regional hemodynamic failure as assessed by positron emission tomography (PET). We studied to elucidate whether ACZ challenge $^{123}I-IMP$ brain single photon emission tomography (SPECT) can accurately grade the seventy of regional hemodynamic failure. Materials and Methods: Eighteen patients (M: 16, F: 2, average age: 61 years) with unilateral occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA). Patients undewent $^{123}I-IMP$ brain SPECT study with acetazolamide challenge and PET study was carried out within 2 weeks before and after SPECT study. Five healthy volunteers with a mean age of 48 years (range: 28-73 yr, M: 3, F: 2) underwent PET studies to determine normal values. In SPECT study, an asymmetry index (Al)-the percentage of radioactivity of region of interest (ROI) in the occlusive cerebrovascular lesion to the contralateral homologous ROI-was used for numerical evaluation of relative $^{123}I-IMP$ distribution. In PET study, regional CBF, oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen ($CMRO_2$) and cerebral blood volume (CBV) values were measured with $^{15}O-labeled$ gas inhalation method and the values were used for comparison with Al (Al during acetazolamide challenge-Al of basal study) on the SPECT study. ROls were classified by severity into three groups (normal, stage I and stage II). Results: Mean values of Al in areas with normal, stage I and stage II hemodynamic failure were $6.25{\pm}7.77%\;(n=107),\;-10.38{\pm}10.41%\:(n=117)\;and\;13.30{\pm}10.51%\;(n=140)$, respectively. Al significantly differed with each groups (p<0.05). Correlation between Al and CBF, OEF and CBV/CBF in hemisphere with occlusive cerebrovascular lesion was 0.20 (p<0.01), -0.28 (p<0.01) and -0.28 (p<0.01), respectively. Conclusion: We concluded that $^{123}I-IMP$ brain SPECT with acetazolamide challenge could determine the severity ad stage of regional hemodynamic failure as assessed by PET.

Optimization of Correction Factor for Linearization with Tc-99m HM PAO and Tc-99m ECD Brain SPECT (Tc-99m HMPAO와 Tc-99m ECD 뇌SPECT의 뇌혈류량 정량화에 사용되는 Linearization Algorithm의 Correction Factor 조사)

  • Cho, Ihn-Ho;Hayashida, Kohei;Won, Kyu-Chang;Lee, Hyoung-Woo;Watabe, Hiroshi;Kume, Norihiko;Uyama, Chikao
    • 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.

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Effect of Acupuncture on Regional Cerebral Blood Flow at Acupoints GV 20, GV. 26, LI. 4, ST. 36, SP. 6 Evaluated by Tc-99m ECD Brain SPECT (Tc-99m ECD 뇌혈류 SPECT를 이용한 백회, 인중, 합곡, 족삼리, 삼음교에서 체침의 뇌혈류에 대한 효과)

  • Song, Ho-Chun;Bom, Hee-Seung;Kang, Hwa-Jeong;Ahn, Soo-Gi;Kim, Seong-Min;Jeong, Hwan-Jeong;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.456-464
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    • 2000
  • Purpose: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm 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 acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. Conclusion: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.

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Mechanism and Application Methodology of Mental Practice (정신 연습의 기전과 적용 방법)

  • Kim Jong-soon;Lee Keun-heui;Bae Sung-soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.2
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    • pp.75-84
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    • 2003
  • The purpose of this study was to review of mechanism and application methodology about mental practice. The mental practice is symbolic rehearsal of physical activity in the absence of any gross muscular movements. Human have the ability to generate mental correlates of perceptual and motor events without any triggering external stimulus, a function known as imagery, Practice produces both internal and external sensory consequences which are thought to be essential for learning to occur, It is for this reason that mental practice, rehearsal of skill in imagination rather than by overt physical activity, has intrigued theorists, especially those interested in cognitive process. Several studies in sport psychology have shown that mental practice can be effective in optimizing the execution of movements in athletes and help novice learner in the incremental acquisition of new skilled behaviors. There are many theories of mental practice for explaining the positive effect In skill learning and performance. Most tenable theories are symbolic learning theory, psyconeuromuscular theory, Paivio's theory, regional cerebral blood flow theory, motivation theory, modeling theory, mental and muscle movement nodes theory, insight theory, selective attention theory, and attention-arousal set theory etc.. The factors for influencing to effects of mental practice are application form, application period, time for length of the mental practice, number of repetition, existence of physical practice.

