HIGHER BRAIN FUNCTION AND AUTONOMIC NERVOUS SYSTEM : URINARY-EVOKED FUNCTIONAL BRAIN MAPPING USING 3D-SSP

对8例多系统萎缩(MSA)患者(男2例，女6例，平均年龄61岁)和年龄匹配的5例正常对照组(男3例，女2例；年龄62岁)进行SPECT脑显像。两组患者均在3种情况下进行成像：空膀胱、储尿和排尿。静脉注射555MBq的[^&lt；99m&gt；Tc]标记的ECD，并立即将其捕获并稳定在脑内。利用NeUROSTAT软件消除MSA与正常脑的形态差异，计算两组各时相归一化平均示踪剂计数的统计学差异，并将其可视化。在储存期，MSA组双侧小脑虫体内的示踪剂活性显著降低，尤其是右侧(p&lt；0.05)，该示踪剂也参与了排尿的神经控制。在排尿阶段，MSA组小脑鞭毛区示踪剂活性下降的区域变得更宽。静息状态下，两组间差异无统计学意义。综上所述，提示在储尿期和排尿期小脑鞭毛区示踪剂活性降低是导致该疾病排尿障碍的原因之一。

SPECT brain imaging with special reference of bladder function was performed in 8 multiple system atrophy (MSA) patients (2 men, 6 women ; mean age, 61 years) and age-matched 5 normal control subjects (3 men, 2 women ; 62 years). In both groups imagings were obtained in 3 conditions ; empty bladder, storage, and micturition. 555 MBq of [^<99m>Tc]-labeled ECD was intravenously injected, which was immediately trapped and stabilized within the brain. Using NEUROSTAT software, which could also cancel morphologic differences between MSA and canonical brain, statistical difference between normalized mean tracer counts of both groups in each phase was calculated and visualized. In the storage phase, there was a significant decrease in tracer activity in bilateral cerebellar vermis, particularly of the right side in the MSA group (p<0.05), which is also known to be involved in the neural control of micturition. In the micturition phase, the area of decrease in tracer activity in the cerebellar vermis became wider in the MSA group. In the resting state, no statistically significance was seen between both groups. In conclusion, it is suggested that the decrease in tracer activity in the cerebellar vermis during urinary storage and micturition is contributing to the micturitional disturbance in this disorder.