OBJECTIVES: Obsessive-compulsive(OC) symptoms have yet to be directly studied in neurodegenerative conditions involving behavioral changes. To examine regional abnormalities in the brains of dementia patients with OC symptoms, we assessed the gray matter density using voxel-based morphometry(VBM). METHODS: We performed brain magnetic resonance imaging(MRI) with VBM analysis in 106 dementia patients with OC behaviors. In this study, OC behaviors were investigated in patients with neurodegenerative disease using the modified Manchester Behavior Questionnaire. RESULTS: The OC behavior scores were correlated with structural brain volume using VBM. The total OC symptom score correlated negatively with the volume of both putamens, the right middle orbitofrontal gyrus, both anterior cingulate cortices, and the left insula(p<0.001, uncorrected). No gray matter reductions were associated specifically with the OC symptom sub-categories. CONCLUSIONS: Our results suggest that abnormalities in these brain regions may play an important role in the pathophysiology of OCD in neurodegenerative disease. This is the first lesion study to investigate the neural basis of OCD behaviors in neurodegenerative disease.
Brain ; Dementia ; Humans ; Neurodegenerative Diseases* ; Putamen ; Questionnaires

Hemichorea have been reported in patients with nonketotic hyperglycemia. Usually, hemichorea and hyperglycemia are concomitant. A 73-year-old woman was admitted for investigation of an acute hemichorea. T1-weighted brain magnetic resonance imaging showed hyperintensity in the right putamen. Although she was a diabetic patient, she had no hyperglycemia. Interestingly, 4 weeks earlier, the patient was admitted due to nonketotic hyperglycemia. However, there were no hemichorea at that time. Although pathophysiologically controversial, a delayed hemichorea without nonketotic hyperglycemia should be considered as one of many different causes when evaluating acute hemichorea in diabetic patients.
Aged ; Brain ; Chorea ; Female ; Humans ; Hyperglycemia* ; Magnetic Resonance Imaging ; Putamen

Transient memory impairment can be occurred by many causes. One of them is acute focal brain lesion in strategic site. Caudate nucleus and medial basal ganglia (globus pallidus) are lesion of strategic site. They play its role in cognitive processing. But lateral basal ganglia (putamen) is known as a structure involving movement, not cognitive function. We report a interesting case of transient memory dysfunction with acute focal putamen ICH with old caudate nucleus infarction.
Basal Ganglia ; Brain ; Caudate Nucleus ; Infarction ; Intracranial Hemorrhages ; Memory ; Putamen

OBJECTIVE: Auditory hallucinations (AHs) are a core symptom of schizophrenia. We investigated the neural signature of AHs by comparing hallucinating patients with schizophrenia with non-hallucinating patients with schizophrenia. METHODS: We recruited hallucinating patients with schizophrenia meeting the criteria for persistent, prominent, and predominant AHs (n=10) and non-hallucinating patients with schizophrenia (n=12). Various clinical assessments were performed incluing Psychotic Symptom Rating Scale for Auditory Hallucinations. Using fludeoxyglucose (¹⁸F) positron emission tomography, regional differences in neural activity between the groups were analyzed. RESULTS: The regions of interest analysis showed significantly lower standardized uptake value ratio (SUVR) in the superior, middle, and inferior frontal gyri, and higher SUVR in the putamen in patients with AHs versus patients without AHs. These findings were confirmed in the voxel-wise analysis. CONCLUSION: Our findings indicate that hypoactivity in the frontal and cingulate gyri, coupled with hyperactivity in the temporal gyrus and putamen, may contribute to the pathophysiology of AHs.
Electrons* ; Hallucinations* ; Humans ; Positron-Emission Tomography* ; Putamen ; Schizophrenia* ; Temporal Lobe

Paralimbic association area in the temporal pole is situated between sensory association areas and the limbic regions and has direct connections with these areas and the ventral striatum. Corticostriatal connections of paralimbic association area in the temporal pole were studied with particular emphasis on specific projections of the ventral striatum to identify different contributions to the functional outcome of the ventral striatum. Retrograde tracers were injected into the five different regions of the ventral striatum such as the ventromedial caudate nucleus, ventral shell, central shell, dorsal core of the nucleus accumbens (NA), and ventrolateral putamen to identify the labeled cells of origin. Present results indicate that the temporal pole has specifically dense projections to the ventral shell of NA. This differential pattern of corticostriatal connectivity suggests that ventral shell region of ventral striatum is preferentially involved in the convergence of sensory and limbic stimulus to motivational and emotional states.
Basal Ganglia ; Caudate Nucleus ; Nucleus Accumbens ; Primates* ; Putamen

