Authors: Eun Yeon Joo Seung Bong Hong Minjoo Lee Woo Suk Tae James Lee Suk Won Han KiHwan Ji Minah Suh
Publish Date: 2010/10/01
Volume: 258, Issue: 3, Pages: 366-372
Abstract
The aim of this study is to investigate regional cerebral blood flow rCBF in patients with syncope We compared brain single photon emission computed tomography SPECT images of neurally mediated syncope patients with those of age/sex matched healthy volunteers 99mTcethylcysteinate dimer ECD brain SPECT was performed in 35 patients M/F = 17/18 mean 366 years with syncope during the asymptomatic period and in 35 healthy volunteers For statistical parametric mapping SPM analysis all SPECT images were spatially normalized to the standard SPECT template and then smoothed using a 14mm full width at half maximum Gaussian kernel The mean duration of syncope history was 49 years and the mean number of syncope episodes was 63 In all patients syncope or presyncope episodes occurred during headup tilt tests and all were the vasodepressive type SPM analysis of brain SPECT images showed significantly decreased rCBF in the right anterior insular cortex left parahippocampal gyrus bilateral fusiform gyri bilateral middle and inferior temporal gyri left lingual gyrus bilateral precuneus and bilateral posterior lobes of the cerebellum in syncope patients at a false discovery rate corrected p 005 There were no brain regions that showed increased rCBF in syncope patients Furthermore we found a negative correlation between the total number of syncopal episodes and the rCBF of the right prefrontal cortex and between the duration of syncope history and the rCBF of the right cingulate gyrus at uncorrected p 0001 Decreases of rCBF in multiple brain regions may be responsible for autonomic dysregulation and improper processing of emotional stress in neurally mediated syncope patients and frequent syncope episodes may lead to frontal dysfuctionThis study was supported by a Grant 2010K000817 from Brain Research Center of the 21st Century Frontier Research Program funded by the Ministry of Education Science and Technology and by a grant of the Korean Health Technology RD Project Ministry for Health Welfare Family Affairs Republic of Korea No A090579
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