RT Journal Article
SR Electronic
T1 Pathophysiological Decrease in the Regional Cerebral Blood Flow in Hashimoto's Encephalopathy: A Multiple-Case SPECT Study (S30.004)
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP S30.004
VO 84
IS 14 Supplement
A1 Ikawa, Masamichi
A1 Muramatsu, Tomoko
A1 Sugimoto, Katsuya
A1 Matsunaga, Akiko
A1 Yamamura, Osamu
A1 Hamano, Tadanori
A1 Nakamoto, Yasunari
A1 Okazawa, Hidehiko
A1 Yoneda, Makoto
YR 2015
UL http://n.neurology.org/content/84/14_Supplement/S30.004.abstract
AB OBJECTIVE: To evaluate the changes in regional cerebral blood flow (CBF) in multiple cases of Hashimoto's encephalopathy (HE). BACKGROUND: HE is an autoimmune encephalopathy associated with Hashimoto's thyroiditis, presenting with various neurological and psychiatric manifestations. Although pathological findings including vasculitis or lymphocyte infiltration in cerebral small vessels suggest that cerebrovascular insufficiency causes the neuropsychiatric symptoms in HE, no investigation evaluating CBF has been performed in multiple cases of HE, and the changes in regional CBF in HE remain to be elucidated. DESIGN/METHODS: Seven untreated patients with HE (3 males/4 females, mean age 66.3±14.3) and 10 age-matched healthy controls (4 males/6 females, mean age 61.0±2.9) underwent brain 123I-IMP-SPECT and MRI. All patients presented with some neurological and/or psychiatric symptoms at the time of scan; of these, 5 presented with acute neuropsychiatric symptoms such as consciousness disturbance and/or psychosis, and responded to corticosteroid therapy. Anti-NH2-terminal of α-enolase autoantibodies (Abs), which served as a useful diagnostic marker for HE, were detected in sera of all patients in addition to anti-thyroid Abs. The obtained SPECT images were compared between the patients and the controls using 3D-SSP analysis. RESULTS: The regional CBF of all patients with HE was significantly decreased in the bilateral anterior cingulate areas and left prefrontal cortex compared with the controls (p<0.05). These regions of decreased CBF were not abnormal on MRI. Focusing on the HE patients with acute neuropsychiatric symptoms, the decreased regional CBF in these areas was more significant, and the regional CBF in the right frontal cortex was also decreased. CONCLUSIONS: Statistical analysis of these multiple-case SPECT images revealed the regions of decreased CBF associated with clinical symptoms, especially acute neuropsychiatric symptoms, in HE patients, suggesting the pathophysiological decrease in regional CBF observed in HE. Study Supported by: Grants-in-Aid for Scientific Research (C) and Young Scientists (B) from JSPS.Disclosure: Dr. Ikawa has nothing to disclose. Dr. Muramatsu has nothing to disclose. Dr. Sugimoto has nothing to disclose. Dr. MATSUNAGA has nothing to disclose. Dr. Yamamura has nothing to disclose. Dr. Hamano has nothing to disclose. Dr. Nakamoto has nothing to disclose. Dr. Okazawa has nothing to disclose. Dr. Yoneda has nothing to disclose.Wednesday, April 22 2015, 4:00 pm-5:45 pm