THE METABOLIC TOPOGRAPHY OF PARKINSONISM
THE METABOLIC TOPOGRAPHY OF PARKINSONISM
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DOI：
10.1038/jcbfm.1994.99
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发表时间：
1994-09-01
影响因子：
6.3
通讯作者：
FAHN, S
中科院分区：
文献类型：
--
作者：
EIDELBERG, D;MOELLER, JR;FAHN, S
我们使用[F-18]氟脱氧葡萄糖/正电子发射断层扫描（F-18-FDG/PET）和区域协变的统计模型来研究帕金森病患者的脑地形组织。我们研究了22例帕金森病（PD）患者，20例年龄匹配的正常志愿者，10例年龄和严重程度匹配的假定纹状体黑质变性（SND）患者。我们使用FDG/PET计算葡萄糖的整体、区域和标准化代谢率（GMR、rCMR（glc）、rCMR（glc）/GMR）。使用方差分析、多重比较校正和判别分析比较三组的代谢参数。将缩放子曲线模型（SSM）应用于合并的rCMR（glc）数据集，以确定区分PD患者与SND患者和正常人的地形协方差曲线。PD组GMR、rCMR（glc）和rCMR（glc）/GMR正常; SND组尾状核和豆状核rCMR（glc）/GMR降低（p < 0.01）。SSM分析的合并组的患者和正常人揭示了一个显着的地形轮廓，其特征是增加的代谢活动在豆状核和丘脑与活动减少的侧额叶，中央旁，下顶叶，顶叶枕区。与正常人和SND患者相比，PD患者的个体受试者评分显著升高（p < 0.001），并区分了三组。在PD组中，该因子的受试者评分与个体受试者Hoehn和Yahr（H&Y）评分相关（p < 0.02），与定量僵硬（p < 0.01）和运动迟缓（p < 0.03）评分相关，但与震颤评分无关。右-左代谢不对称性的SSM分析产生了一个地形对比曲线，该曲线准确地区分了轻度受累的PD患者（H&Y I期）与正常人。我们的研究结果表明，异常地形协方差配置文件存在于帕金森氏症。这些档案有潜在的临床应用作为帕金森症的神经影像学标记。
We used [F-18]fluorodeoxyglucose/positron emission tomography (F-18-FDG/PET) and a statistical model of regional covariation to study brain topographic organization in parkinsonism. We studied 22 patients with Parkinson's disease (PD), 20 age-matched normal volunteers, and 10 age- and severity-matched patients with presumed striatonigral degeneration (SND). We used FDG/PET to calculate global, regional, and normalized metabolic rates for glucose (GMR, rCMR(glc), rCMR(glc)/GMR). Metabolic parameters in the three groups were compared using an analysis of variance, with a correction for multiple comparisons, and discriminant analysis. The scaled subprofile model (SSM) was applied to the combined rCMR(glc) dataset to identify topographic covariance profiles that distinguish PD patients from SND patients and normals. GMR, rCMR(glc), and rCMR(glc)/GMR were normal in PD; caudate and lentiform rCMR(glc)/GMR was reduced in the SND group (p < 0.01). SSM analysis of the combined group of patients and normals revealed a significant topographic profile characterized by increased metabolic activity in the lentiform nucleus and thalamus associated with decreased activity in the lateral frontal, paracentral, inferior parietal, and parietooccipital areas. Individual subject scores for this profile were significantly elevated in PD patients compared with normals and SND patients (p < 0.001) and discriminated the three groups. In the PD group, subject scores for this factor correlated with individual subject Hoehn and Yahr (H&Y) scores (p < 0.02), and with quantitative rigidity (p < 0.01) and bradykinesia (p < 0.03) ratings, but not with tremor ratings. SSM analysis of right-left metabolic asymmetries yielded a topographic contrast profile that accurately discriminated mildly affected PD patients (H&Y Stage I) from normals. Our findings demonstrate that abnormal topographic covariance profiles exist in parkinsonism. These profiles have potential clinical application as neuroimaging markers in parkinsonism.