Brain perfusion SPECT and EEG study

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Brain Dev. 2010 Jun 29. [Epub ahead of print]

Brain perfusion SPECT and EEG findings in children with autism spectrum

disorders and medically intractable epilepsy.

<http://www.ncbi.nlm.nih.gov/pubmed/20594786>

Sasaki M

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sasaki%20M%22%5BAuthor%5D> ,

Nakagawa E

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Nakagawa%20E%22%5BAuthor%5D>

, Sugai K

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sugai%20K%22%5BAuthor%5D> ,

Shimizu Y

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Shimizu%20Y%22%5BAuthor%5D>

, Hattori A

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Hattori%20A%22%5BAuthor%5D>

, Nonoda Y

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Nonoda%20Y%22%5BAuthor%5D> ,

Sato N

<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sato%20N%22%5BAuthor%5D> .

Department of Child Neurology, National Center of Neurology and

Psychiatry (NCNP), 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551,

Japan.

Abstract

Objective: We performed brain perfusion single-photon emission computed

tomography (SPECT) to detect the abnormal brain region in children with

both autism spectrum disorders (ASD) and medically intractable

epilepsy. Methods: Fifteen children aged 4-16years underwent multimodal

examinations (MRI, interictal and/or ictal ECD-SPECT, EEG and MEG) to

investigate their indications for surgical treatment. All children were

diagnosed with ASD according to DSM-IV criteria and intractable

epilepsy. Despite medical treatment for more than a year, all

experienced at least one seizure per month. All had no underlying basic

disorders. Each SPECT result was statistically analyzed by comparing

with standard SPECT images obtained from our institute (easy Z-score

imaging system; eZIS). The relationship between the eZIS pattern and

EEG abnormalities or clinical symptoms was investigated. Results: All

children showed focal abnormal patterns on eZIS and focal spikes on

EEG. In all children, eZIS revealed a mixed hypoperfusion pattern,

especially in the prefrontal cortex, medial frontal cortex, anterior

cingulate cortex, medial parietal cortex, and/or anterior temporal

cortex. In seven of 12 children who underwent interictal SPECT studies,

areas of hypoperfusion were related to the focus observed on EEG; in

six children, the focal EEG spikes represented areas of hyperperfusion.

The children were divided into two groups according to the main type of

hypoperfusion patterns seen on eZIS; medial-cingulate type and temporal

type. No significant relationship was observed between the areas of

hypoperfusion and clinical symptoms. eZIS showed the epileptic focus

clearly on ictal SPECT. Conclusions: SPECT was useful to detect the

abnormal brain region not only in searching for the epileptic focus but

also in assessing the low or high functioning region of the brain.

. Published by Elsevier B.V.

PMID: 20594786