Functional analysis of the neuronal network in patients with functional disorder of basal ganglia using non-invasive neurotransmitter imaging

基底节无疑是哺乳动物前脑中最复杂、最不被了解的结构之一。在本研究中，我们用正电子发射计算机断层扫描(PET)和氟多巴-正电子发射计算机断层扫描(PET)对基底神经节功能障碍患者治疗前后的脑组织磷脂酰肌醇代谢和基底节多巴胺代谢进行了研究。帕金森病患者治疗前后双侧纹状体磷脂酰肌醇代谢加速，同侧丘脑功能受抑。这些结果表明丘脑底核间接通路在帕金森病患者中的优越性。脑梗塞患者的~(11)&gt；C-二酰甘油-正电子发射计算机断层扫描显示脑梗塞亚急性期额叶前区过度蓄积。亚急性期前额叶区β&lt；11&gt；C-二酰甘油过度蓄积可能提示大脑网络可塑性。系列研究显示泡头娃娃综合征患者双侧纹状体突触前多巴胺能细胞功能亢进。突触前多巴胺能细胞功能亢进对输出系统的抑制可能在泡头娃娃运动的发生中起重要作用。在基底节弥漫性浸润性肿瘤中，~(18)F-F-氟代多巴-正电子发射计算机断层扫描显示双侧纹状体内突触前多巴胺能细胞在肿瘤内是一致的。在膨胀型肿瘤中，如转移性肿瘤，~(18)F-Folododa-PET显示肿瘤周围纹状体区有~~(18)F-Folodopa的聚集。这些结果表明，~(18)F-Folodopa-PET研究有助于对基底节肿瘤的定性诊断，这些PET数据将在活体分析人类基底节和直接预测大脑网络可塑性方面有实用价值。

The basal ganglia are undoubtedly among the most complex and least understood structures in the mammalian forebrain. In this study, we evaluated phosphoinositide turnover in the cerebrum and dopamine metabolism in the basal ganglia using ^<11>C-diacylglycerol-positron emission computed tomography(PET) and ^<18>F-fluorodopa-PET in patients with functional disorder of basal ganglia before and after treatment.^<11>C-diacylglycerol-PET of Parkinson's disease showed acceleration of the phosphoinositide turnover of the bilateral striatum and functional supression of the ipsilateral thalamus. These results indicate the superiority of the indirect pathway through subthalamic nucleus in patients with Parkinson's disease.^<11>C-diacylglycerol-PET studies in patients with cerebral infarction revealed hyperaccumlation in the prefrontal area in the subacute stage of cerebral infarction. The hyperaccumlation of ^<11>C-diacylglycerol in the prefrontal area in the subacute stage may indicate network plasticity in the cerebrum.Serial ^<18>F-fluorodopa-PET studies revealed hyperfunction of the presynaptic dopaminergic cells of the bilateral striatum in bobble-head doll syndrome. The suppression of output systems caused by hyperfunction of the presynaptic dopaminergic cells may play an important role of the occurrence of bobble-head doll movement.In the diffuse infiltrating tumor of the basal ganglia, ^<18>F-fluorodopa-PET study revealed that the presynaptic dopaminergic cells of the bilateral striatum were consistent within the tumor. In the expansive tumor such as metastatic tumors, ^<18>F-fluorodopa-PET showed accumulation of ^<18>F-fluorodopa in the striatum around the tumor. These results indicate that ^<18>F-fluorodopa-PET studies contribute to a qualitative diagnosis of the tumor in the basal ganglia.These PET data will be practical use for in vivo analysis of human basal ganglia and direct prediction of the network plasticity in the cerebrum.