POSITRON EMISSION TOMOGRAPHY STUDY IN PROGRESSIVE SUPRANUCLEAR PALSY - BRAIN HYPOMETABOLIC PATTERN AND CLINICOMETABOLIC CORRELATIONS
POSITRON EMISSION TOMOGRAPHY STUDY IN PROGRESSIVE SUPRANUCLEAR PALSY - BRAIN HYPOMETABOLIC PATTERN AND CLINICOMETABOLIC CORRELATIONS
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DOI：
10.1001/archneur.1990.00530070035009
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发表时间：
1990-07-01
影响因子：
--
通讯作者：
AGID, Y
中科院分区：
文献类型：
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作者：
BLIN, J;BARON, JC;AGID, Y
在41例进行性核上性麻痹（PSP）患者中，根据8项临床标准进行诊断（25例符合所有8项标准[可能的PSP]，16例符合6项或7项标准[可能的PSP]），我们使用正电子发射断层扫描和氟脱氧葡萄糖F18或氧15法研究了脑能量代谢。与年龄匹配的对照组相比，在可能和可能PSP的两组患者中，皮质和皮质下代谢值均显著降低，其中额叶皮质占主导地位，这两组之间无差异，表明类似的潜在疾病。额叶代谢值随病程延长而降低，但相对额叶代谢减退（以额枕代谢比表示）显然在疾病早期就已存在。帕金森运动评分与尾状核和丘脑代谢值相关。智力衰退指数与额叶和非额叶代谢值均显著相关。最后，额叶神经心理学评分仅与额枕代谢比显著相关。因此，在PSP，一种退行性脑疾病与皮质下病变，突出的额叶样综合征基本上取决于相对代谢低下的额叶皮质。
In 41 patients with progressive supranuclear palsy (PSP) that was diagnosed on the basis of eight clinical criteria (25 patients with all eight criteria [probable PSP] and 16 with six or seven criteria [possible PSP]), we studied cerebral energy metabolism by using positron emission tomography and the fludeoxyglucose F 18 or the oxygen 15 method. Compared with age-matched controls, each of the cortical and subcortical metabolic values was significantly reduced, with a predominance in the frontal cortex, in both groups of patients with probable and possible PSP, without a difference between these two groups, suggesting similar unerlying disease. The frontal metabolic value decreased with disease duration, but the relative frontal hypometabolism (expressed as the fronto-occiptal metabolic ratio) was apparently already present in the early stages of the disease. The parkinsonian motor score was correlated with the caudate and thalamic metabolic values. The intellectual deterioration index was significantly correlated with both the frontal and the nonfrontal metabolic values. Finally, the frontal neuropsychological score was significantly correlated with only the fronto-occipital metabolic ratio. Hence, in PSP, a degenerative brain disease with subcortical lesions, the prominent frontal lobe-like syndrome essentially depends on the relative hypometabolism of the frontal cortex.