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The Psychological Refractory Period in Parkinson Disease (PD): Effects of Response Modality and Cognitive ComplexityReif, Angela Elizabeth 26 April 2018 (has links)
No description available.
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Effect of Parkinson Disease on Concurrent Speech and Manual Task PerformanceKriegel, Zoe, Kriegel 10 August 2018 (has links)
No description available.
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Quantification of postural stability in Parkinson's disease patients using mobile technologyOzinga, Sarah J. 16 December 2015 (has links)
No description available.
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Overgeneral autobiographical memory in Parkinson's diseaseSmith, Sarah J., Souchay, C., Conway, M.A. 27 August 2009 (has links)
No / Autobiographical memory (AM) concerns the ability to remember past events from one's own life and consists of autobiographical knowledge (personal facts) and autobiographical incidents (personal events). The novelty of this research was to assess both personal factual and personal event AM in Parkinson's disease (PD) for specified lifetime periods. An autobiographical fluency task was used in which participants were asked to recall personal events and personal facts from five separate lifetime periods. Previous findings as well the brain regions affected in PD lead to the hypothesis that Parkinson's patients would recall less autobiographical memories especially for the most recent lifetime periods. Sixteen non-demented and non-depressed Parkinson's patients and sixteen age-education-matched controls participated. The results showed a temporal gradient for the recall of personal events in Parkinson's patients as they recalled fewer events for recent time periods. The PD group also had more difficulties in recalling autobiographical events rather than an autobiographical knowledge. The difficulty in recalling autobiographical events was characterized by overgenerality, with PD patients failing to generate specific episodic memories.
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Distúrbios miccionais em pacientes com doença de Parkinson: associação entre parâmetros clínicos e urodinâmicos / Voiding disfunction in patients with Parkinson\'s disease: association between clinical and urodynamic parametersSammour, Zein Mohamed 07 May 2007 (has links)
INTRODUÇÃO E OBJETIVOS: Distúrbios miccionais são freqüentes em pacientes com doença de Parkinson, mas sua associação com parâmetros como idade do paciente, gênero, gravidade do comprometimento neurológico e duração da doença não é bem conhecida. Neste estudo, avaliamos prevalência e características dos sintomas miccionais em pacientes com doença de Parkinson e examinamos sua associação com parâmetros clínicos com potencial impacto sobre a disfunção miccional. MÉTODOS: Avaliamos prospectivamente 110 pacientes, incluindo 84 homens (76,4%) e 26 mulheres (23,6%), com idade média de 61,8 ± 9,6 anos. Os critérios de inclusão foram doença de Parkinson idiopática e idade acima de 40 anos. Pacientes com outras doenças neurológicas, história de cirurgia e radioterapia pélvica foram excluídos. A duração média da doença foi 12,3 ± 7,2 anos. O comprometimento neurológico foi avaliado pelas escalas Hoehn-Yahr (HY) e Escala Unificada de Avaliação da Doença de Parkinson (UPDRS). Os sintomas miccionais foram avaliados pelo questionário da Sociedade Internacional de Continência para Homens, incluindo uma questão de qualidade de vida relacionada a sintomas miccionais. Consideramos sintomáticos os pacientes que queriam tratamento para sua disfunção miccional. Estes foram avaliados com análise de urina, creatinina sérica, PSA, ultra-sonografia do aparelho urinário e urodinâmica. Avaliamos a associação da disfunção miccional com idade, gênero, tempo de duração da doença, grau de comprometimento neurológico, impacto na qualidade de vida e achados urodinâmicos. RESULTADOS: A avaliação neurológica demonstrou média de 3,0 ± 0,8 na escala de HY e 70,0 ± 31,1 na escala de UPDRS. A média do escore miccional foi de 11,9 ± 9,3 e os sintomas mais comuns foram noctúria em 89 (80,9%) pacientes, urgência em 40 (36,3%) e aumento da freqüência miccional em 39 (35,4%) pacientes. A duração média dos sintomas miccionais foi de 3,8 ± 3,4 anos. A prevalência da disfunção miccional aumentou significativamente com o aumento no grau de comprometimento neurológico, mas não com a idade nem com a duração da doença. A qualidade de vida relacionada aos sintomas miccionais foi afetada pela severidade da disfunção miccional e os sintomas de freqüência e noctúria são