Flow-metabolism uncoupling in the cervical spinal cord of ALS patients.
Flow-metabolism uncoupling in the cervical spinal cord of ALS patients.
复制标题
ALS 患者颈脊髓的血流代谢解偶联。
DOI：
10.1007/s10072-017-2823-y
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Abe K.
中科院分区：
文献类型：
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作者：
Yamashita T;Hatakeyama T;Sato K;Fukui Y;Hishikawa N;Ohta Y;Nishiyama Y;Kawai N;Tamiya T;Abe K.
肌萎缩侧索硬化症（ALS）是一种致命的运动神经元疾病。据报道，在ALS中，当通过正电子发射断层扫描（PET）测量时，大脑运动皮层中的葡萄糖消耗和神经元强度都降低。在这项研究中，我们评估了10名ALS患者的颈脊髓葡萄糖代谢，血流量，上肢（U/E）萎缩的神经元强度与18 F-2-氟-2-脱氧-d-葡萄糖（18 F-FDG）PET和11 C-氟马西尼（11 C-FMZ）PET。在C5和T1水平的同侧，18F-FDG摄取显著增加（*p< 0.05），并且与ALS FRS-R-U/E评分的进展率相关（R= 0.645，*p= 0.041）。尽管存在这种高葡萄糖代谢，11 C-FMZ PET研究并未显示脊髓血流量的偶联增加，即使神经元强度并未降低。这些结果表明高葡萄糖代谢和ALS进展之间的强相关性，以及血流代谢的解偶联。这种机制可能导致随后的运动神经元死亡，可能是ALS的潜在治疗靶点。
Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease. In ALS, both glucose consumption and neuronal intensity reportedly decrease in the cerebral motor cortex when measured by positron emission tomography (PET). In this study, we evaluated cervical spinal glucose metabolism, blood flow, and neuronal intensity of 10 ALS patients with upper extremity (U/E) atrophy both with18F-2-fluoro-2-deoxy-d-glucose (18F-FDG) PET and11C-flumazenil (11C-FMZ) PET. On the ipsilateral side of C5 and T1 levels,18F-FDG uptake increased significantly (*p< 0.05), and was correlated with the rate of progression of the ALS FRS-R-U/E score (R= 0.645, *p= 0.041). Despite this hyperglucose metabolism, the11C-FMZ PET study did not show a coupled increase of spinal blood flow even though neuronal intensity did not decrease. These results indicate a strong correlation between hyperglucose metabolism and ALS progression alongside the uncoupling of flow-metabolism. This mechanism, which could result in subsequent motor neuronal death, may be a potential therapeutic target for ALS.