Garraux G, Salmon E, Peigneux P, Kreisler A, Degueldre C, Lemaire C, Destée A, Franck G
Cyclotron Research Center, Department of Neurology, University of Liège, Belgium.
Mov Disord. 2000 Sep;15(5):894-904. doi: 10.1002/1531-8257(200009)15:5<894::aid-mds1021>3.0.co;2-s.
This report emphasizes the precise topographic distribution of cerebral metabolic impairment in corticobasal degeneration (CBD) and the pathophysiological differences between CBD and progressive supranuclear palsy (PSP). Statistical parametric mapping (SPM96) analysis of 18FDG positron emission tomography (PET) data was performed in 22 patients with CBD compared with 46 healthy subjects (HS) and 21 patients with PSP who were studied at rest. A statistical threshold of p <0.001 was fixed, further corrected for multiple or independent comparisons (p <0.05). In comparison with HS, the metabolic impairment in CBD was asymmetrically distributed in the putamen, thalamus, precentral (Brodmann's area, BA 4), lateral premotor (BA 6/44) and supplementary motor areas (SMA, BA 6), dorsolateral prefrontal (8/9/46) cortex, and the anterior part of the inferior parietal lobe (BA 40) including the intraparietal sulcus (BA 7/40). A similar hypometabolic pattern was observed for most individual analyses. When PSP was compared with CBD, metabolic impairment predominated in the midbrain, anterior cingulate (BA 24/32), and orbitofrontal regions (BA 10). The reverse contrast showed more posterior involvement in CBD (BA 6 and 5/7/40) including SMA. Our data suggest that multiple components of neural networks related to both movement execution and production of skilled movements are functionally disturbed in CBD compared with both HS and PSP.
本报告强调了皮质基底节变性(CBD)中脑代谢损害的确切地形分布以及CBD与进行性核上性麻痹(PSP)之间的病理生理差异。对22例CBD患者、46名健康受试者(HS)和21例PSP患者在静息状态下进行的18FDG正电子发射断层扫描(PET)数据进行了统计参数映射(SPM96)分析。设定统计学阈值p<0.001,并针对多重或独立比较进行进一步校正(p<0.05)。与HS相比,CBD的代谢损害不对称分布于壳核、丘脑、中央前回(布罗德曼区,BA4)、外侧运动前区(BA6/44)和辅助运动区(SMA,BA6)、背外侧前额叶(8/9/46)皮质以及顶下叶前部(BA40)包括顶内沟(BA7/40)。在大多数个体分析中观察到类似的代谢减低模式。当将PSP与CBD进行比较时,代谢损害主要见于中脑、前扣带回(BA24/32)和眶额区域(BA10)。反向对比显示CBD中后部受累更多(BA6和5/7/40),包括SMA。我们的数据表明,与HS和PSP相比,与运动执行和熟练运动产生相关的神经网络的多个组成部分在CBD中功能紊乱。