Objective ‐ To clarify how chronic solvent abuse affects cognitive function using magnetic resonance imaging as an index of brain damage. Material and methods ‐ A total of 25 chronic solvent abusers underwent magnetic resonance imaging with quantitative neurometry and Wechsler Adult Intelligence Scales revised. Results ‐ The abusers with white matter change (n=10) showed significantly (P < 0.05) lower performance IQ, especially in Digit Symbol subtest (P<0.01). Also, the severity of pontine atrophy was significantly correlated with PIQ (r=0.60, P<0.01). Conclusions ‐ These data indicate that solvent abuse causes the decline in the test performance reflecting cognitive and fine motor dysfunction and that white matter changes and pontine atrophy may have some roles in this decline.

We examined the brain activation induced by a complex ®nger movement task using functional magnetic resonance imaging (fMRI) with echo planar imaging (EPI). Imaging planes were set up for the observation of non-primary motor areas. Among ®ve normal males examined, four subjects naive to the task showed activations in contralateral primary and supplementary motor areas and the ipsilateral superior anterior part of the cerebellar hemisphere. Also, the bilateral premotor areas and the contralateral ventrolateral nucleus of thalamus were occasionally activated. No changes were observed in the putamen and globus pallidus. The subject accustomed to the task showed activation in the narrow areas of the contralateral primary motor and supplementary motor and premotor areas but not in the cerebellum. These results suggest that fMRI has nearly the same degree of detectability to that of positron emission tomography (PET) in regard to motor functions.

Key wordsThree case reports of morbidly obese patients (two women and a man) who underwent vertical banded gastropIasty and who subsequently fell into depression, are presented here. The psychiatric diagnosis according to DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised), the eating pattern before obesity surgery, the past history of mental disorder, social adaptation before surgery, psychological gain from their obese state, and the presence of unrealistic expectations of obesity surgery were investigated. Case I was diagnosed postoperatively as having a major depressive episode without a personality disorder. Case 2 was diagnosed postoperatively as having a major depressive episode. Case 3 had a depressive disorder not otherwise specified. Cases 2 and 3 had a social phobia with comorbidity of personality disorders. Binge eating disorder was confirmed in all patients before obesity surgery. There were differences between case I and cases 2 and 3 based on the presence of personality disorder and the time of onset of depression. When some psychiatric characteristics are confirmed in obese patients, obesity surgery should be undertaken more prudently because the patients may manifest depression postoperatively. The preoperative psychiatric assessment is essential for a decision on indication of obesity surgery. binge eating disorder, depression, obesity surgery, personality disorder.

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The purpose of this study was to investigate T2 changes in the central nervous system of solvent misusers and to validate a classification of white matter changes (restricted, intermediate and diffuse) proposed in our previous study by visual inspection of magnetic resonance images. T2 values were calculated from the intensity measurements at nine regions in the brain of eight solvent misusers, six of whom showed white matter changes on MRI (two patients for each type), compared with age and gender-matched controls. The misusers with white matter changes on MRI showed significantly prolonged T2 in the centrum semiovale (p= 0.002), periventricular white matter (p= 0.016), internal capsule (p= 0.040), and cerebellar white matter surrounding the dentate nucleus (p= 0.001) and shortened T2 in the thalamus (p= 0.025) compared to controls by ANOVA with post hoc comparison of Scheffe. In addition, each type of white matter changes showed different distribution of T2 changes corresponding to the findings from visual inspection. These results confirmed T2 prolongation in the white matter with T2 shortening in the thalamus of solvent misusers with white matter changes, and provided further support for our classification of white matter changes.