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    99mTc-HMPAO brain perfusion single-photon emission computed tomography in children with Down syndrome
    (Sage Publications Inc, 2006) Altiay, Suriye; Kaya, Meryem; Karasalihoglu, Serap; Gultekin, Aziz; Oner, Naci; Biner, Betul
    In recent years, it has been possible for patients with Down syndrome to live longer with advanced medical treatment and social support. As a result, the problems of these patients, such as thyroid diseases, leukemia, and Alzheimer disease, would be encountered more frequently. In this study, we aimed to perform the brain perfusion of children with Down syndrome by technetium 99m hexamethylpropylene amine oxime (Tc-99m-HMPAO) single-photon emission computed tomography (SPECT) and to determine the relationship between brain perfusion and epilepsy, thyroid function tests, congenital heart disease, and level of mental and motor development. Thirty patients with Down syndrome, aged between 1 and 15 years, were included in our study. Demographic data, the existence of epilepsy and congenital heart defects, the level of mental and motor development, serum. levels of thyroid hormones, and autoantibodies were determined. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI). Cerebral SPECT was per-formed in all cases to evaluate the brain perfusion pattern. According to the visual evaluation of cerebral SPECT results, hypoperfusion was detected in 11 cases (37%). Patients with cerebral hypoperfusion (group 1) and patients with normal cerebral perfusion (group 2) were compared. There was no difference between group 1 and group 2 in terms of demographic data, congenital heart defects, IQ levels, thyroid hormones, and autoantibodies, but the incidence of epilepsy was significantly higher in group 1 (P < .001). When motor and mental development levels were compared, it was found that cases in group 1 were significantly more retarded in personal-social and fine motor skills (P < .05). The present study showed that cerebral hypoperfusion in children with Down syndrome is mostly related to epilepsy and the other coexisting conditions, congenital heart disease and hypothyroidism. Patients with cerebral hypoperfusion also have more retarded developmental levels, especially in personal-social and fine motor skills.
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    Assessment of regional blood flow in cerebral motor and sensory areas in patients with spinal cord injury
    (Elsevier Science Bv, 2006) Cermik, Tevfik Fikret; Hakan, Tuna; Kaya, Meryem; Tuna, Filiz; Gultekin, Aziz; Yigitbasi, Omer Necmi; Alavi, Abass
    We assessed the presence and the degree of alteration of the regional blood flow (rCBF) as visualized by Tc-99m HMPAO brain rest SPECT in the sensory motor cortex and subcortical structure in spinal cord injury (SCI) patients, who suffered from various levels of motor and sensory function loss. Twenty-two patients (mean age: 42.1 +/- 13.4 years, 18 M, 4 F) and 11 control subjects (mean age: 32.2 +/- 6.4 years, 8 M, 3 F) participated in this study. The spinal cord injury group was consisted of 2 groups (14 paraplegic and 8 tetraplegic patients). The corticocortical rCBF ratios were calculated by using region of interests obtained from 34 cortical areas on coronal slices. Significantly reduced rCBF were measured from 11 cortical areas in tetraplegic patients and 11 cortical areas in paraplegic patients. Some of these areas different in each group. In the tetraplegic group, significant reduction was observed in the following rCBF areas: left anterior cingulate gyrus, left medial supplementary motor area, bilateral front and back aspects of posterior cingulate gyrus, right lateral primary motor area, right medial primary sensory area, bilateral putamen, and right cerebellum. In the paraplegic group, reduced rCBF areas were as follows: bilateral anterior cingulate gyrus, lateral supplementary motor area, left front aspect of posterior cingulate gyrus, left primary motor area, bilateral back aspects of posterior cingulate gyrus, right medial sensory area, left lateral primary sensory area and bilateral putamen. In conclusion, some of the movement-cortical and subcortical areas having significantly reduced blood in SCI may be helpful to demonstrate the disrupted areas of rCBF by SPECT. We believe it may be useful if these findings should be considered during the evaluations related to reorganization in SCI cases. (c) 2006 Elsevier B.V. All rights reserved.