The object of the scientific study decides the process of the study to the researcher, and the next step defines every step in the scientific observation and understanding of the object. We believe it was not spontaneous to proceed from the assessment of biogenic amines in dystonic patients to their PET sample. We discovered that the most competent leader in this exploration, Dr. Thomas Chase, had made the same transition from chromatography to PET, evaluating the previous investigations done in the field. Therefore the inner scientific rationale unites two sections of our chapter together as biochemical analysis of plasma and urine is done through direct biochemical study of the brain of the patient, biochemical conception of dystonia is achieved.
In our initial studies, we reported enhanced serotonin exchange in dystonia. More sophisticated statistical analysis methods, such as decision tree and discrimination analysis, were later applied to that data, and these advanced methods allowed us to develop new powerful diagnostic tests for dystonia diagnosis[1,2]. In the first part of our chapter, we’re talking about these new approaches and their effects.
The findings of the PET research of 18-FDG brain patients with dystonia and critical tremor were published in 2010 (ET). The findings of the percentage change in glucose metabolism were presented in semi-quantitative form, without comparison with safe controls. The calculation was carried out using the SPM2 software package in the MATLAB v. 6.1 software environment installed on a personal computer (OS Windows 2000). Initially, on the basis of the above research methods, we reported that we had shown a decrease in glucose metabolism in all patients in various brain regions, and that the analysis failed to identify any difference between the dystonia group and the ET group. Subsequently, the Benefit Workstation of the same tomograph used for the analysis was fitted with a Cortex ID software package that enables PET brain visualisation to be examined compared to control group scans.
In the Z score equation, this programme calculates the effects of such a comparison. Recounting the previous data using the Z score equation confirmed hypometabolism in both dystonia and ET groups, but contrary to the previous findings, the disparity between these 2 patient groups was observed in certain brain areas. In clinical characteristics, the two nosological types overlap and are difficult to distinguish. We are suggesting in the second part of our chapter that the PET image might provide the clue for differential diagnosis in dealing with the biochemical difference in the exchange of dopamine (DA) revealed by us in this community of patients before.
Dr. V. Belenky
Arsvita Clinic, St. Petersburg, Russia.
Neurology Department, North-Western State Medical University Named after I. I. Mechnikov, St. Petersburg, Russia.
Russian Research Center for Radiology and Surgical Technologies, St. Petersburg, Russia.
Department of Pedagogies, Philosophy and Law, North-Western State Medical University Named after I. I. Mechnikov, St. Petersburg, Russia.
Department of Medical Informatics and Physics, North-Western State Medical University named after I. I. Mechnikov, St. Petersburg, Russia.
Institute of Applied Analytical Biochemistry, St. Petersburg, Russia.
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