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Biomedical subjects

J A Besson

Publications and source records attributed to J A Besson.

At least 55 records · Page 3Linked to original sources

A comparison of Tc-99m HM-PAO and I-123 IMP cerebral SPECT images in Alzheimer's disease and multi-infarct dementia.

SPECT images of the brain can be obtained using either 123I labelled amines or 99mTc-hexamethylpropyleneamineoxime (HM-PAO). Both materials produce images which are blood flow dominated and so appear similar in normal subjects, although the respective mechanisms of uptake are not yet finally established. It seems likely, however, that the different mechanisms of uptake are responsible for recent reports of some differences seen in images obtained with the two types of agent in patients with cerebral pathology, mainly cerebrovascular disease. In this study, 12 demented patients, 6 with dementia of the Alzheimer type (DAT) and 6 with multi infarct dementia (MID), were imaged with 123I-isopropylamphetamine (IMP) and 99mTc-HM-PAO and the images compared. Significantly more lesions were seen with IMP than HM-PAO (P less than 0.02); out of a possible 120 sites, 41 lesions were seen with IMP compared to 28 with HM-PAO, 23 being seen with both agents. However, it is concluded that either agent can be used for the differential diagnosis of dementia, a task for which the new cerebral blood flow agents seem well suited.

Aged

The use of technetium-99m-HM-PAO in the assessment of patients with dementia and other neuropsychiatric conditions.

One hundred fourteen patients suffering from neuropsychiatric conditions have been studied using 99mTc-labeled hexamethylpropyleneamine oxime (HM-PAO) and single photon emission computed tomography (SPECT). Ninety-one patients had a firm clinical diagnosis while 23 were examined without knowledge of the clinical diagnosis. Of the 91 patients, 51 were suffering from dementia, 25 multi-infarct type and 26 Alzheimer's disease. In 19 of the Alzheimer's patients, a characteristic pattern of decreased perfusion in the parieto-occipital regions was demonstrated while those with multi-infarct type showed varying degrees of irregular uptake in the cerebral cortex. These appearances are similar to those shown with positron emission tomography (PET) and we believe that HM-PAO will provide a widely available method for identifying patients with Alzheimer's disease. Twenty-nine patients were suffering from diseases involving the basal ganglia. Fifteen patients with Parkinson's disease showed no significant abnormality in basal ganglia uptake, while 7 or 8 patients with Huntington's disease who had full examinations showed decreased uptake in the caudate nuclei. Similarly, four of six patients with other basal ganglia diseases showed impaired uptake by basal ganglia, and it is concluded that HM-PAO may be useful for the diagnosis and management of this type of patient. Twenty-three patients received HM-PAO imaging as part of their diagnostic work-up; in 19 of them, detailed follow-up was obtained, which indicated that in 7 cases the result of the HM-PAO scan altered the clinical diagnosis and in 9 cases resulted in a change in management. In the remaining 13 cases, the study was found to be helpful in confirming the diagnosis.

Adult

The relationship between demographic variables and NART performance in normal subjects.

The relationship between NART performance and demographic variables was examined in a group of subjects free of neurologic or psychiatric disorder (n = 201). NART estimated IQ was significantly correlated with education, social class and age. The correlation between age and NART IQ was no longer significant after partialling out either education or social class. There was no evidence of a curvilinear relationship between age and NART performance. There was no significant sex difference in NART performance. Nelson's (1982) report of a high split-half reliability was confirmed.

Adolescent

Imaging of cerebral blood flow markers in Huntington's disease using single photon emission computed tomography.

Single photon emission computed tomography (SPECT) imaging of six Huntington's disease patients revealed a striking reduction in regional uptake of cerebral blood flow markers in vivo. Similar changes were found in one patient with "early stage" disease. The findings are compared with parallel magnetic resonance imaging (MRI) studies, and in one case, results of postmortem examination.

Adult

Estimation of premorbid intelligence in organic conditions.

The validity of premorbid IQ estimates provided by the National Adult Reading Test (NART) and Vocabulary sub-test of the Wechsler Adult Intelligence Scale were evaluated, by comparison with matched, healthy control subjects, in Korsakoff psychosis, alcoholic dementia, dementia Alzheimer type (DAT), multi-infarct dementia (MID), Huntington's disease, and closed head injury (CHI). There was no significant difference in NART performance between control subjects and the alcoholic dementia, DAT, MID, and CHI groups. Although there appeared to be a decline in NART performance in the Korsakoff and Huntington's groups, it did provide a significantly higher IQ estimate than the Vocabulary sub-test. All clinical groups, with the exception of the CHI group, performed at a significantly lower level than the control group on the Vocabulary sub-test.

Adult

Brain imaging and treatment response in spasmodic torticollis.

A patient with spasms of the neck, occurring when he turned his head to the left, responded to treatment with benzhexol. Cerebral blood flow imaging demonstrated reduced uptake in the right corpus striatum compared with the left. The study demonstrates the presence of an abnormality in the basal ganglia; it also illustrates response to drug treatment. Cerebral blood flow imaging may be useful in the detection of basal ganglia abnormalities in spasmodic torticollis and assist in the selection of cases which should be targeted for treatment with drugs.

Adult

Technetium-99m HMPAO imaging in patients with basal ganglia disease.

Technetium 99m hexamethylpropylene-amine oxime (HMPAO) is trapped by cerebral grey matter and the basal ganglia on its first pass through the brain. To assess its potential for studying patients with diseases of the basal ganglia, a study of 15 normal volunteers and 32 patients with known or suspected basal ganglia disease have been investigated. Sixteen patients with idiopathic Parkinson's disease showed no abnormality of the basal ganglia and varying degrees of cerebral underperfusion consistent with their intellectual status. Eight patients with Huntington's chorea showed a characteristic pattern of reduced or absent caudate nucleus uptake. Patients with diseases affecting the basal ganglia, such as Fahr's disease, Wilson's disease and hemibalismus had varying degrees of basal ganglia underperfusion as demonstrated by an HMPAO scan. We believe that this new radiopharmaceutical for the demonstration of cerebral blood flow shows significant potential for the diagnosis and management of patients with basal ganglia disease.

Adult

An NMR study of lithium responding manic depressive patients.

Manic depressive patients on long-term prophylactic therapy with lithium carbonate are examined by nuclear magnetic resonance imaging of the brain. Their ventricular brain ratios and cerebral grey and white matter spin lattice relaxation times (T1) are within normal limits. The implication of these findings in the light of previous studies using other techniques is discussed.

Adult

Nuclear magnetic resonance imaging and single photon emission tomography with radio-iodine labelled compounds in the diagnosis of dementia.

White matter lesions and T1 changes were identified using NMR and then compared between groups of patients suffering from dementia of the Alzheimer type (DAT), Multiple infarct dementia (MID) and normal controls. All DAT and MID patients were also imaged with a gamma camera using 123Iodo-n-isopropyl-amphetamine, a radiopharmaceutical whose uptake in the brain follows the regional blood flow. While NMR was not able to differentiate between DAT and MID, 19 out of 21 DAT patients compared to four out of 18 MID patients showed bilateral parietal lesions on IMP scans.

Adult

Estimation of premorbid intellectual status in depression.

The validity of the NART and Vocabulary subtest of the WAIS as measures of premorbid IQ in depression was assessed by comparing a group of depressed patients (n = 39) with matched controls. The Vocabulary performance of the depressed group was significantly poorer than controls but there was no significant difference in NART performance.

Adult

Nuclear magnetic resonance brain imaging in chronic schizophrenia.

Patients with chronic schizophrenia were examined by nuclear magnetic resonance imaging of the brain. Subgroups of the syndrome with high positive or high negative symptom scores and ventricular dilatation were compared with each other and with normal controls in respect of regional spin lattice relaxation time (T1) changes. Significant differences were not observed between the schizophrenic subgroups and controls but there were significant differences between the subgroups themselves. The presence of tardive dyskinesia was associated with increased T1 of the basal ganglia. The significance of these results is discussed in relation to findings using other techniques.

Adult

The psychological well-being of supporters of the demented elderly.

Interviews were conducted with the co-resident supporters of 79 elderly subjects. Forty of these elderly subjects had been diagnosed as being demented (20 mildly, 12 moderately and eight severely) following psychiatric assessment. The supporters were screened for psychological well-being with the 60-item General Health Questionnaire (GHQ) and the Relatives' Stress Scale (RSS). Supporters of demented relatives showed significantly raised levels of stress on the RSS, but no increase in psychiatric morbidity on the GHQ, when compared with the supporters of non-demented relatives. The implications of these findings are discussed.

Aged

Nuclear magnetic resonance (NMR): I. Imaging biochemical change.

Nuclear magnetic resonance (NMR) imaging of hydrogen in body water and fat is proving valuable in clinical investigation of the brain. An introduction to the technique and to the biological significance of the images is presented here. The 'multi-parameter' nature of these images is stressed, and the individual parameters described. NMR imaging may well be of value in investigating the pathology of organic and functional psychoses.

Brain