Serial Brain SPECT Images in a Case of Sydenham Chorea

Lee, Phil Hyu; Nam, Hyo Suk; Lee, Ki Young; Lee, Jong Doo

doi:10.1001/archneur.56.2.237

Cited by 46 publications

(29 citation statements)

References 18 publications

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“…We also know that the brain SPECT abnormality in SC can be reversed (17)(18)(19). The normal examination observed in some of our patients could reflect the phase of brain SPECT normalization.…”

Section: Discussionmentioning

confidence: 57%

Brain SPECT imaging in Sydenham's chorea

Barsottini

Ferraz

Seviliano

et al. 2002

Braz J Med Biol Res

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The objective of the present study was to determine whether brain single-photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities. Ten Sydenhams chorea (SC) patients, eight females and two males, 8 to 25 years of age (mean 13.4), with a clinical diagnosis of SC were submitted to brain SPECT imaging. We used HMPAO labeled with technetium-99m at a dose of 740 MBq. Six examinations revealed hyperperfusion of the basal ganglia, while the remaining four were normal. The six patients with abnormal results were females and their data were not correlated with severity of symptoms. Patients with abnormal brain SPECT had a more recent onset of symptoms (mean of 49 days) compared to those with normal SPECT (mean of 85 days) but this difference did not reach statistical significance. Brain SPECT can be a helpful method to determine abnormalities of the basal ganglia in SC patients but further studies on a larger number of patients are needed in order to detect the phase of the disease during which the examination is more sensitive.

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Section: Discussionmentioning

confidence: 57%

Brain SPECT imaging in Sydenham's chorea

Barsottini

Ferraz

Seviliano

et al. 2002

Braz J Med Biol Res

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“…Of the immunological and neurochemical measures that were taken in the present study, IgG deposits in the thalamus are the only one which parallels the pattern of behavioral deficits in the food manipulation task (i.e., no IgG deposits – no motor deficit). In humans, damage to the thalamus caused by stroke can lead to choreic movements [56], [57] and thalamic structural and functional alterations are correlated with motor symptoms in disorders such as SC, TS, Huntington’s disease, Parkinson’s disease and schizophrenia [58]–[63]. In animals, different manipulations that disrupt thalamic functioning lead to motor alterations such as reduced grip strength, involuntary clasping movement and impairments in limb coordination and balance [64], [65].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Treatment Attenuates Behavioral and Neurochemical Changes Induced by Exposure of Rats to Group A Streptococcal Antigen

2014

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Post-streptococcal A (GAS) sequelae including movement and neuropsychiatric disorders have been associated with improvement in response to antibiotic therapy. Besides eradication of infection, the underlying basis of attenuation of neuropsychiatric symptoms following antibiotic treatment is not known. The aim of the present study was to test the efficacy of antibiotic treatment in a rat model of GAS-related neuropsychiatric disorders. In the model, rats were not infected but were exposed to GAS-antigen or to adjuvants only (Control rats) and treated continuously with the antibiotic ampicillin in their drinking water from the first day of GAS-antigen exposure. Two additional groups of rats (GAS and Control) did not receive ampicillin in their drinking water. Behavior of the four groups was assessed in the forced swim, marble burying and food manipulation assays. We assessed levels of D1 and D2 dopamine receptors and tyrosine hydroxylase in the prefrontal cortex and striatum, and IgG deposition in the prefrontal cortex, striatum and thalamus. Ampicillin treatment prevented emergence of the motor and some of the behavioral alterations induced by GAS-antigen exposure, reduced IgG deposition in the thalamus of GAS-exposed rats, and tended to attenuate the increase in the level of TH and D1 and D2 receptors in their striatum, without concomitantly reducing the level of sera anti-GAS antibodies. Our results reinforce the link between exposure to GAS antigen, dysfunction of central dopaminergic pathways and motor and behavioral alterations. Our data further show that some of these deleterious effects can be attenuated by antibiotic treatment, and supports the latter’s possible efficacy as a prophylactic treatment in GAS-related neuropsychiatric disorders.

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“…In a case report of an 18-year-old man with bilateral Sydenham chorea, a 99m Tc HMPAO-SPECT during the first week of symptom onset showed hypoperfusion in the left basal ganglia [58]. In another case report in a young girl with Sydenham chorea, serial 99m Tc –ethyl cysteinate dimer ( 99m Tc-ECD) cerebral perfusion SPECT imaging showed increased cerebral perfusion in the striatum and thalamus during the period of active chorea, with levels similar to baseline on repeat scan after the resolution of symptoms [59]. In study of seventeen patients with Sydenham chorea, 99m Tc HMPAO-SPECT performed 0 to 3 weeks from symptom onset demonstrated hyperperfusion in the basal ganglia and thalamus in 94.1% of patients and was normal in one patient.…”

Section: Single-photon Emission Computed Tomography (Spect)mentioning

confidence: 99%

Functional neuroimaging and chorea: a systematic review

Ehrlich

Walker

2017

J Clin Mov Disord

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Chorea is a hyperkinetic movement disorder consisting of involuntary irregular, flowing movements of the trunk, neck or face. Although Huntington’s disease is the most common cause of chorea in adults, chorea can also result from many other neurodegenerative, metabolic, and autoimmune conditions. While the pathophysiology of these different conditions is quite variable, recent advances in functional imaging have enabled the development of new methods for analysis of brain activity and neuronal dysfunction. In this paper we review the growing body of functional imaging data that has been performed in chorea syndromes and identify particular trends, which can be used to better understand the underlying network changes within the basal ganglia. While it can be challenging to identify whether changes are primary, secondary, or compensatory, identification of these trends can ultimately be useful in diagnostic testing and treatment in many of the conditions that cause chorea.

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Serial Brain SPECT Images in a Case of Sydenham Chorea

Cited by 46 publications

References 18 publications

Brain SPECT imaging in Sydenham's chorea

Brain SPECT imaging in Sydenham's chorea

Antibiotic Treatment Attenuates Behavioral and Neurochemical Changes Induced by Exposure of Rats to Group A Streptococcal Antigen

Functional neuroimaging and chorea: a systematic review

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