scholarly journals Diogenes syndrome in dementia: a case report

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Luca Sacchi ◽  
Emanuela Rotondo ◽  
Sara Pozzoli ◽  
Alessio Fiorentini ◽  
Giuseppina Schinco ◽  
...  
Keyword(s):  
Verbal Fluency ◽  
Brain Magnetic Resonance Imaging ◽  
Superior Temporal Gyrus ◽  
Amyloid Pet ◽  
Resonance Imaging ◽  
Mental Functioning ◽  
Diagnostic Challenge ◽  
Positron Emission ◽  
Diogenes Syndrome ◽  
State Examination

Background Diogenes syndrome is a neurobehavioural syndrome characterised by domestic squalor, hoarding and lack of insight. It is an uncommon but high-mortality condition, often associated with dementia. Aims To describe the clinical features and treatment of Diogenes syndrome secondary to behavioural variant frontotemporal dementia (bvFTD). Method We describe a case of bvFTD in a 77-year-old man presenting with Diogenes syndrome. Results The patient's medical and psychiatric histories were unremarkable, but in recent years he had begun packing his flat with ‘art pieces’. Mental state examination revealed confabulation and more structured delusions. Neuropsychological evaluation outlined an impairment in selective attention and letter verbal fluency, but no semantic impairment, in the context of an overall preserved mental functioning. Brain magnetic resonance imaging and positron emission tomography (PET) with fluorodeoxyglucose showed mild bilateral temporo-insular atrophy and hypometabolism in the left-superior temporal gyrus respectively. An amyloid PET scan and genetic analysis covering the dementia spectrum were normal. A diagnosis of bvFTD was made. Conclusions The clinical framing of behavioural symptoms of dementia such as hoarding poses a diagnostic challenge. This case illustrates the importance of a deeper understanding of Diogenes syndrome, leading to timelier diagnosis and effective therapeutic strategies.

Decreased Thalamic Monoamine Availability in Drug-Induced Parkinsonism

2021 ◽  
Author(s):  
Yoon-Sang Oh ◽  
Sang-Won Yoo ◽  
Chul Hyoung Lyoo ◽  
Joong-Seok Kim
Keyword(s):  
Ventral Striatum ◽  
Brain Magnetic Resonance Imaging ◽  
Imaging Biomarker ◽  
Resonance Imaging ◽  
Drug Induced ◽  
Dopamine Transporter Imaging ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Volume Of Interest ◽  
Normal Controls

Abstract Drug-induced parkinsonism (DIP) is caused by a dopamine receptor blockade and is a major cause of misleading diagnosis of Parkinson’s disease (PD). Striatal dopamine activity has been investigated widely in DIP; however, most studies with dopamine transporter imaging have focused on the clinical characteristics and prognosis. This study investigated differences in striatal subregional monoamine availability among patients with DIP, normal controls, and patients with early PD. Thirty-five DIP patients, the same number of age-matched PD patients, and 46 healthy controls were selected for this study. Parkinsonian motor status was examined. Brain magnetic resonance imaging and positron emission tomography with 18F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane were performed, and the regional standardized uptake values were analyzed with a volume-of-interest template and compared among the groups. Females were more predominant in the DIP group than in the PD group. Parkinsonian motor symptoms were similar in the DIP and PD groups. Monoamine availability in the thalamus of the DIP group was lower than that of the normal controls and similar to that of the PD group. In other subregions (putamen, globus pallidus, and ventral striatum), monoamine availability in the DIP group and normal controls did not differ and was higher than that in the PD group. These findings suggest that low monoamine availability in the thalamus could be an imaging biomarker of DIP.

scholarly journals Longitudinal Observation of Early-Onset Alzheimer’s Disease Dementia with Positive CSF Biomarkers/Negative Amyloid-β Positron-Emission Tomography