os de pior impacto na qualidade de vida. Sessenta e três pacientes (57,2%) eram sintomáticos e 54 (43 homens e 11 mulheres) completaram a avaliação. Os pacientes sintomáticos apresentaram disfunção neurológica mais severa (HY médio 3,2 ± 0,8 vs 2,8 ± 0,9 para os assintomáticos; p=0,035). A idade, a duração da doença e dos sintomas miccionais não diferiram entre sintomáticos e assintomáticos. O volume médio da próstata foi 30,3 ± 10,7 cc. Os achados urodinâmicos foram obstrução infravesical em 38 (70,3%) pacientes, hiperatividade detrusora em 27 (50,0%), e hipocontratilidade detrusora em seis (11,1%) pacientes. O grau de comprometimento neurológico não se associou com nenhum padrão urodinâmico. Na comparação entre homens e mulheres sintomáticos a única diferença observada foi a maior gravidade dos sintomas de esvaziamento nos homens. CONCLUSÕES: A maior parte dos pacientes com doença de Parkinson apresenta disfunção miccional significativa e a gravidade da doença neurológica é o principal fator preditivo para a ocorrência de disfunção miccional. Obstrução infravesical e hiperatividade detrusora são os achados urodinâmicos mais comuns, mas não estão associados com o grau de comprometimento neurológico. Homens e mulheres são similarmente afetados pelos sintomas miccionais e não demonstraram distinção quanto aos achados urodinâmicos. / INTRODUCTION AND OBJECTIVES: Voiding dysfunction often occurs in patients with Parkinsons disease, but its association with patients age, gender, degree of neurological impairment, and disease duration is not fully known. In this study, we assessed the prevalence and characteristics of lower urinary tract symptoms (LUTS) in patients with Parkinson\'s disease and examined their association with those clinical parameters that could have an impact on voiding dysfunction. METHODS: We prospectively evaluated 110 patients, of which 84 were men (76.4%) and 26 were women (23.6%), with a mean age of 61.8 ± 9.6 years. The inclusion criteria were: idiopathic Parkinsons disease and age > 40 years. Patients with other neurological diseases and history of pelvic surgery and radiotherapy were excluded. Mean duration of the disease was 12.3 ± 7.2 years. The neurological impairment was assessed by the Hoehn-Yahr scale (HY) and the Unified Parkinson Disease Rating Scale (UPDRS). Lower urinary tract symptoms were assessed by the International Continence Society male questionnaire, which included a question about quality of life related to LUTS. Those patients who wanted to be treated for their voiding dysfunction were considered as symptomatic. They underwent urine analysis, serum creatinine measurement, PSA, urinary tract imaging and urodynamic study. We examined the association between voiding dysfunction and age, gender, disease duration, degree of neurological impairment, impact on quality of life, and urodynamic findings. RESULTS: The neurological assessment showed a mean HY score of 3.0 ± 0.8 and a mean UPDRS score of 70.0 ± 31.1. Mean LUTS score was 11.9 ± 9.3, and the most prevalent symptoms were nocturia in 89 (80.9%) patients, urgency in 40 (36.3%), and frequency in 39 (35.4%). Mean duration of LUTS was 3.8 ± 3.4 years. The prevalence of voiding dysfunction increased significantly with the degree of neurological impairment, but not with patients age or disease duration. Quality of life was affected by the severity of the voiding dysfunction, and the symptoms with the worst impact on quality of life were frequency and nocturia. Sixty-three patients (57.2%) were symptomatic and 54 (43 men and 11 women) concluded the evaluation. Symptomatic patients had more severe neurological dysfunction (mean HY 3.2 ± 0.8 vs 2.8 ± 0.9 for asymptomatic patients; p=0.035). Symptomatic and asymptomatic patients did not differ as to age, disease duration and LUTS. Mean prostate volume was 30.3 ± 10.7 cc. The urodynamic findings were bladder outlet obstruction in 38 (70.3%) patients, detrusor overactivity in 27 (50.0%), and detrusor underactivity in 6 (11.1%). The degree of neurological impairment was not associated with any urodynamic pattern. The only difference observed between symptomatic men and women was that the voiding symptoms were more severe in men. CONCLUSIONS: Most patients with Parkinsons disease have significant voiding dysfunction, and the severity of the neurological disease is the main predictive factor for the occurrence of voiding dysfunction. Bladder outlet obstruction and detrusor overactivity are the most common urodynamic findings, although not associated with the degree of neurological impairment. Men and women are equally affected by LUTS and show similar urodynamic findings.
