Creutzfeldt-Jakob disease (CJD) is a low-prevalence, fatal neurodegenerative disease. Parkinsonism as first symptom of CJD is rare. We present a case manifesting difficulty falling asleep as unspecific prodromal symptom and parkinsonism as initial symptom. The patient received positron emission tomography/computed tomography (PET/CT) of dopamine transporter (DAT) using 18 F-FP-CIT. The DAT-scan demonstrated presynaptic dopaminergic deficit in bilateral posterior putamen, which supports the hypothesis of nigrostriatal pathway dysfunction in CJD.
Recent studies suggest that selective serotonin reuptake inhibitors (SSRIs) and exposure therapies have been used to reduced footshock-induced posttraumatic stress disorder (PTSD) symptoms. However, the therapeutic effect of the combination of SSRIs treatment with exposure therapy remains a matter of debate.This study aimed to evaluate these therapeutic effect through the behavioral and the neuroimaging changes by positron emission tomography (PET) in model rats. We adopted a Pavlovian fear conditioning paradigm to establish model rats, and serial [ 18 F] uorodeoxyglucose (FDG) PET imaging was performed to investigate the neurofunctional changes before and after the therapies (chronic uoxetine and/or extinction). Behavioral tests indicated combined therapy group performanced lower freezing (%) than the two other groups.Compared with the baseline, fear conditioning increased 18 F-FDG uptake in the right amygdala but decreased uptake in the left primary somatosensory cortex. After extinction retrieval, there was increased [ 18 F]FDG uptake in the left striatum but decreased uptake in the anterior cingulate cortex in the extinction group. Fluoxetine increased [ 18 F]FDG uptake in the left hippocampus but decreased uptake in the cuneiform nucleus. The combined therapy increased [ 18 F]FDG uptake in the left hippocampus, left striatum, right insular cortex but reduced uptake in the cerebellar lobule. c-Fos expression was signi cantly higher in the hippocampal dentate gyrus and anterior cingulate cortex in the uoxetine and combined groups than that in the extinction group, with no signi cant difference between the two groups. Taken together, chronic uoxetine enhanced the effects of extinction training in a rat model of PTSD. In vivo PET imaging may provide a promising approach for evaluation chronic uoxetine treatment of PTSD.
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