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Analysis of Regional Cerebral Blood Flow Using $^{99m}Tc-HMPAO$ Brain SPECT in Senile Dementia of Alzheimer Type (알쯔하이머형의 노인성 치매에서 $^{99m}Tc-HMPAO$ 뇌 SPECT를 이용한 뇌혈류분포의 분석)

  • Lee, Myung-Hae;Lee, Myung-Chul;Koh, Chang-Soon;Roh, Jae-Kyu;Woo, Chong-In
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.2
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    • pp.147-156
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    • 1988
  • 알쯔하이머병 환자 11명, 우울증 환자 7명 그러고 정상 대조군 12명을 대상으로 $^{99m}Tc-HMPAO$ 뇌 SPECT를 이용하여 국소 뇌혈류 분포를 분석하여 다음과 같은 결과를 얻었다. 1) SPECT소견은 정상 대조군과 우울증군에서는 모두 정상이 있으나 알쯔하이머병군에서는 7명은 양측 측두엽 및 두정엽에, 3명은 편측 측두엽 및 두정엽에 그리고 1명은 전두엽에 뇌혈류 감소의 소견을 보였다. 2) 대뇌반구간 혈류분포의 변화를 비교하는 지수인 Cerebral asymmetry index는 정상 대조군에서 $0.08{\pm}0.03$, 알쯔하이머병군에서는 $0.11{\pm}0.04$ 그리고 우울증군에서는 $0.09{\pm}0.03$으로서 세 군간에 유의한 차이가 없었다. 3) 소뇌반구간 혈류분포의 변화를 비교하는 지수인 Percent index of cerebellar asymmetry는 정상 대조군에서 $0.4{\pm}0.7%$, 알쯔하이머병군에서 $-0.7{\pm}0.08%$ 그리고 우울증군에서 $-0.7{\pm}0.7%$로서 세군 간에 유의한 차이는 없었다. 4) 소뇌 계수치를 대조값으로 각 영역별 혈류분포의 변화정도를 비교하는 지수인 Region to cerebellum ratio는 우울증군에서는 정상 대조군과 유의한 차이를 보이지 않았으나 알쯔하이머병군에서는 양측 두정엽과 측두엽에서 유의한 감소를 보였다(p<0.05). 이상의 결과로 $^{99m}Tc-HMPAO$ 뇌 SPECT는 알쯔하이머병의 진단에 있어서 유용한 방법임을 알 수 있었다.

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Effect of ST 36-ST 41 Electro-acupuncture on Regional Cerebral Blood Flow in Normal Volunteers Evaluated by $^{99m}Tc$-ECD SPECT (족삼리-해계 전침치료가 정상인의 국소 뇌혈류에 미치는 영향 -Brain SPECT와 SPM을 이용하여-)

  • Moon, Sang-Kwan;Min, In-Kyu;Park, Sung-Uk;Jung, Woo-Sang;Park, Jung-Mee;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Young-Suk;Kim, Deok-Yoon
    • 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.

Pseudo Continuous Arterial Spin Labeling MR Imaging of Status Epilepticus (간질중첩증의 동맥 스핀 라벨링 자기공명영상)

  • Yi, Min-Kyung;Choi, Seung-Hong;Jung, Keun-Hwa;Yoon, Tae-Jin;Kim, Ji-Hoon;Sohn, Chul-Ho;Chang, Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.142-151
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    • 2012
  • Purpose : The purpose of this study was to describe arterial spin labeling MR image findings of status epilepticus. Materials and Methods: A retrospective chart review within our institute revealed six patients who had been clinically diagnosed as status epilepticus and had also undergone MR imaging that included ASL in addition to routine sequences. Results: Six patients with status epilepticus were studied by conventional MR and arterial spin labeling imaging. All patients showed increased regional CBF correlating with EEG pathology. Notably, in two patients, conventional MRI and DWI showed no abnormal findings whereas pCASL demonstrated regional increased CBF in both patients. Conclusion: Arterial spin labeling might offer additional diagnostic capabilities in the evaluation of patients with status epilepticus.

