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이승재,양동원,손영민,김범생,정용안,손형선,주라형 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.1
Background & Objectives:Transient global amnesia (TGA) is a clinical syndrome characterized by sudden memory loss of recent events, transient inability to retain new information, and retrograde amnesia in the absence of other neurological signs and symptoms, resolving within 24 hours. This study investigated alterations in regional cerebral blood flow (rCBF) in patients with TGA by using statistical parametric mapping 99 (SPM99). Methods:5 patients with TGA and 9 age-matched normal control subjects were evaluated. Tc-99m-ethyl cysteinate dimer (ECD) SPECT were performed within 1 to 4 days of the event to measure the regional CBF, and SPM99 were applied to the objective analysis of SPECT data between two groups. Follow-up ECD SPECT was done at 49 to 107 days (mean 76.8) after the previous SPECT to evaluate the long term changes of the regional CBF. Results:The SPM analysis of SPECT images revealed significantly decreased rCBF in the left superior temporal gyrus, the left parietal supramarginal gyrus and the left thalamus (corrected p=0.01) and increased CBF in the contralateral mirror regions in patients with TGA. Follow-up SPECT showed persistent rCBF changes in the same regions. Conclusions:We demonstrate decreased perfusion in the left cerebral hemisphere and increased perfusion in the right cerebral hemisphere in patients with TGA. This reciprocal change of rCBF might suggest that imbalanced neuronal activity between two hemispheres may be important in the pathogenesis of the TGA. Also, the abnormal rCBF changes appeared to last long after the complete recovery of clinical manifestation of TGA.
양동원,김범생,손영민,박정욱,정용안,손형선,김상윤 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2
Background and Objectives . Alzheimer's disease (AD) is the most common cause of the dementia Pathologic and functional changes of AD are known to be unevenly distributed in the brain. This study investigates changes of cerebral blood flow (CBF) in patients with AD to determine brain regions with hypoperfusion that reflects progression of disease. Methods. Tc-99m-ECD single photon emission computed tomography (SPECT) was performed to measure regional CBF and statistical parametric mapping (SPM) 99 soft ware was used for the automated and objective approach to analyze SPECT image data. Twenty-five patients with mild to moderate dementia who met NINCDS-ADRDA critena for AD (male 11 female 14) and 17 age-matched normal control subjects were studied. The severity of AD was measured by clinical dementia rating (CDR) scale Results. SPM analysis of SPECT images revealed that CBF in the anterior cingulate gyrus left superior panetal cortex left medial frontal cortex left infenor temporal cortex. right thalamus and left hippocampus was significantly decreased in AD patients compared with normal controls (corrected p<0.05). The reduction of CBF according to CDR was localized in the left hippocampus and infenor temporal cortex right antenor and postenor ciagulate cortex and right superior panetal cortex (uncorrected p<0.01). Conclusions : Our data suggest that the cognitive dysfunction of AD is strongly related with functional abnormality in discrete brain areas 99m-Tc ECD SPECT with SPM analysis could be used as a useful functional imaging tool in AD study.