Hosaka Kayo, Ishii Kazunari, Sakamoto Setsu, Mori Tetsuya, Sasaki Masahiro, Hirono Nobutsugu, Mori Etsuro
Division of Imaging Research, Hyogo Institute for Aging Brain and Cognitive Disorders, 520 Saisho-Ko, Himeji, Hyogo 670-0981, Japan.
J Neurol Sci. 2002 Jul 15;199(1-2):67-71. doi: 10.1016/s0022-510x(02)00102-8.
Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are neurodegenerative disorders that may be accompanied by dementia and parkinsonism as clinical symptoms. The purpose of this study was to elucidate cerebral metabolic differences of these two diseases with cognitive impairments by [18F] fluorodeoxyglucose (FDG) and positron emission tomography (PET).
A total of 12 patients with PSP (age: 62.8+/-6.0 years old, m: 7, f: 5, Mini-Mental State Examination (MMSE): 23.4+/-2.6), 12 patients with CBD (age: 64.8+/-6.3 years old, m: 6, f: 6, MMSE: 22.9+/-4.5), and age-matched healthy subjects (normal control (NC)) (age: 63.8+/-7.7 years old, m: 7, f: 5) were subjected to FDG-PET to obtain glucose metabolic images. We compared regional cerebral metabolic images by a voxel-by-voxel analysis with statistical parametric mapping (SPM) among PSP, CBD, and NC subjects, and evaluated differences of hypometabolic regions.
The patients with PSP showed reduced cerebral glucose metabolism in the medial and lateral frontal gyri, basal ganglia, and midbrain compared with NC, whereas the patients with CBD showed significant reduction in the parietal lobes (p<0.001). SPM also revealed parietal hypometabolism in CBD patients compared with PSP patients (p<0.001).
The predominant parietal glucose metabolic reduction in CBD patients was different from previously reported findings. This finding would be the characteristic substance of patients with CBD accompanying cognitive impairments. Our findings suggest that measurement of glucose metabolism by PET and a voxel-based analysis is useful to understand the pathophysiology of these two diseases with cognitive impairments.
进行性核上性麻痹（PSP）和皮质基底节变性（CBD）是神经退行性疾病，临床症状可能伴有痴呆和帕金森综合征。本研究的目的是通过[18F]氟脱氧葡萄糖（FDG）和正电子发射断层扫描（PET）阐明这两种伴有认知障碍疾病的脑代谢差异。
共纳入12例PSP患者（年龄：62.8±6.0岁，男性7例，女性5例，简易精神状态检查表（MMSE）：23.4±2.6）、12例CBD患者（年龄：64.8±6.3岁，男性6例，女性6例，MMSE：22.9±4.5）以及年龄匹配的健康受试者（正常对照（NC））（年龄：63.8±7.7岁，男性7例，女性5例），进行FDG-PET检查以获取葡萄糖代谢图像。我们通过统计参数映射（SPM）逐体素分析比较了PSP、CBD和NC受试者之间的局部脑代谢图像，并评估了代谢减低区域的差异。
与NC相比，PSP患者在内侧和外侧额回、基底节和中脑的脑葡萄糖代谢降低，而CBD患者在顶叶有显著降低（p<0.001）。SPM还显示，与PSP患者相比，CBD患者顶叶代谢减低（p<0.001）。
CBD患者顶叶葡萄糖代谢显著降低与先前报道的结果不同。这一发现将是伴有认知障碍的CBD患者的特征性表现。我们的研究结果表明，通过PET测量葡萄糖代谢并进行基于体素的分析有助于理解这两种伴有认知障碍疾病的病理生理学。
