Cerebral perfusion abnormality in narcolepsy with cataplexy
Cerebral perfusion abnormality in narcolepsy with cataplexy
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DOI：
10.1016/j.neuroimage.2005.06.019
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发表时间：
2005-11-01
期刊：
影响因子：
5.7
通讯作者：
Kim, L
中科院分区：
文献类型：
--
作者：
Joo, EY;Hong, SB;Kim, L
为探讨发作性睡病合并发作性睡病患者的脑血流灌注异常，25例发作性睡眠性发作性发作性睡病患者和25例正常人作为研究对象。脑血流灌注采用99m-半胱氨酸乙酯二聚体脑单光子发射计算机断层扫描(SPECT)。患者和正常对照组在SPECT扫描前没有接受任何药物治疗。用统计参数图(SPM)分析发作性睡病患者和正常对照组之间脑血流灌注的差异。所有患者均进行夜间多导睡眠图和多次睡眠潜伏期试验(MSLT)。所有患者和正常对照组均在清醒状态下进行脑SPECT检查。所有患者的临床症状和MSLT结果均符合国际睡眠障碍分类发作性睡病标准。MSLT患者平均睡眠潜伏期较短(1.69±1.0min)，入睡REM间期为2~5个。SPECT SPM分析显示发作性睡眠者双侧下丘脑前核、尾状核和枕核、部分背外侧/腹内侧前额叶皮质、海马旁回和扣带回灌注量低[P<；0.05经t检验和假发现率(FDR)校正]。发作性睡病患者的额叶和顶叶白质也有明显的低灌注率。这项研究显示发作性睡病患者皮质下结构和皮质区域的脑灌注量减少。脑血流灌注异常的分布与脑下丘脑的途径相一致。
To investigate abnormal cerebral perfusion in narcoleptics with cataplexy, 25 narcoleptics with cataplexy and 25 normal controls were enrolled in this study. Cerebral perfusion was measured by brain single photon emission computed tomography (SPECT) using Tc-99m-ethylcysteinate dimer. Patients and normal controls had not received any medication prior to the SPECT scan. Differences in cerebral perfusion between narcoleptics and normal controls were subjected to statistical parametric mapping (SPM) analysis. Overnight polysomnography and multiple sleep latency test (MSLT) were performed in all patients. Brain SPECT was carried out on all patients and normal controls during the waking state. Clinical symptoms and MSLT results of all patients are in accord with the International Classification of Sleep Disorders criteria for narcolepsy. MSLT showed a short mean sleep latency (1.69 +/- 1.0 min) and 2-5 sleep onset REM periods in individual patient. SPM analysis of brain SPECT showed hypoperfusion of the bilateral anterior hypothalami, caudate nuclei, and pulvinar nuclei of thalami, parts of the dorsolateral/ventromedial prefrontal cortices, parahippocampal gyri, and cingulate gyri in narcoleptics [P < 0.05 by Student's t test with false discovery rate (FDR) correction]. Significant hypoperfusion in the white matter of frontal and parietal lobes was also noted in narcoleptics. This study shows reduced cerebral perfusion in subcortical structures and cortical areas in narcoleptics. The distribution of abnormal cerebral perfusion is concordant with the pathway of the cerebral hypocretin.