Patterns of brain atrophy that differentiate corticobasal degeneration syndrome from progressive supranuclear palsy
Patterns of brain atrophy that differentiate corticobasal degeneration syndrome from progressive supranuclear palsy
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DOI：
10.1001/archneur.63.1.81
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发表时间：
2006-01-01
影响因子：
--
通讯作者：
Rosen, HJ
中科院分区：
文献类型：
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作者：
Boxer, AL;Geschwind, MD;Rosen, HJ
背景：进行性脑萎缩与皮质基底节变性综合征（CBDS）和进行性核上性麻痹（PSP）有关。脑萎缩的区域差异可能反映了疾病的临床特征。目的：量化CBDS和PSP.Design之间的结构神经解剖差异：在所有患者的神经功能缺损进行了调查。使用基于体素的形态测量来量化每个受试者组的磁共振图像上的结构神经解剖学差异。设置：大学医院痴呆症诊所。参与者：14名符合CBD临床研究标准的患者和15名符合PSP临床研究标准的患者，他们在疾病严重程度、年龄和功能状态方面相匹配，以及80名年龄匹配的对照受试者。主要结果测量：统计学显着差异，在区域灰色和白色物质的体积，多重比较校正后，组之间的subjects.Results：CBDS患者显示不对称（左>右）模式的脑萎缩，涉及双边运动前皮质，上级顶叶小叶，纹状体。进行性核上性麻痹与中脑、脑桥、丘脑和纹状体萎缩相关，额叶皮质受累最少。PSP的中脑结构比CBD的萎缩程度更大，而CBD的背额叶和顶叶皮质比PSP的萎缩程度更大。中脑和脑桥被盖和左额叶视野的萎缩程度区分两个病人groups.Conclusions的准确率为93%：脑萎缩的CBDS和PSP存在不同的模式，可以用来区分这两种疾病。这些疾病的脑萎缩评估应集中在皮质和脑干眼运动控制区。
Background: Progressive brain atrophy is associated with the corticobasal degeneration syndrome (CBDS) and progressive supranuclear palsy (PSP). Regional differences in brain atrophy may reflect the clinical features of disease.Objective: To quantify the structural neuroanatomical differences between CBDS and PSP.Design: A survey of neurologic deficits was conducted in all patients. Voxel-based morphometry was used to quantify structural neuroanatomical differences on magnetic resonance images in each subject group.Setting: University hospital dementia clinic.Participants: Fourteen patients who met clinical research criteria for CBD and 15 patients who met clinical research criteria for PSP, who were matched for severity of disease, age, and functional status, and 80 age-matched control subjects.Main Outcome Measures: Statistically significant differences in regional gray and white matter volume, after multiple comparisons correction, between groups of subjects.Results: The patients with CBDS displayed an asymmetric (left > right) pattern of brain atrophy that involved the bilateral premotor cortex, superior parietal lobules, and striatum. Progressive supranuclear palsy was associated with atrophy of the midbrain, pons, thalamus, and striatum, with minimal involvement of the frontal cortex. Midbrain structures were more atrophied in PSP than in CBD, whereas dorsal frontal and parietal cortices were more atrophied in CBD than in PSP. The degree of atrophy of the midbrain and pontine tegmentum and the left frontal eye field differentiated the 2 patient groups with 93% accuracy.Conclusions: Distinct patterns of brain atrophy exist in CBDS and PSP that can be used to differentiate the 2 diseases. Assessments of brain atrophy in these disorders should be focused on cortical and brainstem ocular motor control areas.