Essential tremor: clinical analysis and 99m Tc-ECD SPECT findings

• Main Authors: Cheng-Sue Chang, 張振書
• Other Authors: 沈戊忠
• Format: Others
• Language: en_US
• Online Access: http://ndltd.ncl.edu.tw/handle/13983580500065821756

碩士 === 中國醫藥學院 === 醫學研究所 === 91 === Essential tremor: clinical analysis and 99m Tc-ECD SPECT findings ABSTRACT Background Essential tremor (ET) is the most prevalent movement disorder. The diagnosis is based on clinical findings, and its treatment is mainly symptomatic. The pathogenesis of ET is unknown. Some pieces of evidence suggest that the olivo-cerebello-thalamo-cortical circuitry is pivotal for the development of essential tremor. Previous studies with positron emission tomography (PET) have revealed an alternation of the regional cerebral blood flow (rCBF) in ET patients. However PET is not universally available as compared with single photon emission computed tomography (SPECT). The aim of this study was to evaluate the potential usefulness of technetium-99m ethyl cysteinate dimer (99m Tc ECD) SPECT in detecting the possible alternation of brain perfusion in patients with ET. Methods In this study, 25 ET patients with normal findings on brain magnetic resonance imaging (MRI) were examined with a 99m Tc ECD SPECT of the brain to detect the status of the regional cerebral blood flow. Results Relative hypoperfusion was found in the thalamus, basal ganglia, temporal lobe, and frontal lobe. Among these spots, only the perfusion of the thalamic region contralateral to the more vigorous tremor side was found to be significantly diminished. No statistically significant difference was present in either the basal ganglia or the cerebellum. The decrease in rCBF was irrelevant to the tremor severity and duration of tremor. Conclusion Our study demonstrates that hypoperfusion of the thalamic region can be detected by 99mTc-ECD brain SPECT in patients with ET, which implies that the thalamus might be crucial for the generation or modulation of ET. In addition, the finding also strengthens the viewpoint that this SPECT technique is an appropriate and convenient tool for the investigation of ET or other sorts of tremor.