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Nuklearmedizin 2002; 41(06): 233-239
DOI: 10.1055/s-0038-1625294
Editorial
Schattauer GmbH

PET in patients with clear-cut multiple chemical sensitivity (MCS)

PET bei Patienten mit klar definierter multipler chemischer Sensibilität (MCS)
S. Bornschein
1   Toxikologische Abteilung der II. Medizinischen Klinik und Poliklinik (Leitender Arzt: Prof. Dr. Thomas Zilker)
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Hans Förstl)
,
C. Hausteiner
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Hans Förstl)
,
A. Drzezga
3   Nuklearmedizinische Klinik und Poliklinik (Direktor: Prof. Dr. Markus Schwaiger) der Technischen Universität München, Klinikum rechts der Isar, München
,
P. Bartenstein
4   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. Peter Bartenstein), Universitätsklinikum Mainz, Deutschland
,
M. Schwaiger
3   Nuklearmedizinische Klinik und Poliklinik (Direktor: Prof. Dr. Markus Schwaiger) der Technischen Universität München, Klinikum rechts der Isar, München
,
H. Förstl
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Hans Förstl)
,
Th. Zilker
1   Toxikologische Abteilung der II. Medizinischen Klinik und Poliklinik (Leitender Arzt: Prof. Dr. Thomas Zilker)
› Author Affiliations
Further Information

Publication History

Eingegangen: 12 November 2001

06 September 2002

Publication Date:
11 January 2018 (online)

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Summary

Aim: Multiple chemical sensitivity (MCS) is a controversially discussed symptom complex. Patients afflicted by MCS react to very low and generally nontoxic concentrations of environmental chemicals. It has been suggested that MCS leads to neurotoxic damage or neuroimmunological alteration in the brain detectable by positron emission tomography (PET) and single photon emission computer tomography (SPECT). These methods are often applied to MCS patients for diagnosis, although they never proved appropriate. Method: We scanned 12 MCS patients with PET, hypothesizing that it would reveal abnormal findings. Results: Mild glucose hypometabolism was present in one patient. In comparison with normal controls, the patient group showed no significant functional brain changes. Conclusion: This first systematic PET study in MCS patients revealed no hint of neurotoxic or neuroimmuno-logical brain changes of functional significance.

Zusammenfassung

Ziel: Multiple chemische Sensibilität (MCS) ist ein umstrittenes Krankheitsbild, das durch Reaktionen auf geringe, für Normalpersonen unschädliche Mengen an Umweltchemikalien gekennzeichnet ist. Es wurde postuliert, dass MCS zu neurotoxischer Schädigung bzw. neuroimmunologischer Veränderung im Gehirn führt, die mittels funktioneller bildgebender Verfahren, z.B. Positronenemissionstomographie (PET), Single-Photon-Emissions-Computer-Tomographie (SPECT) dargestellt werden könnte. Obwohl hierfür kein wissenschaftlicher Beleg erbracht wurde, werden diese Methoden vielfach diagnostisch bei MCS-Patienten eingesetzt. Methode: Wir untersuchten 12 MCS-Patienten mit PET, um etwaige funktionelle Hirnveränderungen nachzuweisen. Ergebnisse: Im Einzelvergleich war bei einem Patienten ein diskreter Glukose-Hypometabolismus in einzelnen Hirnregionen vorhanden. Im Gruppenvergleich konnte keine signifikante Abweichung von der Norm gefunden werden. Schlussfolgerung: Diese erste systematische PET-Studie bei MCS-Patienten erbrachte keinen Hinweis auf nachweisbare funktionelle Hirnveränderung bei diesen Patienten.

