ABSTRACT
Eating disorders have been redefined in recent years. Brain imaging techniques are useful in demonstrating the association between the morphologic and the functional cerebral changes in these cases. We report 99mTc-HMPAO brain SPECT findings in two patients with anorexia nervosa, before and after the treatment. While the detailed neurologic and laboratory examinations, including EEG and cranial CT, were within normal limits before therapy, SPECT study revealed diffuse bilateral hypoperfusion in frontal, parietal and frontotemporal areas which was more prominent in the left hemisphere. Post-treatment SPECT studies obtained after a clinical remission period of 3 mo showed normal brain perfusion in both patients. The pre- and post-treatment SPECT studies accurately reflect the functional state of the patients, and this technique may be used to follow-up the effect of treatment and predict the clinical response to therapy in patients with eating disorders.
Subject(s)
Anorexia Nervosa/diagnostic imaging , Brain/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Tomography, Emission-Computed, Single-Photon , Adolescent , Anorexia Nervosa/physiopathology , Anorexia Nervosa/therapy , Cerebrovascular Circulation , Electroencephalography , Female , HumansABSTRACT
BACKGROUND: We examined the functional and structural cerebral changes in chronic alcoholics, analysing their association with personality features and alcohol drinking habits. METHOD: Forty patients with alcohol dependency, including 15 with antisocial personality disorder (ASP) as defined in DSM-III-R and 10 age and sex matched healthy controls were studied after termination of withdrawal symptoms, using high resolution single photon emission tomography (SPECT), cranial computerised tomography (CT) and brainstem auditory evoked potentials (BAEP). RESULTS: We found significant reductions in regional cerebral blood flow (rCBF) measurements of alcoholic patients. Low flow in frontal regions encountered in 67.5% of the patients was associated with the duration of alcohol consumption, while no such relation existed with the amount of daily intake. Patients with ASP exhibited more marked frontal hypoperfusion. Significant brain atrophy detected by CT was present in 40% of the patients and did not correlate with frontal hypoperfusion. CONCLUSIONS: Patients with ASP are more sensitive to toxic effects of alcohol. Alternatively chronic alcoholism leads to frontal lobe dysfunction recognised as ASP in the clinical setting.