Effect of Clinical Improvement of Schizophrenic Symptoms on $^{99m}Tc$-HMPAO Brain SPECT (정신분열병 환자의 임상적 증세 호전에 따른 $^{99m}Tc$-HMPAO 뇌 SPECT 소견의 변화)

  • Shin, Chul-Jin;Koong, Sung-Soo;Chung, In-Won
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.310-319
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    • 1997
  • This study investigated regional blood flow changes of frontal, temporal, and basal ganglia in eleven schizophrenic patients on DSM-IV criteria to examine the relationship between rCBF and clinical improvement of symptoms. Single-photon emission computed tomography imaging with $^{99m}Tc$-HMPAO was peformed in baseline and sixth weeks after the treatment, and concurrently psychopathology was assessed by PANSS. Antipsychotics wash-out period was more than 2 weeks, and three patient were drug naive. All patients were finally divided into two groups, the improved or not improved. We examined the difference of the amount of rCBF changes between two groups. Finally, frontal activity shows no significant difference between two groups but both groups show decreased frontal blood flow after antipsychotic treatment. However, the change of right temporal rCBF had positive correlation with the change of the total PANSS score, and the change of left temporal lobe activity was greater in the improved group than in the not improved group. Our results suggest that the temporal lobe activity has relation to the underlying schizophrenic symptoms.

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Research trends on the Saam's Acupuncture Method in Korea (국내에서 보고된 사암침법에 대한 연구 동향)

  • Han, Chang-Hyun;Shin, Mi-Suk;Park, Sun-Hee;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.12 no.2 s.17
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    • pp.15-30
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    • 2006
  • Background The Saam's Acupuncture Method is one of the most widely adopted techniques used by clinicians and educational institutions in Korea today. It is originated in the 17th century from a Buddhist monk known as 'Saam'. The reports on the bibliography. biological responses and therapeutic effects of Saam's Acupuncture method were done but trends on the Saam's Acupuncture method were insufficient. Objectives This study aims to review the bibliography, biological responses and therapeutic effects of Saam's Acupuncture. In the process, this review will grasp trends in this field of studies and will direct further researches into the right direction. Method We searched and investigated th journals supplied by Korean Oriental Medical Society and Je-Han Oriental Medical Academy homepage etc. with the key world 'Saam(사암), jung-geuk(정격), seung-gyuk(승격), han-geuk(한격), yul-geuk(열격)'. Fifty journals were chosen for the review. Result 1. The proportion of basic researches was 10%. The biological responses of Saam's Acupuncture method reveal on blood pressure, regional cerebral blood flow (rCBF). 2. The proportion of literature researches was 48%. The application of Saam's Acupuncture method was many. 3. The proportion of case reports was 26%. Saam's Acupuncture method is applied in the various disease. 4. The proportion of clinical studies was 16%. Clinical studies were increased after the year 2000. Conclusions To elevated quality of studies, we need well-designed experimental methods, efficient secure of experimental groups, appropriate statistical verification, accumulations of knowledges about data research.

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Relationship between Brain Perfusion SPECT and MMSE Score in Dementia of Alzheimer's Type: A statistical Parametric Mapping Analysis (알쯔하이머형 치매환자에서 SPM 방법을 이용한 뇌 관류 SPECT와 정신-인지기능 수행성능의 상관)

  • Kang, Hye-Jin;Lee, Dong-Soo;Kang, Eun-Joo;Lee, Jae-Sung;Yeo, Seong-Seok;Kim, Jin-Yeong;Lee, Dong-Woo;Cho, Maeng-Je;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.2
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    • pp.91-101
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    • 2002
  • Purpose : The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Materials and Methods : Tc-99m HMPAO brain SPECT was peformed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5 - 24) and the mean MMSE score of the follow-up was 8.1 (range: 0 - 17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was peformed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Results : Significant correlation was found between the blood-flow decrease in left inferior prefrontal region (BA 47) and left middle temporal legion (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed the similar trends. Conclusions : A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's disease(AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease.