抽动秽语综合征患者额叶脑血流增加：一项锝-99m-六甲基丙烯胺肟单光子发射计算机断层扫描研究

Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: a 99Tcm-HMPAO SPECT study.

作者信息

George M S, Trimble M R, Costa D C, Robertson M M, Ring H A, Ell P J

机构信息

Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.

出版信息

Psychiatry Res. 1992 Nov;45(3):143-51. doi: 10.1016/0925-4927(92)90022-v.

DOI:10.1016/0925-4927(92)90022-v

PMID:1484907

Abstract

Case reports, numerous brain imaging studies, and certain disease states suggest that the orbital frontal cortex and the striatum are dysfunctional in obsessive-compulsive disorder (OCD). Interest has also grown recently concerning the genetic, neuroanatomic, and clinical links between OCD, chronic motor tics, and Gilles de la Tourette Syndrome (GTS). To test the hypothesis of possible orbito-frontal/basal ganglia dysfunction in GTS, similar to OCD, we studied 20 unmedicated GTS subjects, 10 of whom also had comorbid OCD (GTS/OCD), and 8 control subjects. The subjects were examined with high-resolution single photon emission computed tomography (SPECT) and the labeled regional cerebral blood flow (rCBF) ligand technetium-99m-d,l-hexamethyl-propylene amine oxime (99Tcm-HMPAO). As a group, GTS subjects showed significantly elevated right frontal/visual cortex activity (mean = 0.879, SD = 0.107) compared with control subjects (mean = 0.798, SD = 0.049). A subanalysis comparing simple GTS versus GTS with comorbid OCD failed to reveal significant differences in regional flow.

摘要

病例报告、大量脑成像研究以及某些疾病状态表明，眶额皮质和纹状体在强迫症（OCD）中功能失调。最近，人们对强迫症、慢性运动抽动和吉尔·德拉·图雷特综合征（GTS）之间的遗传、神经解剖学和临床联系的兴趣也在增加。为了验证GTS中可能存在与OCD类似的眶额/基底神经节功能障碍这一假设，我们研究了20名未接受药物治疗的GTS患者，其中10名还患有共病强迫症（GTS/OCD），以及8名对照受试者。使用高分辨率单光子发射计算机断层扫描（SPECT）和标记的局部脑血流（rCBF）配体锝-99m-d，l-六甲基丙烯胺肟（99Tcm-HMPAO）对受试者进行检查。与对照受试者（平均值 = 0.798，标准差 = 0.049）相比，GTS患者组右侧额叶/视觉皮质活动显著升高（平均值 = 0.879，标准差 = 0.107）。一项比较单纯GTS与合并OCD的GTS的亚分析未发现区域血流存在显著差异。