BACKGROUND AND PURPOSE: The aim of this paper was to investigate the utility of 18F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography (PET) for evaluating the severity of Parkinson's disease (PD) according to various clinical stages, and to identify the relationship between the striatal substructure and the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, cognitive symptoms through 18F-FP-CIT PET. METHODS: We retrospectively identified 542 patients with various clinical stages of PD who underwent an 18F-FP-CIT PET at our clinics. The difference between the 18F-FP-CIT PET according to the Hoehn-Yahr stage, correlation between 18F-FP-CIT PET and the UPDRS III grouped motor items, and the Korean Mini-Mental State Examination (K-MMSE) were investigated. RESULTS: As disease progressed, the right caudate and both the anterior putamen and caudate/putamen ratios exhibited a significantly lower uptake. The uptake of all striatal substructures was significantly correlated with the UPDRS total motor score. The right caudate nucleus was significantly related to both the UPDRS tremor items and the right UPDRS akinesia-rigidity items. The left caudate nucleus was related to both the UPDRS tremor items and UPDRS akinesia-rigidity items. The right anterior putamen was related to the axial items, right tremor and akinesia-rigidity items; while the left anterior putamen was related to the right tremor and right akinesia-rigidity items. Both of the posterior putamens were related to the axil items, left tremor and left akinesia rigidity items. K-MMSE was not significantly related to any striatal substructures. CONCLUSIONS: The UPDRS total motor score was significantly correlated with the uptake of all striatal substructures. However, the 18F-FPCIT uptake in specific striatal substructures was rather complexly correlated with the UPDRS motor grouped items and was not significantly related to K-MMSE. These results suggest the possibility of the complex pathophysiology of motor symptoms of PD and limitation of 18F-FPCIT PET for the evaluation of the severity of PD motor and cognitive symptoms.
Caudate Nucleus ; Electrons* ; Humans ; Neurobehavioral Manifestations* ; Parkinson Disease* ; Positron-Emission Tomography* ; Putamen ; Retrospective Studies ; Tremor

BACKGROUND: A silent period (SP), recorded with transcranial magnetic stimulation (TMS) reflects the cortical inhibition of the central motor pathway. In most previous reports involving unilateral cerebral lesions, prolonged cortical SPs recorded with TMS on the affected side compared with SPs on the contralateral hemisphere were observed. However, in only a few studies, a shortened SP has been observed. In the present study, we assumed a shortened SP mechanism in the association with stoke. METHODS: We studied cortical SPs of both first dorsal interossei muscles evoked by TMS in 21 normal subjects and 13 patients with single focal cerebral lesions (lacunar infarct or small hemorrhage). We divided lesions into two groups with prolonged and shortened SP. Interside differences of SP recorded in both groups were compared with that of normal subjects. RESULTS: Shortened SP was observed in 3 thalamic, 3 motor cortical, and 1 caudate nucleus head lesions. Four thalamic and 2 putamenal lesions showed prolonged SP. In patients with thalamic lesions, SPs were shortened in ventrolateral thalamic lesions and prolonged in dorsomedial lesions. Interside differences of both the shortened and prolonged groups were 85.8+/-47.6 msec, and 99.3+/-49.7 msec, respectively (normal control, 7.3+/-5.9 msec). CONCLUSIONS: These results suggest that shortened SP is related to anatomical sites of lesions including motor cortex, caudate nucleus, and ventrolateral thalamus. Divergent results obtained from thalamic lesions also suggest that the thalamocortical pathway plays a significant role in cortical SP induced by TMS.
Caudate Nucleus ; Head ; Humans ; Motor Cortex ; Muscles ; Putamen ; Stroke* ; Thalamus ; Transcranial Magnetic Stimulation*