2021 ◽  
Vol 39 (3) ◽  
pp. 214-218
Author(s):  
Min Hye Kim ◽  
Joonho Lee ◽  
Hong Nam Kim ◽  
In Ja Shin ◽  
Keun Lee ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Positron Emission Tomography ◽  
Early Onset ◽  
Brain Magnetic Resonance Imaging ◽  
Amyloid Β ◽  
Emission Tomography ◽  
Csf Biomarkers ◽  
Amyloid Pet ◽  
Positron Emission

We report a 61-year-old woman with clinical course for Alzheimer’s disease (AD) dementia and discordant amyloid-β positron-emission tomography (PET) and cerebrospinal fluid biomarkers. Brain magnetic resonance imaging revealed remarkable atrophy in the hippocampus. However, repeated delayed <sup>18</sup>F-flutemetamol brain amyloid PET images with 1 year-interval revealed no amyloid deposition, whereas her CSF revealed low Aβ42, high total tau and p-tau181. This discordant amyloid-β PET and CSF biomarkers in this early-onset AD dementia might be associated with her low resilience or mixed pathology.

scholarly journals A Patient with Limbic Encephalitis, Ear Perichondritis, and Episcleritis – An Unusual Presentation of Relapsing Polychondritis

2020 ◽  
Vol 12 (3) ◽  
pp. 378-386
Author(s):  
Stanley Angkodjojo ◽  
Crystal Jing Jing Yeo
Keyword(s):  
Limbic Encephalitis ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Relapsing Polychondritis ◽  
Response To Treatment ◽  
Diagnostic Challenge ◽  
Positron Emission ◽  
Pet Ct ◽  
System Manifestation ◽  
Recurrent Inflammation

Relapsing polychondritis (RPC) is a rare autoimmune disease that is characterized by recurrent inflammation and destruction of cartilaginous tissues. Limbic encephalitis is a rare central nervous system manifestation of RPC that has been mentioned in case reports. Recognition of this association, and reliable methods of diagnosis, including the utility of neuroimaging modalities such as positron emission tomography/computed tomography (PET/CT) can be useful in the evaluation of this diagnostic challenge. We report a patient with limbic encephalitis associated with RPC, where PET/CT was effectively used in the diagnosis, and monitoring of response to treatment. We also demonstrate that it can be a useful modality in certain situations when brain magnetic resonance imaging cannot be done.

Reversible MRI Abnormalities in a Patient with Recurrent Status Migrainosus

Cephalalgia ◽  
2009 ◽  
Vol 29 (6) ◽  
pp. 687-690 ◽  
Author(s):  
S Gentile ◽  
I Rainero ◽  
D Daniele ◽  
E Binello ◽  
W Valfrè ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Positron Emission Tomography ◽  
Magnetic Resonance ◽  
Migraine Without Aura ◽  
Cerebral Oedema ◽  
Brain Magnetic Resonance Imaging ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Status Migrainosus

Status migrainosus is a condition characterized by a migraine attack causing disability, with or without aura, lasting for > 72 h. The pathophysiological mechanisms underlying this complication of migraine remain a matter of debate. We describe a migraine without aura patient who presented two episodes of status migrainosus associated with recurrent and reversible brain magnetic resonance imaging abnormalities. These abnormalities, confirmed also by positron emission tomography, suggest that status migrainosus can be associated with a condition of vasogenic cerebral oedema.

scholarly journals Brain Glucose Metabolism in Cerebral Amyloid Angiopathy

Stroke ◽  
2021 ◽  
Vol 52 (4) ◽  
pp. 1478-1482
Author(s):  
Sébastien Bergeret ◽  
Mathieu Queneau ◽  
Mathieu Rodallec ◽  
Brigitte Landeau ◽  
Gaël Chetelat ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Standardized Uptake Value ◽  
Regions Of Interest ◽  
Emission Tomography ◽  
Amyloid Angiopathy ◽  
Resonance Imaging ◽  
Cortical Areas ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Positron Emission ◽  
Cerebral Amyloid

