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Yuri Nakagawa

Publications and source records attributed to Yuri Nakagawa.

3 recordsLinked to original sources

Improvement of regional cerebral blood flow after oral intake of branched-chain amino acids in patients with cirrhosis.

AIM: To evaluate the effect of oral intake of branched-chain amino acids (BCAA) on brain perfusion in patients with liver cirrhosis. METHODS: Single photon emission computed tomography scans were performed in 43 patients with cirrhosis and in 15 age-matched healthy subjects. Twenty-nine out of forty-three patients were randomly treated with either BCAA granules or placebo, and single photon emission computed tomography was performed before and after the treatment. We measured the regional cerebral blood flow values using a three-dimensional stereotaxic region of interest template. RESULTS: Cirrhotic patients had regions of significant hypoperfusion in the bilateral central (right P=0.039, P<0.05; left P=0.006 P<0.01), parietal (right P=0.018, P<0.05; left P=0.009, P<0.01), angular (right P=0.039, P<0.05; left P 0.008, P<0.01), and left pericallosal segments (P=0.038 P<0.05) as compared with healthy subjects. A significant increase in cerebral perfusion was observed 70 min after the oral intake of BCAA in the angular (right P=0.012, P<0.05; left P=0.049, P<0.05), temporal (right P=0.012, P<0.05; left P=0.038, P<0.05), pericallosal segments (right P=0.025, P<0.05; left P=0.049, P<0.05) and left precentral (P=0.044, P<0.05), parietal (P=0.040, P<0.05) and thalamus (P=0.033, P<0.05). No significant change in perfusion was observed in the placebo group. CONCLUSION: Administration of BCAA rapidly improves cerebral perfusion.

Administration, Oral↗

Evaluation of cingulate gyrus blood flow in patients with liver cirrhosis.

Although neuropsychological tests are commonly applied to detect minimal hepatic encephalopathy (HE) in patients with liver cirrhosis (LC), they provide no information about the cerebral regions involved. Recently, it has been reported that some populations of alcoholic cirrhotics, with mild HE, have reduced cerebral metabolic rate for glucose in bifrontal cortices and in the anterior cingulate gyrus. We evaluated the degree of reduction in blood flow at the anterior cingulate gyrus and the frontal lobes in cirrhotic patients who underwent single photon emission computed tomography (SPECT). Data were obtained from 47 cirrhotic patients and 47 subjects without LC. Three radiologists unaware of the results of laboratory tests visually evaluated the transaxial, coronal, and sagittal views of SPECT. The area and the degree of blood flow reduction in the anterior cingulate gyrus and frontal lobes were scored. Reduced blood flow in the anterior cingulate gyrus was observed in most LC patients. In patients without overt HE, poor performance in neuropsychological tests was correlated with reduced cerebral blood flow in the anterior cingulate gyrus. Blood flow in the anterior cingulate gyrus as measured by SPECT may be a simple and good indicator of cerebral functional changes in patients with LC.

Aged↗

Single photon emission computed tomography and statistical parametric mapping analysis in cirrhotic patients with and without minimal hepatic encephalopathy.

OBJECTIVE: The early diagnosis and treatment of cognitive impairment in cirrhotic patients is needed to improve the patients' daily living. In this study, alterations of regional cerebral blood flow (rCBF) were evaluated in cirrhotic patients using statistical parametric mapping (SPM). The relationships between rCBF and neuropsychological test, severity of disease and biochemical data were also assessed. METHODS: 99mTc-ethyl cysteinate dimer single photon emission computed tomography was performed in 20 patients with non-alcoholic liver cirrhosis without overt hepatic encephalopathy (HE) and in 20 age-matched healthy subjects. Neuropsychological tests were performed in 16 patients; of these 7 had minimal HE. Regional CBF images were also analyzed in these groups using SPM. RESULTS: On SPM analysis, cirrhotic patients showed regions of significant hypoperfusion in the superior and middle frontal gyri, and inferior parietal lobules compared with the control group. These areas included parts of the premotor and parietal associated areas of the cortex. Among the cirrhotic patients, those with minimal HE had regions of significant hypoperfusion in the cingulate gyri bilaterally as compared with those without minimal HE. CONCLUSIONS: Abnormal function in the above regions may account for the relatively selective neuropsychological deficits in the cognitive status of patients with cirrhosis. These findings may be important in the identification and management of cirrhotic patients with minimal HE.

Aged↗