The simultaneous occurrence of intracerebral hemorrhages in different arterial territories is an uncommon clinical event. The authers report a case of simultaneous bilateral intracerebral hemorrhages treated with stereotactic aspiration. A 64-year-old male presented with simultaneous bilateral intracerebral hemorrhages in the both putamens. The hematomas were demonstrated by computed tomography performed after a few hours of onset. The patient underwent computed tomography-guided stereotactic aspiration but he finally became vegetative state. Most of patients reported previously usually have unfavorable functional outcome and high mortality because of the severe neurological deficits. Therefore, the role of the surgical treatment in case of bilateral intracerebral hemorrhages should be surveyed closely in according to clinical state. The authors describe a case of simultaneous bilateral intracerebral hemorrhages and with discussion focused in the predisposing factors, pathogenesis and therapeutic approach.
Causality ; Cerebral Hemorrhage* ; Hematoma ; Humans ; Male ; Middle Aged ; Mortality ; Persistent Vegetative State ; Putamen

PURPOSE: To determine whether 1H magnetic resonance spectroscopy (MRS) is useful in differentiating idiopathic Parkinson's disease (IPD) from progressive supranuclear palsy (PSP), based on metabolite ratios. MATERIALS AND METHODS: Using a 1.5 T MR Unit, single voxel 1H MRS using STEAM with a TR of 2000ms and a TE of 135ms was performed in seven PD and eight PSP patients. Five age-matched volunteers(mean age, 63 years) andanother five younger healthy volunteers(mean age, 30 years) were studied as normal controls. The regions of interest were the putamen and pallidum, with a size of 2 X 2 X 2cm. After measuring the spectral intensities ofeach metabolite (N-acetylaspartate=NAA, choline=Cho, creatine=Cr and lactate), relative peak height ratios ofNAA/Cr, Cho/Cr and Naa/Cho, and lactate levels among four groups were compared. ESULTS: NAA/Cho and NAA/Crratios were statistically lower in the PSP group than the IPD group (1.21 +/-0.26 versus 1.45 +/-0.20, and 1.26 +/-.23 versus 1.38 +/-0.19, respectively : p<0.05). NAA/Cho and NAA/Cr ratios were significantly lower inage-matched controls than in younger normal controls (1.39 +/-0.21 versus 1.76 +/-0.15, and 1.36 +/-0.13 versus1.79 +/-0.17, respectively : p<0.05). However, NAA/Cho and NAA/Cr ratios between age-matched controls and IPD werenot significantly different (p>0.05). Cho/Cr ratios were not different among four groups. Lactate was not detectedin any patients. CONCLUSION: NAA/Cho and NAA/Cr ratios in the corpus striatum were significantly lower in the PSP group than in the age-matched control and IPD groups. These results suggest that loss of neuron cells in thecorpus striatum is more prominent in PSP than in IPD, and that NAA/Cho and NAA/Cr ratios may help in differential diagnosis of IPD and PSP.
Corpus Striatum ; Humans ; Lactic Acid ; Magnetic Resonance Spectroscopy* ; Neurons ; Parkinson Disease* ; Putamen ; Steam ; Supranuclear Palsy, Progressive*

OBJECTIVE: In humans, a single exposure to phencyclidine (PCP) can induce a schizophrenia-like psychosis which can persist for up to two weeks. In rats, an acute dose of PCP increases dopaminergic activity and causes changes in dopamine related behaviours some of which are sexually dimorphic. To better understand the effects of PCP on dopamine receptor adaptations in the short term we examined dopamine D1-like receptors (D1R) and D2-like receptors (D2R) in the mesolimbic and nigrostriatal dopamine pathways, 4 hours after exposure to PCP in female rats. METHODS: Animals received a single dose of 40 mg/kg PCP and were sacrificed 4 hours later. In vitro autoradiography was carried out using [3H] SCH 23390 and [3H] raclopride that target D1R and D2R respectively, in cryostat brain sections. RESULTS: Two way analysis of variance (ANOVA), revealed an overall effect of PCP treatment (F [1,63]=9.065; p=0.004) on D1R binding with an 18% decrease (p<0.01) in binding in the medial caudate putamen. PCP treatment also had an overall effect on D2R binding (F [1,47]=5.450; p=0.024) and a trend for an increase in D2R binding across all the brain regions examined. CONCLUSION: These results suggest opposing D1R and D2R adaptations in striatal subregions of female rats following acute exposure to PCP that may occur through indirect mechanisms.
Animals ; Autoradiography ; Benzazepines ; Brain ; Dopamine ; Female ; Humans ; Phencyclidine ; Psychotic Disorders ; Putamen ; Raclopride ; Rats ; Receptors, Dopamine