scholarly journals The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial

Biomolecules ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 880
Author(s):  
Evelien Zoons ◽  
Marina A.J. Tijssen ◽  
Yasmine E.M. Dreissen ◽  
Marenka Smit ◽  
Jan Booij
Keyword(s):  
Cervical Dystonia ◽  
Psychiatric Symptoms ◽  
Single Photon ◽  
Controlled Trial ◽  
Photon Emission ◽  
Placebo Treatment ◽  
Binding Potential ◽  
Emission Computed Tomography ◽  
Double Blind ◽  
Before And After

Purpose: The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on changes in dopamine D2/3 receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BPND) after a six-week treatment course with escitalopram or placebo. Methods: CD patients had [123I]FP-CIT SPECT (I-123 fluoropropyl carbomethoxy-3 beta-(4-iodophenyltropane) single-photon emission computed tomography) scans, to quantify extrastriatal SERT and striatal DAT, and [123I]IBZM SPECT (I-123 iodobenzamide SPECT) scans to quantify striatal D2/3R BPND before and after six weeks of treatment with either escitalopram or placebo. Treatment effect was evaluated with the Clinical Global Impression scale for dystonia, jerks and psychiatric symptoms, both by physicians and patients. Results: In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BPND. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (p = 0.13) towards lower extrastriatal SERT BPND in the SSRI group (median SERT occupancy of 64.6%). After treatment with escitalopram, patients who reported a positive effect on dystonia or psychiatric symptoms had significantly higher SERT occupancy compared to patients who did not experience an effect. Conclusion: Higher extrastriatal SERT occupancy after treatment with escitalopram is associated with a trend towards a positive subjective effect on dystonia and psychiatric symptoms in CD patients.

scholarly journals Effects of NK1 receptors on gastric motor functions and satiation in healthy humans: results from a controlled trial with the NK1 antagonist aprepitant

2017 ◽  
Vol 313 (5) ◽  
pp. G505-G510 ◽  
Author(s):  
Deepti Jacob ◽  
Irene Busciglio ◽  
Duane Burton ◽  
Houssam Halawi ◽  
Ibironke Oduyebo ◽  
...  
Keyword(s):  
Single Photon ◽  
Controlled Trial ◽  
Photon Emission ◽  
Gastrointestinal Transit ◽  
Gastric Volume ◽  
Emission Computed Tomography ◽  
Nk1 Receptor ◽  
Double Blind ◽  
Nk1 Receptors ◽  
Healthy Humans

Aprepitant, an NK1 receptor antagonist, is approved for the treatment of chemotherapy-induced or postoperative emesis by blocking NK1 receptors in the brain stem vomiting center. The effects of NK1 receptors on gastric functions and postprandial symptoms in humans are unclear; a single, crossover study did not show a significant effect of aprepitant on gastrointestinal transit. Our aim was to compare, in a randomized, double-blind, placebo-controlled, parallel-group study (12 healthy volunteers per group), the effects of aprepitant vs. placebo on gastric emptying of solids (by scintigraphy) with a 320-kcal meal, gastric volumes (GVs; fasting and accommodation by single photon emission-computed tomography ), satiation [maximum tolerated volume (MTV)], and symptoms after a dyspeptogenic meal of Ensure. Aprepitant (125 mg on day 1, followed by 80 mg on days 2–5) or placebo, one tablet daily, was administered for 5 consecutive days. Statistical analysis was by unpaired rank sum test, adjusted for sex difference and body mass index. To assess treatment effects on symptoms, we incorporated MTV in the model. Aprepitant increased fasting, postprandial, and accommodation GV and tended to increase volume to fullness and MTV by ~200 kcal. However, aprepitant increased aggregate symptoms, nausea, and pain scores after ingestion the MTV of Ensure. There was no significant effect of aprepitant on gastric half-emptying time of solids. We conclude that NK1 receptors are involved in the control of GV and in determining postprandial satiation and symptoms. Further studies of the pharmacodynamics and therapeutic role of NK1 receptor antagonists in patients with gastroparesis and dyspepsia are warranted. NEW & NOTEWORTHY Aprepitant increases fasting, postprandial, and accommodation gastric volumes. Aprepitant increases volume to fullness and maximum tolerated volume during a nutrient drink test. NK1 receptors are involved in the control of gastric volume and in determining postprandial satiation and symptoms.

Neuroimaging and the Origin of Psychiatric Symptoms in Dementia

1997 ◽  
Vol 8 (S3) ◽  
pp. 239-243 ◽  
Author(s):  
David L. Sultzer
Keyword(s):  
Computed Tomography ◽  
Density Functional ◽  
Psychiatric Symptoms ◽  
Functional Neuroimaging ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Positron Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Neuroimaging studies have contributed greatly to our understanding of Alzheimer's disease and other dementias. Computed tomography and magnetic resonance imaging reveal brain structure and aid in the diagnostic evaluation of patients with cognitive impairment. Functional neuroimaging studies use positron emission tomography, single-photon emission computed tomography, and other methods to measure regional cerebral activity, including metabolic rate, blood flow, and neuroreceptor density. Functional neuroimaging results can be useful clinically and have also been used in a variety of research applications to examine physiologic variables in neuropsychiatric illnesses.

scholarly journals DL-3-n-butylphthalide improves cerebral hypoperfusion in patients with large cerebral atherosclerotic stenosis. A single-center, randomized, double-blind, placebo-controlled study.