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"Can I trust you with my medicines?" : a grounded theory study of patients with Parkinson's disease perceptions of medicines managementDunsmure, Louise Charlotte January 2012 (has links)
Introduction: People with Parkinson's disease require individualised medication regimens to achieve symptomatic control whilst managing complications of the treatments and the underlying disease. Patients should continue to receive their individualised regimen when they are admitted to hospital but studies have highlighted that this may not happen. There is a paucity of research about patients' perceptions of the management of antiparkinsonian medicines during a hospital admission and the aim of this study was to explore the perceptions of Parkinson's disease patients admitted to Leeds Teaching Hospitals about the management of their antiparkinsonian medications.Method: Grounded theory methodology was used to allow detailed exploration of patients' perceptions and to generate theory about this under-researched area. Face to face, semi-structured interviews were conducted with 13 Parkinson's disease patients during their hospital admission, fully transcribed and analysed using the constant comparative approach. Results: Categories contributing to the core category of 'patient anxiety' were identified as 'maintaining usual medication routine', 'access to antiparkinsonian medications', 'accuracy and consistency', 'trust in healthcare professionals' and 'staff knowledge about Parkinson's disease'. Strategies used to manage the anxiety were related to the categories 'utilising expertise' in Parkinson's disease and 'patient involvement' in their care. Discussion: The theory suggests that some patients have negative perceptions about the management of their medicines during a hospital admission. Areas for practice development are presented along with areas for future research. Conclusion: This study provides new insight into the perceptions of patients with Parkinson's disease about the management of their medicines during a hospital admission.
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3D FUNCTIONAL MODELING OF DBS EFFICACY AND DEVELOPMENT OF ANALYTICAL TOOLS TO EXPLORE FUNCTIONAL STNKumbhare, Deepak 27 April 2011 (has links)
Introduction: Exploring the brain for optimal locations for deep brain stimulation (DBS) therapy is a challenging task, which can be facilitated by analysis of DBS efficacy in a large number of patients with Parkinson’s disease (PD). The Unified Parkinson's Disease Rating Scale (UPDRS) scores indicate the DBS efficacy of the corresponding stimulation location in a particular patient. The spatial distribution of these clinical scores can be used to construct a functional model which closely models the expected efficacy of stimulation in the region. Designs and Methods: In this study, different interpolation techniques were investigated that can appropriately model the DBS efficacy for Parkinson’s disease patients. These techniques are linear triangulation based interpolation, ‘roving window’ interpolation and ‘Monopolar inverse weighted distance’ (MIDW) interpolation. The MIDW interpolation technique is developed on the basis of electric field geometry of the monopolar DBS stimulation electrodes, based on the DBS model of monopolar cathodic stimulation of brain tissues. Each of these models was evaluated for their predictability, interpolation accuracy, as well as other benefits and limitations. The bootstrapping based optimization method was proposed to minimize the observational and patient variability in the collected database. A simulation study was performed to validate that the statistically optimized interpolated models were capable to produce reliable efficacy contour plots and reduced false effect due to outliers. Some additional visualization and analysis tools including a graphic user interface (GUI) were also developed for better understanding of the scenario. Results: The interpolation performance of the MIDW interpolation, the linear triangulation method and Roving window method was evaluated as interpolation error as 0.0903, 0.1219 and0.3006 respectively. Degree of prediction for the above methods was found to be 0.0822, 0.2986 and 0.0367 respectively. The simulation study demonstrate that the mean improvement in outlier handling and increased reliability after bootstrapping based optimization (performed on Linear triangulation interpolation method) is 6.192% and 12.8775% respectively. The different interpolation techniques used to model monopolar and bipolar stimulation data is found to be useful to study the corresponding efficacy distribution. A user friendly GUI (PDRP_GUI) and other utility tools are developed. Conclusion: Our investigation demonstrated that the MIDW and linear triangulation methods provided better degree of prediction, whereas the MIDW interpolation with appropriate configuration provided better interpolation accuracy. The simulation study suggests that the bootstrapping-based optimization can be used as an efficient tool to reduce outlier effects and increase interpolated reliability of the functional model of DBS efficacy. Additionally, the differential interpolation techniques used for monopolar and bipolar stimulation modeling facilitate study of overall DBS efficacy using the entire dataset.
