title: Functional brain imaging in Sydenham's chorea and streptococcal tic disorders.
abstract: Group A streptococcal infections cause a wide range of neuropsychiatric disorders, such as Sydenham's chorea, tics, obsessive-compulsive disorders, and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Structural (computed tomography and magnetic resonance imaging) and functional (positron emission tomography, single-photon emission computed tomography) imaging studies in patients with Sydenham's chorea have suggested reversible striatal abnormalities. The objective of this study was to investigate the cerebral perfusion patterns of the subcortical structures by using hexamethylpropylenamine oxime single-photon emission computed tomography (HMPAO-SPECT) in seven cases of Sydenham's chorea and two cases of streptococcal tic disorder. HMPAO-SPECT studies revealed a hyperperfusion pattern in two and a hypoperfusion pattern in five of the chorea patients and in two patients with tic disorder. The results are discussed in relation to the duration and severity of the symptoms and the response to therapy. Functional imaging findings can be variable in Sydenham's chorea, and hyperperfusion of the striatum and thalamus could be an indicator of the response to therapy and the severity of symptoms. However, the number of cases so far investigated by either SPECT or positron emission tomography is still too limited to draw any firm conclusions.
authors.affiliation: Department of Pediatric Neurology, Gazi University Medical Faculty, Ankara, Turkey.
authors.forename: Elvan Caglar
authors.initials: EC
authors.lastname: Citak
authors.forename: Kivilcim
authors.initials: K
authors.lastname: Gücüyener
authors.forename: Nese Ilgin
authors.initials: NI
authors.lastname: Karabacak
authors.forename: Ayşe
authors.initials: A
authors.lastname: Serdaroğlu
authors.forename: Cetin
authors.initials: C
authors.lastname: Okuyaz
authors.forename: Kurşad
authors.initials: K
authors.lastname: Aydin
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002648:Child; D002819:Chorea / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes; D013981:Tic Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology