Mori Etsuro
Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center.
Rinsho Shinkeigaku. 2002 Nov;42(11):1158-61.
Progressive supranuclear palsy (PSP) and cortocobasal degeneration (CBD) are often clinically confused with each other. In this paper, based our previous and on-going morphological and functional neuroimaging studies, the features characteristic of the two diseases are discussed. In PSP patients, the atrophic and metabolic changes are dominant in the frontal lobes, basal ganglia, and midbrain, while in CBD patients, the changes are dominant in the parietal lobe. There is little overlap of topographical distribution of atrophy and functional changes between PSP and CBD, despite the considerable similarity of symptoms of the two disorders. The clear distinction between the two diseases may be in part caused by the criteria-based subject selection process; based on stringent clinical diagnostic criteria for each disorder, which have a high specificity and a low sensitivity, only patients that are typical of each disease are compared. Nevertheless, these neuroimaging features appear to reflect different clinical and pathologic phenotypes between the two diseases. These findings suggest that neuroimagings facilitate the differential diagnosis between patients with PSP and those with CBD.
进行性核上性麻痹(PSP)和皮质基底节变性(CBD)在临床上常常相互混淆。在本文中,基于我们之前及正在进行的形态学和功能神经影像学研究,对这两种疾病的特征进行了讨论。在PSP患者中,萎缩和代谢变化主要发生在额叶、基底节和中脑,而在CBD患者中,这些变化主要发生在顶叶。尽管这两种疾病的症状有相当大的相似性,但PSP和CBD之间萎缩及功能变化的地形分布几乎没有重叠。这两种疾病的明确区分可能部分是由于基于标准的受试者选择过程;基于每种疾病严格的临床诊断标准,其具有高特异性和低敏感性,仅比较每种疾病典型的患者。然而,这些神经影像学特征似乎反映了这两种疾病不同的临床和病理表型。这些发现表明神经影像学有助于PSP患者和CBD患者之间的鉴别诊断。