Pathophysiological Decrease in the Regional Cerebral Blood Flow in Hashimoto's Encephalopathy: A Multiple-Case SPECT Study
Pathophysiological Decrease in the Regional Cerebral Blood Flow in Hashimoto's Encephalopathy: A Multiple-Case SPECT Study
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DOI：
10.1159/000358220
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发表时间：
2014-01-01
影响因子：
2.4
通讯作者：
Nakamoto, Yasunari
中科院分区：
文献类型：
--
作者：
Muramatsu, Tomoko;Ikawa, Masamichi;Nakamoto, Yasunari
背景资料：本研究的目的是评价多例桥本脑病（HE）患者局部脑血流量（rCBF）的变化。研究方法：7名未经治疗的HE患者和10名年龄匹配的健康对照者接受了NH 2-异丙基-p-[I-123]碘苯丙胺脑单光子发射计算机断层扫描（SPECT）。所有患者血清中均存在抗α-烯醇化酶氨基端自身抗体（Abs），该抗体可作为HE的有用诊断标志物，此外还存在抗甲状腺Abs，并对皮质类固醇治疗有反应。使用3D-SSP分析比较患者和对照组之间获得的SPECT图像。结果如下：HE组双侧前扣带回和左前额叶rCBF均较对照组显著降低（p < 0.05）。以伴有意识障碍和/或精神病性等急性神经精神症状的HE患者（n = 5）为例，上述脑区rCBF降低更为显著，右侧额叶rCBF也降低。结论：这些多例SPECT图像的统计分析显示，脑血流量减少的地区与临床症状，特别是急性神经精神症状，在HE患者。本研究阐明了HE中观察到的rCBF的病理生理学降低。(C)2014 S. Karger AG，巴塞尔
Background: The aim of this study was to evaluate the changes in regional cerebral blood flow (rCBF) in multiple cases of Hashimoto's encephalopathy (HE). Methods: Seven untreated patients with HE and 10 age-matched healthy controls underwent brain single photon emission computed tomography (SPECT) with NH2-isopropyl-p-[I-123] iodoamphetamine. All patients had anti-NH2-terminal of a-enolase autoantibodies (Abs), which served as a useful diagnostic marker for HE, in addition to anti-thyroid Abs in their sera and responded to corticosteroid therapy. The obtained SPECT images were compared between the patients and the controls using 3D-SSP analysis. Results: The rCBF of all patients with HE was significantly decreased in the bilateral anterior cingulate areas and left prefrontal cortex compared with the controls (p < 0.05). Focusing on the HE patients with acute neuropsychiatric symptoms (n = 5) such as consciousness disturbance and/ or psychosis, the decreased rCBF in these areas was more significant, and the rCBF in the right frontal cortex was also decreased. Conclusion: Statistical analysis of these multiple-case SPECT images revealed the regions of decreased CBF associated with clinical symptoms, especially acute neuropsychiatric symptoms, in HE patients. This study shed light on the pathophysiological decrease in rCBF observed in HE. (C) 2014 S. Karger AG, Basel