Background and Purpose: The in vivo diagnosis of cerebral amyloid angiopathy (CAA) is currently based on the Boston criteria, which largely rely on hemorrhagic features on brain magnetic resonance imaging. Adding to these criteria 18 F-fluoro-deoxy-D-glucose (FDG) positron emission tomography, a widely available imaging modality, might improve their accuracy. Here we tested the hypothesis that FDG uptake is reduced in posterior cortical areas, particularly the primary occipital cortex, which pathologically bear the brunt of vascular Aβ deposition. Methods: From a large memory clinic database, we retrospectively included all patients in whom both brain magnetic resonance imaging and FDG positron emission tomography had been obtained as part of routine clinical care and who fulfilled the Boston criteria for probable CAA. None had a history of symptomatic intracerebral hemorrhage. FDG data processing involved (1) spatial normalization to the Montreal Neurology Institute/International Consortium for Brain Mapping 152 space and (2) generation of standardized FDG uptake (relative standardized uptake value; relative to the pons). The relative standardized uptake value data obtained in 13 regions of interest sampling key cortical areas and the cerebellum were compared between the CAA and age-matched control groups using 2 separate healthy subject databases and image-processing pipelines. The presence of significant hypometabolism (2-tailed P <0.05) was assessed for the bilaterally averaged regions-of-interest relative standardized uptake values. Results: Fourteen patients fulfilling the Boston criteria for probable CAA (≥2 exclusively lobar microbleeds) were identified. Significant hypometabolism ( P range, 0.047 to <0.0001) consistently affected the posterior cortical areas, including the superior and inferior parietal, primary visual, lateral occipital, lateral temporal, precuneus, and posterior cingulate regions of interest. The anterior cortical areas were marginally or not significantly hypometabolic, and the cerebellum was spared. Conclusions: Supporting our hypothesis, significant glucose hypometabolism predominantly affected posterior cortical regions, including the visual cortex. These findings from a small sample may have diagnostic implications but require replication in larger prospective studies. In addition, whether they generalize to CAA-related symptomatic intracerebral hemorrhage warrants specific studies.

Analysis of the superior temporal gyrus as a possible biomarker in schizophrenia using voxel-based morphometry of the brain magnetic resonance imaging: a comprehensive review

CNS Spectrums ◽  
2020 ◽  
pp. 1-7 ◽  
Author(s):  
Igor D. Bandeira ◽  
Judah L. Barouh ◽  
Ingrid D. Bandeira ◽  
Lucas Quarantini
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Brain Magnetic Resonance Imaging ◽  
Predictive Biomarkers ◽  
Superior Temporal Gyrus ◽  
First Episode ◽  
Voxel Based Morphometry ◽  
Resonance Imaging ◽  
The Brain

Abstract The lack of predictive biomarkers for therapeutic responses to schizophrenia leads clinical procedures to be decided without taking into account the subjects’ neuroanatomical features, a consideration, which could help in identifying specific pharmacological treatments for the remission of symptoms. Magnetic resonance imaging (MRI) is a technique widely used for radiological diagnosis and produces 3-dimensional images in excellent anatomical detail, and with a great capacity to differentiate soft tissue. Various MRI techniques of the human brain have emerged as a result of research, enabling structural tests that may help to in consolidate previous findings and lead to the discovery of new patterns of abnormality in schizophrenia. A literature review was undertaken to assess the superior temporal gyrus (STG) as a possible biomarker in schizophrenia with the use of voxel-based morphometry of the brain using MRI. Many findings in studies of schizophrenia using MRI have been inconclusive and, in some cases, conflicting, although interesting results have been obtained when attempting to correlate neuroimaging changes with aspects of clinical features and prognosis of the disease. The individuals affected by this mental illness appear to have smaller STG volumes when compared to healthy controls and also to subjects with a diagnosis of first-episode affective psychosis or groups of individuals at high risk of psychosis. However, the wide variety of definitions surrounding the STG found in a number of studies is a contributing factor to the lack of correlation between brain abnormalities and clinical symptoms. For instance, disagreements have arisen due to studies using regions of interest to analyze the STG whereas other studies prioritize the analysis of only STG subregions or specific supratemporal plane regions. It is necessary to standardize the nomenclature of the areas to be studied in the future, as this will enable more consistent results, allowing higher clinical and morphological correlations.

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