Keywords

Multiple Chemical Sensitivity - PET - SPECT - brain changes

Schlüsselwörter

Multiple chemische Sensibilität - PET - SPECT - Hirnveränderungen
 

  • Literatur

  • 1 Adamec RE, Stark-Adamec C. Limbic kindling and animal behavior – implications for human psychopathology associated with complex partial seizures. Biol Psychiatry 1983; 18: 269-93.
    PubMedGoogle Scholar
  • 2 Altenkirch H, Hopman D, Brockmeier B. et al. Neurological investigations in 23 cases of pyre-throid intoxication reported to the German Federal Health Office. Neurotoxicology 1996; 17: 645-52.
    PubMedGoogle Scholar
  • 3 Bartenstein P, Grünwald F, Herholz K. et al. Rolle der Positronen-Emissions-Tomographie (PET) und Single-Photon-Emissions-Tomographie (SPECT) bei der sogenannten »Multiple Chemical Sensitivity«. Nuklearmedizin 1999; 38: 1-5.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Bartenstein P, Minoshima S, Hirsch C. et al. Quantitative assessment of cerebral blood flow in patients with Alzheimer’s disease by SPECT. J Nucl Med 1997; 38: 1095-101.
    PubMedGoogle Scholar
  • 5 Bell IR, Miller CS, Schwartz GE. An olfactory limbic model of multiple chemical sensitivity syndrome: Possible relationships to kindling and affective spectrum disorders. Biol Psychiatry 1997; 32: 218-42.
    Google Scholar
  • 6 Black DW, Rathe A, Goldstein RB. Environmental illness. A controlled study of 6 subjects with “20th century disease”. J Am Med Assoc 1990; 264: 3166-70.
    CrossrefGoogle Scholar
  • 7 Blaschko S, Zilker Th, Förstl H. Idiopathic environmental intolerances (IEI) – früher multiple chemical sensitivity (MCS) – aus psychiatrischer Sicht. Fortschr Neurol Psychiatr 1999; 67: 175-87.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Bornschein S, Hausteiner C, Zilker T. et al. Psychiatrische und somatische Morbidität bei Patienten mit vermuteter Multiple Chemical Sensitivity (MCS). Nervenarzt 2000; 71: 737-44.
    CrossrefPubMedGoogle Scholar
  • 9 Brodsky CM. “Allergic to everything”: A medical subculture. Psychosomatics 1993; 24: 731-42.
    Google Scholar
  • 10 Callender TJ, Morrow L, Subramanian K. et al. Three dimensional brain metabolic imaging in patients with toxic encephalopathy. Env Res 1993; 60: 296-319.
    Google Scholar
  • 11 Dresel S, Schwenzer K, Brinkbäumer K. et al. [F-18]FDG imaging of head and neck tumors: comparison of hybrid PET, dedicated PET and CT. Nuklearmedizin 2001; 40: 172-8.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Drzezga A, Arnold S, Minoshima S. et al. [F-18]-FDG-PET Studies in patients with extratemporal and temporal epilepsy: Evaluation of an observer-independent analysis. J Nucl Med 1999; 40: 737-46.
    PubMedGoogle Scholar
  • 13 Fincher CE, Chang TS, Harell EH. et al. Comparison of single photon emission computed tomography findings in cases of healthy adults and solvent-exposed adults. Am J Ind Med 1997; 32: 4-14.
    Google Scholar
  • 14 Fincher CE, Chang TS, Harell EH. et al. Comparison of single photon emission computed tomography findings in cases of healthy adults and solvent-exposed adults: correction of previous results. Am J Ind Med 1997; 32: 693-4.
    CrossrefPubMedGoogle Scholar
  • 15 Franzblau A, Minoshima S, Robins TG. et al. Re: Comparison of single photon emission computed tomography findings in cases of healthy adults and solvent-exposed adults. Am J Ind Med 1997; 32: 695-701.
    CrossrefPubMedGoogle Scholar
  • 16 Friston KJ, Holmes AP, Worsley KJ. et al. Statistical parametric maps in functional imaging: a general linear approach. Hum Brain Mapp 1995; 2: 189-210.
    Google Scholar
  • 17 Haslinghuis-Bajan LM, Hooft L, van Lingen A. et al. Rapid evaluation of FDG imaging alternatives using head-to-head comparisons of full ring and gamma camera based PET scanners: a systematic review. Nuklearmedizin 2002; 41: 208-13.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Herholz K. Möglichkeiten und Grenzen der Positronen-Emissions-Tomographie (PET) bei neurotoxischer Schädigung. Arbeitsmed Sozialmed Präventionsmed 1992; 8: 321-4.
    Google Scholar
  • 19 Heuser G. Veränderte Gehirnaktivitäten nach neurotoxischer Exposition. Funktionelle Gehirn-Bildgebung mit SPECT und PET. Z Umweltmed 1999; 7: 12-5.
    Google Scholar
  • 20 Heuser G, Mena I, Alamos F. NeuroSPECT findings in patients exposed to neurotoxic chemicals. Toxicol Ind Health 1994; 10: 561-71.
    PubMedGoogle Scholar
  • 21 IPCS. Report of Multiple Chemical Sensitivities (MCS) Workshop. Berlin, Germany, 21-23 February 1996. International Programme on Chemical Safety (IPCS) in collaboration with the German Federal Ministry of Health, Federal Institute for Health Protection of Consumers and Veterinary Medicine (BgVV) and the Federal Environmental Agency (UBA); PCS/ 96. 29, August 1996.
    Google Scholar
  • 22 Ishii K, Willoch F, Minoshima S. et al. Statistical brain mapping of 18F-FDG PET in Alzheimer’s disease: validation of anatomic standardization for atrophied brains. J Nucl Med 2001; 42: 548-57.
    PubMedGoogle Scholar
  • 23 Labouvie S, Müller K. Dopamin-D2-Rezeptoren bei Parkinson-Syndrom toxischer Genese. Nuklearmedizin 1999; 38: A80.
    Article in Thieme ConnectGoogle Scholar
  • 24 Levine SA, Reinhardt JH. Biochemical pathology initiated by free radicals, oxidant chemicals and therapeutic drugs in the etiology of chemical hypersensitivity diseases. Orthomol Psych 1983; 12: 166-83.
    Google Scholar
  • 25 Mayberg H. Critique: SPECT studies of multiple chemical sensitivity. Toxicol Ind Health 1994; 10: 661-6.
    PubMedGoogle Scholar
  • 26 McGovern JJ, Lazaroni JA, Saifer P. Clinical evaluation of the major plasma and cellular measures of immunity. Orthomol Psych 1983; 12: 60-71.
    Google Scholar
  • 27 Minoshima S, Berger KL, Lee KS. et al. An automated method for rotational correction and centering of three-dimensional functional brain images. J Nucl Med 1992; 33: 1579-85.
    PubMedGoogle Scholar
  • 28 Minoshima S, Frey KA, Koeppe RA. et al. A diagnostic approach in Alzheimer’s disease using three-dimensional stereotactic surface projections of fluorine-18-FDG-PET. J Nucl Med 1995; 36: 1238-48.
    PubMedGoogle Scholar
  • 29 Minoshima S, Koeppe RA, Frey KA. et al. Anatomic standardization: linear scaling and nonlinear warping of functional brain images. J Nucl Med 1994; 35: 1528-37.
    PubMedGoogle Scholar
  • 30 Minoshima S, Koeppe RA, Frey KA. et al. Stereotactic PET atlas of the human brain: aid for visual interpretation of functional brain images. J Nucl Med 1994; 35: 949-54.
    PubMedGoogle Scholar
  • 31 Neuhann HF, Hodapp V, Reinschmidt U. Umweltbesorgnis bei Klienten einer umweltmedizinischen Beratungsstelle. Gesundheitswesen 1996; 58: 477-81.
    PubMedGoogle Scholar
  • 32 Randolph TG. The specific adaptation syndrome. J Lab Clin Med 1956; 48: 934-9.
    Google Scholar
  • 33 Randolph TG. Human Ecology and Susceptibility to the Chemical Environment. Spring-field/Il.: Thames Publishing Co.; 1962
    Google Scholar
  • 34 Rea WJ. Chemical Sensitivities. Vol 1. Boca Raton/FL: Lewis Publ.; 1992
    Google Scholar
  • 35 Rea WJ. Chemical Sensitivities. Vol 2. Sources of Body Load. Boca Raton/FL: Lewis Publ.; 1994
    Google Scholar
  • 36 Rea WJ. Chemical Sensitivities. Vol 3. Clinical Manifestations of Body Load. Boca Raton/FL: CRC Press; 1996
    Google Scholar
  • 37 Rea WJ. Chemical Sensitivities. Vol 4. Diagnostic and Treatment Practices. Boca Raton/FL: CRC Press; 1996
    Google Scholar
  • 38 Salvaggio JE, Terr AI. Multiple chemical sensitivity, multiorgan dysesthesia, multiple symptom complex, and multiple confusion: Problems in diagnosing the patient presenting with unexplained multisystemic symptoms. Crit Rev Toxicol 1996; 26: 617-31.
    CrossrefPubMedGoogle Scholar
  • 39 Scholtyssek G. SPECT und Neurotoxikologie. Protokoll zum Expertengespräch am 18. 02. 1994 in der Landesunfallkasse Hamburg. Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW) und Landesunfallkasse Freie und Hansestadt Hamburg (Hrsg) 1994.
    Google Scholar
  • 40 Simon GE, Daniell W, Stockbridge H. et al. Immunologic, psychological and neuropsycho-logical factors in multiple chemical sensitivity. A controlled study. Ann Intern Med 1993; 119: 97-103.
    CrossrefPubMedGoogle Scholar
  • 41 Staudenmayer H, Selner JC, Buhr MP. Double-blind provocation chamber challenges in 20 patients presenting with “multiple chemical sensitivity”. Regul Toxicol Pharmacol 1993; 18: 44-53.
    CrossrefPubMedGoogle Scholar
  • 42 Stewart DE, Raskin J. Psychiatric assessment of patients with “20th-century disease” (total allergy syndrome). Can Med Assoc J 1985; 133: 1001-6.
    Google Scholar
  • 43 Talairach J, Tournoux P. Co-Planar Stereotaxic Atlas of the Human Brain: 3-Dimensional Proportional System: An Approach to Cerebral Imaging. Stuttgart: Thieme; 1988
    Google Scholar
  • 44 Thrasher JD, Broughton A, Madison R. Immune activation and autoantibodies in humans with long term inhalation exposure to formalde-hyde. Arch Environ Health 1990; 45: 217-23.
    CrossrefPubMedGoogle Scholar
  • 45 Vojdani A, Ghoneum M, Braubar N. Immune alteration associated with exposure to toxic chemicals. Toxicol Ind Health 1992; 8: 239-53.
    CrossrefPubMedGoogle Scholar
  • 46 Zimny M, Wildberger JE, Cremerius U. et al. Combined image interpretation of computed tomography and hybrid PET in head and neck cancer. Nuklearmedizin 2002; 41: 14-21.
    Article in Thieme ConnectPubMedGoogle Scholar