Chabriat H, Pappata S, Levasseur M, Fiorelli M, Tran Dinh S, Baron J C
Biology Department, Service Hospitalier Frédéric Joliot, CEA, Caen, France.
Acta Neurol Scand. 1992 Sep;86(3):285-90. doi: 10.1111/j.1600-0404.1992.tb05087.x.
In 8 patients with small unilateral posterolateral thalamic (or, in one case, thalamocapsular) stroke (infarction or hemorrhage) selected on strict clinical (pure hemisomatosensory deficit without hemiparesis, visual field defect or neuropsychological impairment) and MRI criteria, we studied cortical energy metabolism using positron emission tomography with the 18F-fluorodeoxyglucose or the 15O-oxygen method. We found no significant ipsi- or contra-lateral metabolic depression either in the whole cortical mantle or in the sensorimotor cortex. These results support the hypothesis that location of thalamic stroke is a major determinant of the ipsilateral cortical hypometabolism characteristic of cognitively impaired patients with thalamic lesions and further emphasize the influence of the "non-specific" thalamocortical system on resting cortical metabolism. The lack of sensorimotor cortex hypometabolism in our patients suffering from hemidysesthesia and/or -hyperpathia also suggests that cortical metabolism is unaltered in thalamic pain.
在8例经严格临床（单纯偏身感觉缺失而无偏瘫、视野缺损或神经心理损害）和MRI标准筛选出的单侧丘脑后外侧（或1例为丘脑豆状核）小卒中（梗死或出血）患者中，我们采用18F - 氟脱氧葡萄糖或15O - 氧正电子发射断层扫描法研究了皮质能量代谢。我们发现，无论是在整个皮质层还是在感觉运动皮质，同侧或对侧均无明显的代谢抑制。这些结果支持这样一种假说，即丘脑卒中的部位是丘脑病变所致认知受损患者同侧皮质代谢减退特征的主要决定因素，并进一步强调了“非特异性”丘脑皮质系统对静息皮质代谢的影响。我们患有偏身感觉异常和/或感觉过敏的患者缺乏感觉运动皮质代谢减退，这也表明丘脑痛时皮质代谢未改变。
