To correlate the resting metabolism of hand knob and hand function after stroke, diffuse tensor tractography (DTT) and 18F-fluorodeoxyglucose position emission tomography (18F-FDG PET) were used to evaluate constructible state of white matter tract and metabolic state of gray matter, respectively.
A total of 17 patients were included in the study, who had suffered a stroke with hand weakness, after a stroke. They underwent diffusion tensor analysis and FDG PET in the subacute period. The ratio of both hemisphere parameters in voxel number of fibers, fractional anisotropy (FA) and apparent diffusion coefficient obtained by corticospinal tract as constructed by DTT, and the metabolism of hand knob area on cerebral cortex obtained from 18F-FDG PET were calculated. Hand movement scale was evaluated on the day of FDG PET or tractography, and at 6 months after onset.
Difference of FA in DTT between both hemispheres and hand knob metabolism in FDG PET significantly correlated with the hand movement scale at the subacute stage and 6 months after onset. However, the difference of both hemispheres in DTT and metabolism of hand knob area was not significant.
Resting metabolism on hand knob in FDG PET correlated with hand function after stroke.
Citations
We report the findings of 18F-fluorodeoxyglocese positron emission tomography (FDG-PET) and diffusion tensor tractography (DTT) in a right-handed patient presenting with callosal disconnection syndrome, including alien hand syndrome, after an anterior communicating artery aneurysmal rupture. The 49-year-old patient had right hemiparesis and unintended movement of the right hand during action of the left hand. A brain magnetic resonance imaging revealed lesions in the upper part of the genu and body in the corpus callosum as well as hemorrhage in the inter-hemispheric fissure. We observed extensive disruption of corpus callosum fibers in the upper genu and trunk by DTT for the evaluation of inter-hemispheric connection. FDG-PET revealed severe hypometabolism in the left cerebral hemisphere, including basal ganglia and thalamus, and hypermetabolism in the right cerebral hemisphere. Based on findings of FDG-PET and DTT, the callosal disconnection syndrome presented in the patient could be the result of loss of transcallosal inhibition in the contralateral hemisphere.
Citations
To evaluate the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the management of cervical dystonia (CD) with botulinum toxin type A (BoNT-A) injection.
Thirty two subjects with CD were included. A BoNT-A injection was provided either by clinically targeting method (group 1) or by 18F-FDG PET/CT-assisted, clinically targeting method (group 2). In group 2, selection of target muscles and dosage of BoNT-A were determined according to the increased 18F-FDG uptake, in addition to physical examination and functional anatomy. The outcomes of BoNT-A injection was compared between the two groups, in terms of the number of subjects who had reinjection before and after 6 months, the number of reinjections, the interval of reinjections, the duration to the minimal Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), the number of adverse events, the reduction rate of TWSTRS at 1-3 months and 3-6 months after injection, and the probability of reinjection-free living.
The number of subjects who had reinjection within 6 months was significantly lower in group 2 than in group 1 (10 in group 1 vs. 3 in group 2). The reduction rate of TWSTRS after 3-6 months (37.8±15.7% of group 1 vs. 63.3±28.0% of group 2) and the probability of reinjection-free living were significantly higher in group 2 than in group 1.
These findings suggest that 18F-FDG PET/CT study could be useful in management of CD in terms of the identification of dystonic muscles if there is an increase in the 18F-FDG uptake in the cervical muscle of the images.
Citations
First
Prev
