Silent cortical neuronal damage in atherosclerotic disease of the major cerebral arteries.
Silent cortical neuronal damage in atherosclerotic disease of the major cerebral arteries.
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DOI：
10.1038/jcbfm.2010.176
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发表时间：
2011-03
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--
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中科院分区：
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在动脉粥样硬化性颈内动脉（ICA）或大脑中动脉（MCA）疾病中，血流动力学损害可能导致选择性神经元损伤，表现为正常大脑皮层中枢苯二氮卓受体（BZRs）的丧失，而不会出现明显的中风发作。为了研究动脉粥样硬化性ICA或MCA无症状患者皮质BZRs下降与血流动力学损害的关系，以及血管紧张素受体阻滞剂（ARBs）对这些受体的影响，我们使用正电子发射断层扫描和11c -氟马西尼测量了79例无症状动脉粥样硬化性ICA或MCA疾病且无皮质梗死的患者的BZRs。使用三维立体定向表面投影来计算BZR指数，这是衡量大脑皮层在MCA分布内异常下降的BZR的指标。多元回归分析表明，该指标与氧提取分数值、有无无症状皮质下梗死、有无缺血性心脏病呈正相关，而与arb治疗高血压呈负相关。在无症状的动脉粥样硬化性ICA或MCA疾病中，血流动力学损害与选择性神经元损伤相关，表现为非梗死大脑皮质皮质BZRs的减少，而ARBs与皮质BZRs的保留有关。
In atherosclerotic internal carotid artery (ICA) or middle cerebral artery (MCA) disease, hemodynamic compromise may cause selective neuronal damage manifested as loss of central benzodiazepine receptors (BZRs) in the normal-appearing cerebral cortex, without overt episode of stroke. To investigate the association of decreases in cortical BZRs with hemodynamic compromise and the effect of angiotensin receptor blockers (ARBs) on these receptors in patients whose atherosclerotic ICA or MCA disease is asymptomatic, we measured BZRs using positron emission tomography and 11C-flumazenil in 79 patients with asymptomatic atherosclerotic ICA or MCA disease and no cortical infarction. Three-dimensional stereotactic surface projections were used to calculate the BZR index, a measure of abnormally decreased BZRs in the cerebral cortex within the MCA distribution. Multiple regression analysis showed this index to be positively correlated with the value of oxygen extraction fraction, with the presence of silent subcortical infarcts, and with the presence of ischemic heart disease, whereas it was negatively correlated with the treatment of hypertension with ARBs. In asymptomatic atherosclerotic ICA or MCA disease, hemodynamic compromise is associated with selective neuronal damage manifested as decreases in cortical BZRs in the noninfarcted cerebral cortex, whereas ARBs are associated with preservation of cortical BZRs.
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影响因子：
1.3
作者：
Okazawa, H;Yamauchi, H;Yonekura, Y
通讯作者：
Yonekura, Y
影响因子：
9.9
作者：
Powers, WJ;Derdeyn, CP;Grubb, RL
通讯作者：
Grubb, RL
影响因子：
8.3
作者：
SETTE, G;BARON, JC;MACKENZIE, ET
通讯作者：
MACKENZIE, ET
影响因子：
4.3
作者：
Kakkos, Stavros K.;Sabetai, Michael;Nicolaides, Andrew N.
通讯作者：
Nicolaides, Andrew N.
影响因子：
11.2
作者：
POWERS, WJ
通讯作者：
POWERS, WJ