title: Brain perfusion SPECT and EEG findings in children with autism spectrum disorders and medically intractable epilepsy.
abstract: OBJECTIVE
  We performed brain perfusion single-photon emission computed tomography (SPECT) to detect the abnormal brain region in children with both autism spectrum disorders (ASD) and medically intractable epilepsy.
  
  
  METHODS
  Fifteen children aged 4-16 years underwent multimodal examinations (MRI, interictal and/or ictal ECD-SPECT, EEG and MEG) to investigate their indications for surgical treatment. All children were diagnosed with ASD according to DSM-IV criteria and intractable epilepsy. Despite medical treatment for more than a year, all experienced at least one seizure per month. All had no underlying basic disorders. Each SPECT result was statistically analyzed by comparing with standard SPECT images obtained from our institute (easy Z-score imaging system; eZIS). The relationship between the eZIS pattern and EEG abnormalities or clinical symptoms was investigated.
  
  
  RESULTS
  All children showed focal abnormal patterns on eZIS and focal spikes on EEG. In all children, eZIS revealed a mixed hypoperfusion pattern, especially in the prefrontal cortex, medial frontal cortex, anterior cingulate cortex, medial parietal cortex, and/or anterior temporal cortex. In seven of 12 children who underwent interictal SPECT studies, areas of hypoperfusion were related to the focus observed on EEG; in six children, the focal EEG spikes represented areas of hyperperfusion. The children were divided into two groups according to the main type of hypoperfusion patterns seen on eZIS; medial-cingulate type and temporal type. No significant relationship was observed between the areas of hypoperfusion and clinical symptoms. eZIS showed the epileptic focus clearly on ictal SPECT.
  
  
  CONCLUSIONS
  SPECT was useful to detect the abnormal brain region not only in searching for the epileptic focus but also in assessing the low or high functioning region of the brain.
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan. masasaki@ncnp.go.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sasaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Nakagawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugai
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Ayako
authors.initials: A
authors.lastname: Hattori
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nonoda
authors.forename: Noriko
authors.initials: N
authors.lastname: Sato
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002675:Child, Preschool; D003545:Cysteine / Q000031:analogs & derivatives; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine