Abstract
1918
Objectives Measure changes in cerebral blood flow (CBF) using SPECT HMPAO in patients with Tourette's syndrome compared to healthy controls. Nuclear Medicine techniques have been used successfully to observe changes in CBF in several psychiatric conditions. Widely available semi-quantitative analysis techniques are used to perform comparisons to healthy control databases.
Methods We measured CBF changes in 10 adults with Tourette’s syndrome using SPECT HMPAO compared to healthy controls. Following injection of 30 mCi of 99mTc HMPAO, 360-degree SPECT images were acquired with a dual headed Symbia T2 camera, 30 seconds per frame. Reconstruction of images was performed using a 3D Flash iterative algorithm. Reconstructed SPECT datasets were co-registered to a healthy control database using the Neuro-MIM software. Z scores are then generated for significant p values < 0.05.
Results Tourette's syndrome subjects were 40 ± 13 years old with an average YGTSS total tic severity score of 27 ± 11. A significant decrease in CBF was noted in the insula, the caudate nucleus, the olfactory cortex, and the medial temporal lobe structures (amygdala, hippocampus and para-hippocampal gyrus) with Z scores of -1.89, -3.04, -2.11, -2.66, -3.0, and -2.82 respectively. Borderline abnormal decreases were noted in the globus pallidus, thalamus and anterior cingulate gyrus (Z scores: -1.34, -1.23, and -1.46 respectively). On the other hand, there were significant increases in the occipital lobe and primary visual cortex regions (Z scores: +1.84, +1.82). Borderline increases were noted in the motor and somatosensory areas (Z scores: +1.2 and +1.47).
Conclusions Measurable changes in cerebral blood flow exist in Tourette’s syndrome patients compared to healthy controls. Our study shows CBF decreases in the insula, caudate nucleus, olfactory cortex, and medial temporal lobe structures and CBF increases in the occipital lobe.
Research Support This study was funded by Rembrandt Foundation and Edison Pharmaceuticals.