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Synthèse et évaluation biologique de molécules neuroprotectrices pour le traitement de la maladie de parkinson / Synthesis and biological evaluation of neuroprotective molecules for the treatment of Parkinson diseaseLe Douaron, Gael 03 December 2013 (has links)
Ce manuscrit détaille la stratégie utilisée par nos laboratoires pour identifier de nouvelles molécules neuroprotectrices pour le traitement curatif de la maladie de Parkinson (MP). La MP est une maladie neurodégénérative caractérisée par des symptômes moteurs invalidants qui résultent de la dégénérescence des neurones dopaminergiques (DA) des noyaux gris centraux. Précédemment, nos laboratoires ont synthétisé et identifié au cours d’un criblage 3 molécules chefs de file qui possèdent un effet neurotrophique sur les neurones DA embryonnaires. Des études préliminaires d’ADMEtox nous ont permis de sélectionner la molécule SF41, un dérivé 6-aminoquinoxaline, pour une première évaluation de l’effet neuroprotecteur in vivo de nos molécules. En effet, cette molécule est bien tolérée chez l’animal et, administrée par voie orale, elle est capable de traverser la BHE. SF41 a montré un faible effet protecteur vis-à-vis des fibres DA dans un modèle animal de la MP. Dans le but d’augmenter l’activité neurotrophique de cette molécule, une 50ène de dérivés de seconde génération ont été synthètisés et criblés in vitro dans un modèle de mort spontanée des neurones DA. Ce criblage nous a permis d’identifier 5 molécules lead plus puisssantes et efficaces que SF41. Ces molécules, qui possédent les mêmes propriétés physico-chimiques que SF41, pourraient également atteindre le système nerveux central et ainsi conduire à un effet neuroprotecteur marqué dans un modèle animal de la MP. De plus, ces molécules possèdent un profil pharmacologique intéressant car elles sont capables d’empêcher la mise en place de mécanismes qui peuvent potentiellement contribuer à la mort des neurones DA dans la MP (stress oxydant, stress médié par les astrocytes, dyshoméostasie calcique, stress médié par la diminution en facteur trophique…). Une étude préliminaire avec la molécule PAQ, l’une de ces 5 molécules, a permis d’obtenir un effet neuroprotecteur dans un modèle in vivo de la MP qui semble supérieur à celui de la molécule SF41. Ces résultats encourageants nous donnent bon espoir d’obtenir la preuve de concept de l’activité neuroprotectrice de nos dérivés 6-aminoquinoxaline. / This manuscript describes the strategy used by our laboratories to identify new neuroprotective molecules for the therapy of Parkinson disease (PD). PD is a neurodegenerative disease characterized by disabling motor symptoms resulting from the degeneration of dopaminergic (DA) neurons of the basal ganglia. Previously, our laboratories have synthesized and identified in a screening 3 lead compound which exhibited a neurotrophic effect on embryonic midbrain DA neurons. Preliminary ADMEtox studies allowed us to select the molecule SF41, a 6-aminoquinoxaline derivative, for a first in vivo evaluation of the neuroprotective effect of our molecules in an animal model of PD. Indeed, SF41 is well tolerated in animals and is able of crossing the BBB after oral treatment. SF41 showed a weak protective effect on DA fibers in an animal model of PD.In order to increase the neurotrophic activity of this molecule, around fifty second generation derivatives were synthesized and screened in vitro in a model of spontaneous death of DA neurons. This screening allowed us to identify five lead compounds more powerful and effective than SF41. These molecules, which possess the same physico-chemical properties that SF41, could also reach the central nervous system and lead to a marked neuroprotective effect in an animal model of PD. In addition, these molecules have an interesting pharmacological profile because they are able to prevent the establishment of mechanisms that can potentially contribute to the death of DA neurons in PD (oxidative stress, stress mediated by astrocytes, calcium dyshomeostasis, stress mediated by trophic factor deprivation...).A preliminary study with the molecule PAQ, one of these five molecules, yielded a neuroprotective effect in animal model of PD that seems higher than with SF41. These encouraging results give us hope to achieve proof of concept of the neuroprotective activity of our 6-aminoquinoxaline derivatives.
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Eficácia e importância da avaliação clínica da deglutição / Effectiveness and importance of clinical evaluation of swallowingSantos, Luciana Avila dos 03 June 2015 (has links)
O corpo humano executa uma determinada função ao se alimentar, a qual promove a condução do alimento ao estômago. Esta função é denominada deglutição. A deglutição pode ser afetada, pela falta de secreção salivar, por processos mecânicos que dificultam a passagem do bolo, ou pela fraqueza das estruturas musculares responsáveis pela disfunção da rede neuronal que coordena e controla a deglutição, e também pela propulsão do bolo alimentar. A dificuldade na deglutição ou disfagia, geralmente reflete problemas que envolvem a transição esofagogástrica, a cavidade oral, faringe e esôfago. Esta disfagia pode trazer alguns problemas ao indivíduo, como entrada de alimento na via aérea, na qual provocam problemas pulmonares, tosse, sufocação/ asfixia ou aspiração. Além disso, traz danos relacionados ao estado nutricional do indivíduo, como perda de peso, desidratação e até mesmo morte. A disfagia orofaríngea neurogênica pode ser causada por doenças neuromusculares degenerativas, encefalopatias, demências, traumas de cabeça ou pescoço, ou acidente vascular cerebral (AVC). A avaliação clínica da deglutição, tem como objetivo identificar alterações da fisiologia da dinâmica da deglutição, fornecer a necessidade ou não de exames objetivos, identificar as fases comprometidas, o grau de severidade, a classificação da disfagia, enfim, colher informações que possam auxiliar num diagnóstico e conduta terapêutica mais adequada. Este estudo teve como objetivo descrever a eficácia e importância da avaliação clínica da deglutição, tendo como referência a avaliação objetiva da deglutição (nasolaringofibroscopia), em pacientes com disfagia orofaríngea neurogênica, com diagnóstico de Acidente Vascular Cerebral (Isquêmico ou Hemorrágico), Doença de Alzheimer e Doença de Parkinson. Foram avaliados 35 pacientes, 6 do gênero feminino e 29 do gênero masculino, que apresentaram a faixa etária de 52-82 anos. A avaliações foram realizadas no mesmo dia, sendo feita primeiramente a avaliação clínica seguindo protocolo proposto por Silva (2004) e posteriormente a avaliação nasofibroscópica da deglutição, seguindo protocolo proposto por Langmore et al (1988); Aviv et al (1998); Macedo Filho (2003). Ocorreram coincidências entre os achados dos resultados da avaliação clínica da deglutição, tendo como padrão a avaliação nasofibroscópica. Houve uma forte correspondência e associação entre as escalas da avaliação clínica e nasofibroscópica. Com base nos achados adquiridos neste estudo, conclui-se que a avaliação clínica da deglutição deve ser realizada no paciente com disfagia orofaríngea neurogênica, pois o fonoaudiólogo pode determinar um diagnóstico adequado, classificar a disfagia quanto ao tipo e grau de severidade; detectar os problemas durante a deglutição; auxiliar na conduta terapêutica; determinar qual via de alimentação e determinar quais manobras específicas da deglutição podem ser utilizadas no paciente avaliado. / The human body performs a certain function by feeding, which promotes driving of the food to the stomach. This is called swallowing. Swallowing can be affected by the lack of saliva secretion, by mechanical means which hinder the passage of the bolus, or muscle weakness of the structures responsible for the dysfunction of the neuronal network that coordinates and controls swallowing, and also by propulsion of the bolus. The difficulty in swallowing or dysphagia, generally reflects problems involving the esophagogastric junction, oral cavity, pharynx and esophagus. This dysphagia may bring some trouble to the individual, such as food intake in the air, which cause lung problems, coughing, choking / suffocation or aspiration. Furthermore, brings harm related to the nutritional status of the individual, such as weight loss, dehydration and even death. The neurogenic oropharyngeal dysphagia can be caused by degenerative neuromuscular diseases, encephalopathy, dementia, head trauma or neck, or stroke. Clinical evaluation of swallowing, aims to identify physiological changes of the swallowing dynamics, provide the necessity of objective tests, identify compromised phases, the degree of severity, dysphagia classification, finally, gather information that can help a diagnosis and improve treatment. This study aimed to describe the effectiveness and importance of clinical evaluation of swallowing, with reference to the objective evaluation of swallowing (nasolaringofibroscopia) in patients with neurogenic oropharyngeal dysphagia, with a diagnosis of stroke (ischemic or hemorrhagic), Alzheimer\'s Disease and Parkinson\'s disease. We evaluated 35 patients, 6 females and 29 males, who presented the age group of 52-82 years. The evaluations were performed on the same day, being first made the following clinical evaluation protocol proposed by Silva (2004) and later the nasofibroscopy swallowing, following the protocol proposed by Langmore et al (1988); Aviv et al (1998); Macedo Filho (2003). There were similarities between the findings of the results of the clinical evaluation of swallowing, and defaults to nasofibroscopy. There was a strong correlation and association between the scales of clinical and nasofibroscopy. Based on the findings obtained in this study, it is concluded that the clinical evaluation of swallowing should be performed in patients with neurogenic oropharyngeal dysphagia because the audiologist can determine a proper diagnosis, sort dysphagia on the type and severity; detect problems during swallowing; support therapeutic conduct; determine which power via determine which specific maneuvers of swallowing can be used in the patient assessed.
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Avaliação comparativa dos diferentes métodos de quantificação de imagens de SPECT com 99mTc: um estudo de validação utilizando um fantoma antropomórfico estriatal / Comparative assessment of the different quantification methods of SPECT image with Tc-99m: a validation study using an anthropomorphic striatal phantomSantos, Leonardo Alexandre 10 November 2015 (has links)
OBJETIVO: A imagem molecular de transportadores de dopamina (DAT) oferecer uma informação diferencial na investigação de doenças neurodegenerativas, como a Doença de Parkinson, diante de uma sólida abordagem quantitativa. Porém, são diversos o número de diferentes métodos semiquantitativos aplicados na prática clínica, que nos quais podem produzir resultados distintos quando aplicados por diferentes avaliadores ou condições de avaliação da imagem de SPECT do corpo estriado. Logo, este estudo pode avaliar a acurácia, precisão e reprodutibilidade de diferentes métodos semiquantitativos de imagens de SPECT do corpo estriado. MATERIAIS E MÉTODOS: Foram realizadas 23 aquisições de SPECT utilizando um simulador antropomórfico estriatal preenchido com diferentes concentrações de atividade de 99mTc. A preparação deste simulador estriatal foi realizada a partir de concentrações de atividades nas cavidades de interesse (núcleo caudado, putâmen e corpo estriado) proporcionalmente maiores do que a da cavidade de referência (background). As imagens foram reconstruídas utilizando parâmetros ideais já protocolados. Cinco métodos baseados em ROIs, dedicados para a quantificação de SPECT do corpo estriado foram avaliados: ROIs desenhadas sobre as imagens de SPECT - (A) Manual, ROIs com dimensões padronizadas - (B) método Twobox e (C) método Threebox; e baseado em imagens estruturais (D) MRI e (E) CT. A acurácia de cada método aplicado foi avaliada através do coeficiente de correlação de concordância (CCC), sua precisão utilizando o coeficiente de Pearson e modelos regressão linear, assim como a reprodutibilidade pode ser investigada através de análises de variabilidade intra- e interobservadores. RESULTADOS: Tanto para as cavidades avaliadas de forma individual (Caudado e Putâmen), quanto para o corpo estriado como um todo, todos os métodos aplicados apresentaram um aumento no CCC dos índices quantificados diante de uma diminuição dos valores nominais de preenchimento. Os métodos D e E apresentaram os máximos valores de CCC na avaliação do núcleo caudado _ 0,89 baixo MRI CA CCC ? e _ 0,84 baixo CT CA CCC ? ) e putâmen ( _ 0,86 baixo MRI PU CCC ? e _ 0,82 baixo CT PU CCC ? ). Entretanto, na avaliação do corpo estriado, o método B apresentou a máxima acurácia dentre os cinco aplicados ( _ 0,95 baixo TWOBOX ST CCC ? ). A significante correlação entre os métodos foi evidenciada por um elevado coeficiente de correlação (r > 0.8). Na avaliação da reprodutibilidade intra e interobservadores uma grande variabilidade foi observada na aplicação do método A, principalmente quando aplicada na semiquantificação de baixas concentrações de atividade. Conclusão: Os cinco métodos semiquantitativos de SPECT do corpo estriado, demonstraram ser eficientes na realização de leituras proporcionais dos índices de BPI mesmo quando aplicados a imagens de diferentes concentrações de atividade. Porém, diante de investigações que necessitem de um processo de quantificação mais acurado e visando avaliar putâmen e núcleo caudado de forma isolada, os métodos estruturais (MRI e CT), demonstraram uma crescente eficiência em representar acurados parâmetros semiquantitativos diante da diminuição dos índices nominais de preenchimento. Na investigação de todo o corpo estriado e carente de qualquer informação estrutural, o método TwoBox passa a ser recomendado devido sua melhor performance diante todos os métodos avaliados. / AIM: The molecular image of dopamine transporters (DAT) gives differential information in research of neurodegenerative diseases, such as Parkinson\'s, when properly approached quantitatively. Yet, each method used in clinical routine may give, or not, different results when the quantifications are applied in images of several activity levels. Hence, this study assessed the accuracy, precision and reproducibility of striatum SPECT images semi-quantification methods, based in ROIs. METHODOLOGY: Twenty-three SPECT images were acquisitions of anthropomorphic striatal phantom filled with different activity concentrations of 99mTc. For each acquisition performed, the specific chambers (caudate and putamen chambers) to large chamber (simulating nonspecific background activity) was filled with solutions activity of different specific to nonspecific ratios (10, 8, 6, 4 and 2 to 1). The images were reconstructed by iterative algorithm, corrected to attenuation effects and the extracted values were analyzed by the specific binding ratio (SBR). Five semi-quantification methods for striatum SPECT, using ROIs was assessment: (A) draw freehand ROIs on SPECT image (manual); standard size ROIs: (B) TwoBox and (C) ThreeBox Methods and VOIs using structural images: (D) MRI and (E) CT. Accuracy of methods applied was assessed by concordance correlation coefficient (CCC) and precision by Pearson\'s coefficient and linear regression. RESUlTS: The SBR quantified both to individual specific chambers and striatal chamber analyzed to all methods applied resulted in a CCC increase with decrease of the nominal values used. For lower SBR values, the D and E methods evidenced the maximum values of CCC in assessment of caudate (CCCMRI_CA = 0.89 e CCCCT_CA = 0.84) and putamen (CCCMRI_PU = 0.86 e CCCCT_PU = 0.82). However, striatal assessments the B method highlights a maximum accuracy between all methods applied (CCCTWOBOX_ST = 0.95), for low values of SBR. A high Pearson\'s coefficient was found in the correlation between the all methods, report thereby a good precision between them (r > 0.8). The high ICC and variability values, showed a high reprodutibility intra- and interobserver for B, C and D methods, white the A and E methods presented a high variability between the raters. CONCLUSION: The five semi-quantification methods of striatum SPECT reported a high precision even when applied in images with activity solutions different. Therefore, to research much accurate and need to assessment just caudate or putamen individually the structural methods - MRI and CT - demonstrated progressive improvement in its quantification to reduction nominal fill index. To assessment striatal chamber and in the absence of structural information, the TwoBox method is advisable due to its excellent agreement with all nominal values when compared to the various semi-quantitative methods investigated. Keywords:
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