Aims:In order to confirm the utility of the voxelbased specific regional analysis system for Alzheimer's disease (VSRAD) in assessing the atrophy of the entorhinal cortex, we investigated whether there were correlations between VSRAD and the scores of neuropsychological tests in the patients with Alzheimer's disease (AD) and mild cognitive impairment.Methods: Thirty patients, including 18 AD and 12 mild cognitive impairment patients, were included in this study. VSRAD was performed to assess the atrophy of the entorhinal cortex. The patients were carefully screened with the neuropsychological tests, including Wechsler Adult Intelligence Scale-III (WAIS-III), the Wechsler Memory Scale-Revised, the Alzheimer's Disease Assessment Scale-Cognitive Part (ADAS-cog) and the revised version of Hasegawa's Dementia Scale.Results: All patients showed atrophy with different degrees in the entorhinal cortex except one case. Z-scores had significant positive correlation with ADAS-cog, and negative correlation with Information subset of WAIS-III (respectively, P = 0.0129 and P = 0.0294). The revised version of Hasegawa's Dementia Scale and the Similarities subsets of the WAIS-III had a tendency of negatively correlating with Z-scores of VSRAD (respectively, P = 0.0532 and P = 0.0635). The Delayed Visual Reproduction subset of the Wechsler Memory Scale-Revised was also found to have a weak negative correlation with Z-scores (P = 0.0609).Conclusions: Z-scores of VSRAD were revealed to have a close relation with many neuropsychological tests, especially ADAS-cog and the Information subset of WAIS-III. The results meant that VSRAD was a useful indictor of early diagnosis of AD, closely correlating with the changes of cognitive functions and the progression of the disease.

Steady-state visual evoked potentials (steady-state VEPs) from pattern-reversal stimulations were compared in treated schizophrenic patients and normal subjects matched for sex and age. The VEP amplitudes were more variable in the patients than in the controls. Furthermore, the VEP amplitudes of the patients mostly showed little or no change when the check size was varied, in contrast to the controls who showed a marked check size effect. These results suggest that schizophrenics receiving drugs have dysfunction of the visual system, especially an inability to respond adequately to changes of visual information.

Aims:The purpose of the present study was to investigate whether there were correlations between atrophy of the entorhinal cortex and individual regional cerebral blood flow (rCBF) in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (MCI) to better clarify the relationships between morphological and functional changes in AD.Methods: Twenty-six patients including sixteen AD and 10 amnestic MCI patients were enrolled. Z scores of voxel-based specific regional analysis system for AD (VSRAD) were determined to assess the degree of atrophy of the entorhinal cortex. Single-photon emission computed tomography (SPECT) and 3-D stereotaxic region of interest template (3DSRT) were used to quantify absolute rCBF.Results: The Z scores of the entorhinal cortex were found to have significant negative correlations with the absolute rCBF in the bilateral hippocampus, thalamus and temporal regions. A negative correlation between Z scores and rCBF of the cerebellum region, especially on the right side, was also noted.Conclusions: Atrophy of the entorhinal cortex had an obvious functional relationship with rCBF changes in the hippocampus, thalamus, temporal lobe and cerebellum in AD and MCI patients, which was attributed to their close anatomical and physiological connections.Key words: Alzheimer's disease, entorhinal cortex, mild cognitive impairment, regional cerebral blood flow, voxel-based specific regional analysis system for Alzheimer's disease. A LZHEIMER'S DISEASE (AD) is a neurodegenerative disorder characterized by progressive cognitive functional decline and behavioral disturbances, and remains the most common type of dementia. The entorhinal cortex, a portion of the anterior parahippocampus gyrus, is considered to be the prime site of neuropathological changes in the earliest stages of AD.1 The size of the entorhinal cortex was shown to be a useful index to discriminate patients with mild AD from healthy controls, as well as being a sensitive predictor of conversion to AD in traditional regions of interest (ROI) studies of magnetic resonance imaging (MRI).2 The atrophy rate in the entorhinal cortex has been found to be higher than that of the hippocampus, consistent with the view that AD pathology begins in the entorhinal cortex. Previous MRI studies were based on ROI analysis, which is, however, both time-consuming and observer dependent. Recently, a new method of voxel-based morphometry (VBM) has been developed and has overcome many of the limitations of ROI analysis, automatically mapping any gray matter loss on a voxel-by-voxel basis after anatomic standardization based on statistical parametric mapping (SPM).4 VBM confirmed temporal lobe atrophy in AD, and it was reported to be more accurate than ROI-based analysis for discriminating mild to moderate AD patients from controls. 5,6 Subsequently,

A patient with a 7-year history of depression relapsed after self-discontinuation of antidepressant drugs. He was admitted to our hospital and re-administered amoxapine 150 mg. p.0. per day, and further given haloperidol 5 mg i.m. or p.0. per day because he was suicidal and excited. One month later, an area of alopecia was found on the back of his head. Immediately, he received dermatological treatment. The psychotropic drugs were continued, but the hair loss was unchanged after one month. So, haloperidol alone was discontinued. One week later, the hair loss had stopped and a month later alopecia had virtually disappeared. We suggest that alopecia areata is associated with haloperidol.

Changes in brain images with single photon emission computed tomography (SPECT) using ^99mTc hexamethylpropyleneamine oxime (HMPAO) before and after therapy with oxygen under high pressure (OHP) were measured in a 66-year-old man with the interval form of carbon monoxide (CO) poisoning by a new technique, i.e., subtraction of brain images. This study was performed 187 days after acute CO poisoning, in a state of chronic akinetic mutism that followed a lucid interval. A diffuse, but frontal-dominant, hypoperfusion pattern involving both the gray and white matter was observed in the pre-OHP SPECT image. After OHP, regional cerebral blood flow increased in both the gray and white matter and markedly increased in the frontal cortical regions. The present finding suggests that OHP is effective against the chronic state of the interval form of CO poisoning.