CORTICAL AND SUBCORTICAL GLUCOSE CONSUMPTION MEASURED BY PET IN PATIENTS WITH HUNTINGTONS-DISEASE
CORTICAL AND SUBCORTICAL GLUCOSE CONSUMPTION MEASURED BY PET IN PATIENTS WITH HUNTINGTONS-DISEASE
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DOI：
10.1093/brain/113.5.1405
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发表时间：
1990-10-01
期刊：
影响因子：
14.5
通讯作者：
FEINENDEGEN, LE
中科院分区：
文献类型：
--
作者：
KUWERT, T;LANGE, HW;FEINENDEGEN, LE
在 23 名中重度亨廷顿病 (HD) 患者和 21 名正常志愿者中，使用正电子发射断层扫描和 18F-脱氧葡萄糖方法测量了小脑、丘脑、纹状体和皮质的局部脑葡萄糖消耗代谢率 (rCMRGlc)。与之前的报道相反，与正常受试者相比，HD患者的rCMRGlc不仅在纹状体中减少，而且在大脑皮层中也减少。 HD 患者和正常受试者之间的丘脑和小脑 rCMRGlc 没有发现显着差异。为了研究临床状态和rCMRGlc之间的关系，计算了rCMRGlc的绝对值和rCMRGlc的小脑比率(CR)的临床数据的相关系数。舞蹈症的持续时间仅与额顶叶和颞枕叶 rCMRGlc 的绝对值以及评估的大多数皮质区域的 CR 显着相关。舞蹈症的严重程度仅与豆状核rCMRGlc显着相关。痴呆的严重程度仅与额顶叶和颞枕叶 CMRGlc、大多数皮质区域的 CR 以及尾状核的 CR 显着相关。除枕叶和上额叶皮质外，残疾程度与所有评估区域的 CR 显着相关。从这项研究中可以看出，在明显的 HD 患者中，不仅纹状体而且皮质 rCMRGlc 都有减少，并且 rCMRGlc 的皮质减少导致这些患者临床症状的严重程度。这挑战了亨廷顿舞蹈症痴呆纯粹是皮质下起源的概念。
In 23 patients with moderate to severe Huntingdon''s disease (HD) and 21 normal volunteers, the regional cerebral metabolic rate of glucose consumption (rCMRGlc) was measured in the cerebellum, thalamus, striatum, and cortex using positron emission tomography and the 18F-deoxyglucose method. In contrast to previous reports, rCMRGlc was reduced not only in the striatum, but also in the cerebral cortex of patients with HD as compared with normal subjects. No significant difference between HD patients and normal subjects was found for thalamic and cerebellar rCMRGlc. To investigate the relationship between the clinical status and rCMRGlc, correlation coefficients for the clinical data were calculated for absolute values of rCMRGlc and for cerebellar ratios (CR) of rCMRGlc. The duration of chorea correlated significantly only with the absolute values of frontoparietal and temporo-occipital rCMRGlc and with the CRs of most cortical regions evaluated. The severity of chorea correlated significantly only with lentiform nucleus rCMRGlc. The severity of dementia correlated significantly only with the frontoparietal and temporooccipital CMRGlc, the CRs of most cortical regions, and the CR for the caudate nucleus. The degree of disability correlated significantly with the CRs of all regions evaluated except the occipital and the superior frontal cortex. It appears from this study that there is a reduction not only for the striatum but also for cortical rCMRGlc in patients with manifest HD, and that the cortical reduction of rCMRGlc contributes to the severity of clinical symptoms in these patients. This challenges the concept that dementia in HD is of purely subcortical origin.