Lee M S, Kim Y D, Im J H, Kim H J, Rinne J O, Bhatia K P
Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Neurology. 1999 Apr 22;52(7):1422-6. doi: 10.1212/wnl.52.7.1422.
To investigate nigral neuronal damage in patients with isolated postural tremor and those with postural and rest tremor without parkinsonism.
Using [123I]-N-(3-iodopropen-2-yl)-2 -carbomethoxy-3beta-(4-chlorophenyl) tropane SPECT, we measured the basal ganglia-occipital cortex/occipital cortex ([BG-OCC]/OCC) uptake ratios in 21 control subjects and patients with isolated postural tremor (n = 9), postural and rest tremor (n = 6), and PD (n = 11).
In the patients with PD, the means (+/-SD) of the (BG-OCC)/OCC ratios of the ipsilateral (2.35+/-0.37) and the contralateral (1.97+/-0.33) sides to the more severely affected limbs were significantly lower than the mean of the bilateral (BG-OCC)/OCC ratios of the age-matched control subjects (3.83+/-0.66). The mean (+/-SD) of the bilateral (BG-OCC)/OCC ratios of the patients with isolated postural tremor (3.60+/-0.83) was comparable with that of the age-matched control subjects. However, the mean (+/-SD) of the bilateral (BG-OCC)/OCC ratios of the patients with postural and rest tremor (2.61+/-0.18) was lower than that of the control subjects (p < 0.05). The mean of the bilateral (BG-OCC)/OCC ratios of the patients with postural and rest tremor was comparable with that of the side ipsilateral to the severely affected limbs of the patients with PD. However, it was higher than that of the side contralateral to the limbs more severely affected by PD. Four of the six patients with postural and rest tremor had (BG-OCC)/OCC ratios lower than 2 standard deviations from the mean of the age-matched control subjects.
Later in their clinical courses, some patients with postural tremor may acquire rest tremor in association with mild substantia nigra neuronal loss.
研究孤立性姿势性震颤患者以及伴有姿势性和静止性震颤但无帕金森病患者的黑质神经元损伤情况。
我们使用[123I]-N-(3-碘丙烯-2-基)-2-甲氧羰基-3β-(4-氯苯基)托烷单光子发射计算机断层扫描（SPECT），测量了21名对照受试者以及孤立性姿势性震颤患者（n = 9）、姿势性和静止性震颤患者（n = 6）和帕金森病患者（n = 11）的基底神经节-枕叶皮质/枕叶皮质（[BG-OCC]/OCC）摄取比值。
在帕金森病患者中，患侧肢体（2.35±0.37）和对侧肢体（1.97±0.33）的（BG-OCC）/OCC比值的均值（±标准差）显著低于年龄匹配的对照受试者双侧（BG-OCC）/OCC比值的均值（3.83±0.66）。孤立性姿势性震颤患者双侧（BG-OCC）/OCC比值的均值（±标准差）（3.60±0.83）与年龄匹配的对照受试者相当。然而，姿势性和静止性震颤患者双侧（BG-OCC）/OCC比值的均值（±标准差）（2.61±0.18）低于对照受试者（p < 0.05）。姿势性和静止性震颤患者双侧（BG-OCC）/OCC比值的均值与帕金森病患者患侧肢体同侧的均值相当。然而，它高于帕金森病患者受影响更严重肢体对侧的均值。6名姿势性和静止性震颤患者中有4人的（BG-OCC）/OCC比值低于年龄匹配的对照受试者均值的2个标准差。
在临床病程后期，一些姿势性震颤患者可能会出现静止性震颤，并伴有轻度黑质神经元丢失。