2020 ◽  
Author(s):  
Dawei Chen ◽  
Yanwei Yin ◽  
Jin Shi ◽  
Fen Yang ◽  
Kehua Wang ◽  
...  
Keyword(s):  
Placebo Group ◽  
Single Photon ◽  
Photon Emission ◽  
Cerebral Hypoperfusion ◽  
Controlled Study ◽  
Emission Computed Tomography ◽  
Single Center ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Atherosclerotic Stenosis

Abstract Background: DL-3-n-butylphthalide (NBP) was demonstrated to increase the cerebral blood flow (CBF) in the animal models, but there are no clinic studies to verify this. We aimed to explore the effect of NBP on improving cerebral hypoperfusion caused by cerebral large-vessel stenosis. Methods: In this single-center, randomized, double-blind, placebo-controlled study, 120 patients with severe carotid atherosclerotic stenosis and cerebral hypoperfusion in the ipsilateral middle cerebral artery (MCA) were included and randomly assigned into NBP or placebo group as 1:1 radio. Patients in NBP or placebo group received 200mg or 20mg of NBP capsules three times daily for four weeks respectively. Single photon emission computed tomography (SPECT) was used to assess regional CBF (rCBF) in four regions of interest (ROIs) corresponding to MCA before and 12 weeks after the treatment. After therapy, the rCBF change for every ROI and the whole CBF change in MCA territory for every patient were classified into amelioration, stabilization and deterioration respectively. Results: 48 NBP patients (6 with bilateral stenosis) and 46 placebo patients (8 with bilateral stenosis) completed the trial. Overall, both groups had 54 stenotic carotid arteries and 216 ROIs for rCBF change analysis. After therapy, the rCBF in ROIs increased in NBP group (83.5%±11.4% vs. 85.8%±12.5%, p=0.000), whereas no change was found in placebo group (86.9%±11.6% vs. 87.8%±11.7%, p=0.331). Besides, there was higher percentages of ROIs with rCBF amelioration and stabilization in NBP group than in placebo group (93.1% vs. 79.2%, p=0.000). Furthermore, ordinal regression analysis showed that compared with placebo, NBP independently made more patients to have whole CBF amelioration in ipsilateral MCA (Wald-χ2=5.247, OR=3.31, p=0.022). Conclusions: NBP might improve the cerebral hypoperfusion in the patients with carotid artery atherosclerotic stenosis. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900028005, registered December 8th 2019- Retrospectively registered ( http://www.chictr.org.cn/index.aspx ).

Uptake of 99mTc-exametazime shown by single photon emission computed tomography before and after lithium withdrawal in bipolar patients: Associations with mania

1997 ◽  
Vol 170 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Guy M. Goodwin ◽  
Jonathan T. O. Cavanagh ◽  
M. F. Glabus ◽  
R. F. Kehoe ◽  
R. E. O'Carroll ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Brain Perfusion ◽  
Anterior Cingulate ◽  
Emission Computed Tomography ◽  
Manic Symptoms ◽  
Before And After ◽  
Bipolar Patients ◽  
The Relationship ◽  
Lithium Withdrawal

BackgroundEarly manic relapse following lithium discontinuation offers an important opportunity to investigate the relationship between symptoms, effects of treatment and regional brain activation in bipolar affective disorder.MethodFourteen stable bipolar patients on lithium were examined with neuropsychological measures, clinical ratings and single photon emission computed tomography (SPECT) before and after acute double-blind withdrawal of lithium. Brain perfusion maps were spatially transformed into standard stereotactic space and compared pixel-by-pixel. A parametric analysis was used to examine the change in brain perfusion on lithium withdrawal, and the relationship between symptom severity and brain perfusion separately both between and within subjects.ResultsLithium withdrawal was associated with an important redistribution of brain perfusion, with increases in inferior posterior regions and decreases in limbic areas, particularly anterior cingulate cortex. Seven of the 14 patients developed manic symptoms during the placebo phase, correlating with relative increases in perfusion of superior anterior cingulate and possibly left orbito-frontal cortex.ConclusionsThe important effect of lithium withdrawal on brain perfusion implies that after withdrawal of lithium, the brain develops an abnormal state of activity in limbic cortex. The structures involved did not co-localise with those apparently modulated by manic symptoms.

scholarly journals Chronological Changes in Brain Blood Flow and Central Benzodiazepine Receptor Binding Potential in a Patient with Symptomatic Epilepsy after Surgery for Aneurysmal Subarachnoid Hemorrhage: 123I-Iomazenil Single-Photon Emission Computed Tomography Studies

2017 ◽  
Vol 9 (3) ◽  
pp. 222-227
Author(s):  
Toshiyuki Murakami ◽  
Hiroshi Kashimura ◽  
Hidehiko Endo ◽  
Hiroki Kuroda ◽  
Kuniaki Ogasawara
Keyword(s):  
Receptor Binding ◽  
Single Photon ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Photon Emission ◽  
Benzodiazepine Receptor ◽  
Binding Potential ◽  
Emission Computed Tomography ◽  
Symptomatic Epilepsy ◽  
Central Benzodiazepine Receptor ◽  
Photon Emission Computed Tomography

Early 123I-iomazenil single-photon emission computed tomography (SPECT) images are correlated with blood flow in the brain, and late images are correlated with cortical benzodiazepine receptor binding potential. Reduced metabolism in the contralateral cerebral hemisphere is indicated by crossed cerebellar hypoperfusion (CCH). We present the case of a 63-year-old man who developed symptomatic epilepsy 13 days after surgery for an aneurysmal subarachnoid hemorrhage. Early images on 123I-iomazenil SPECT 2 days after seizure onset revealed CCH and hyperperfusion in the affected cerebral hemisphere where benzodiazepine receptor binding potential was reduced in late images on 123I-iomazenil SPECT. These abnormal findings resolved on repeated 123I-iomazenil SPECT 1 month after seizure onset. The case we present here is consistent with the idea that the central benzodiazepine receptor system in the human brain undergoes changes that are related to seizures due to epilepsy.

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