ABSTRACT
UNLABELLED: Our study involved performing brain perfusion SPECT scans on Tourette's subjects to observe any common perfusion abnormalities involving the cerebral cortex or subcortical structures. METHOD: Six patients with Tourette's syndrome and nine normal control subjects underwent a brain SPECT study with 99mTc-HMPAO. Regions of interest were generated over the cerebral cortex, basal ganglia, thalamus and cerebellum to evaluate any relative perfusion abnormalities or asymmetry in the Tourette's subjects. RESULTS: Five of the six Tourette's subjects demonstrated a significant decrease in right basal ganglia activity which was not present in any of the normal control subjects. CONCLUSION: Our study suggests an etiology for Tourette's syndrome involving the right basal ganglia. Furthermore, brain SPECT may be useful in the evaluation of these patients if it proves to be sufficiently sensitive and specific in larger study populations.
Subject(s)
Brain/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Tourette Syndrome/diagnostic imaging , Adult , Basal Ganglia/diagnostic imaging , Basal Ganglia/physiopathology , Brain/physiopathology , Female , Functional Laterality , Humans , Male , Middle Aged , Organotechnetium Compounds , Oximes , Technetium Tc 99m Exametazime , Tourette Syndrome/physiopathologyABSTRACT
We conducted a double-blind placebo-controlled crossover study to assess the efficacy of deprenyl for attention deficit hyperactivity disorder (ADHD) in children and adolescents with comorbid Tourette's syndrome (TS). Twenty-four subjects (21 boys, 3 girls; mean age 12 years) were enrolled at two sites (University of Rochester and Baylor College of Medicine). The design included two 8-week treatment periods separated by a 6-week washout period. The primary outcome measures for ADHD and tic severity were total scores on the DuPaul Attention Deficit Hyperactivity Scale (DADHS) and the Yale Global Tic Severity Scale (YGTSS). Fifteen subjects completed the study. The primary analysis revealed no statistically significant beneficial effect of deprenyl on the DADHS (mean improvement 1.3; 95% CI, -2.7 to 5.3; p = 0.50). Further post-hoc analyses revealed, however, that the effect of deprenyl in the first period was substantial (p = 0.02). There was a marginally statistically significant beneficial effect of deprenyl on the YGTSS total score (p = 0.06). Deprenyl may improve both ADHD and tics in children with TS and warrants further study.
Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Selegiline/therapeutic use , Tourette Syndrome/drug therapy , Adolescent , Child , Cross-Over Studies , Double-Blind Method , Female , Humans , Male , Selegiline/adverse effects , Treatment OutcomeABSTRACT
We report on a patient suffering a branch retinal artery occlusion immediately following percutaneous transluminal coronary angioplasty. Balloon angioplasty may produce ocular embolic events consistent with previously reported neurological complaints.
