title: Regional cerebral blood flow changes in a patient with delusional parasitosis before and after successful treatment with risperidone: a case report.
abstract: The pathophysiology and appropriate pharmacological interventions for delusional parasitosis (DP) remain unknown. Here, we present a case of DP following brain infarction of the right temporoparietal region. Pharmacotherapy with risperidone resulted in a dramatic therapeutic response over a short period. In a sequential N-isopropyl-p-[(123)I]-iodoamphetamine single photon emission computed tomography ([(123)I]-IMP SPECT) study, post-treatment SPECT images revealed a marked increase of rCBF in the large areas including the bilateral frontal and left temporoparietal regions, the right parietal operculum and the bilateral basal ganglia, in contrast to pre-treatment SPECT images showing a global decrease of rCBF. Our clinical outcome suggests the efficacy and safety of risperidone for treatment of DP and that both dopaminergic and serotonergic dysfunction may play a role in DP. Our sequential SPECT findings suggest that psychiatric improvement of DP is associated with increased rCBF.
authors.affiliation: Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. jnaru@koto.kpu-m.ac.jp
authors.forename: Jin
authors.initials: J
authors.lastname: Narumoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueda
authors.forename: Hideto
authors.initials: H
authors.lastname: Tsuchida
authors.forename: Tatsuhisa
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yurinosuke
authors.initials: Y
authors.lastname: Kitabayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukui
mesh_terms: D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010272:Parasitic Diseases / Q000523:psychology*; D012039:Regional Blood Flow / Q000187:drug effects; D018967:Risperidone / Q000627:therapeutic use*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone