J Korean Neuropsychiatr Assoc.  2001 Jan;40(1):98-108.

Cerebral Perfusion Assessed with 99m-Tc-ECD-SPECT in Childrens with Attachment Disorder

• Cheon KA
• Lee KS
• Shin YJ

Abstract

OBJECTIVES
This study aimed to reveal that severe disturbance of attachment relationship with primary care-giver can affect functional brain development by measuring with technetium-99m ethyl cysteinate dimer brain single-photon emission tomography.
METHODS
Subjects were 12 children aged 2-6 years who met the diagnostic criteria of reactive attachment disorder. Diagnostic tools were DSM-IV, ICD-10, Strange Situation Procedure(SSP), Vineland Social Maturity Sclae(SMS), and Childhood Autism Rating Scale(CARS). Brain SPECT was performed in all sbjects and each SPECT scan was visually assessed by two nuclear medicine specilalists.
RESULTS
Eleven of 12 children had abnormal brain perfusion on SPECT scans, revealing focal areas of decreased perfusions. Perfusion of thalamus was decreased in 10 subjects decreased perfusion of left thalamus(6/10), right thalamus(1/10), and both thalami(3/10). Perfusion of basal ganglia was decreased in 5 children. Four children had decreased perfusion of thalamus as well as of basal ganglia. Decreased perfusion of parietal area was noted in only one child on SPECT scan. All subjets had normal perfusion of frontal, temporal, occipital, cerebellar areas on SPECT scan.
CONCLUSIONS
Perfusion abnormalities involving thalamus, basal ganglia in most children with attachment disorder were found in this study. These results suggest that brain development of infant could be impeded by severe pathologic care and early nurturing environment would be important for normal brain development.

Keyword

Attachment disorder; 99m-Tc-ECD-SPECT; Cerebral perfusion

MeSH Terms

Autistic Disorder
Basal Ganglia
Brain
Child*
Diagnostic and Statistical Manual of Mental Disorders
Humans
Infant
International Classification of Diseases
Nuclear Medicine
Perfusion*
Rabeprazole
Reactive Attachment Disorder
Thalamus
Tomography, Emission-Computed, Single-Photon