Klein Reinoud C, de Jong Bauke M, de Vries Joeke J, Leenders Klaus L
Department of Neurology, University Hospital Groningen, The Netherlands.
Mov Disord. 2005 Aug;20(8):1021-30. doi: 10.1002/mds.20493.
The differentiation between progressive supranuclear palsy (PSP) and Parkinson's disease (PD) may be difficult, especially in the early stages of disease. Positron emission tomography potentially provides a tool for making such a distinction. To identify key features in the spatial distributions of cerebral glucose metabolism, 18F-fluorodeoxyglucose (FDG) measurements of 10 patients with probable or possible PSP were directly compared with those of 9 PD patients. This analysis was done with statistic parametric mapping. After normalization of global brain uptake, in PSP, relative uptake of FDG was reduced in the caudal (motor) part of the anterior cingulate gyrus (Brodmann's area BA 24; P < 0.05, corrected for multiple comparisons). At a lower threshold, an additional decrease was present in the dorsal mesencephalon. In PD, relative hypometabolism was seen in extrastriate visual, ventrolateral temporal, posterior parietal, and orbitofrontal regions. Only reduction in the right fusiform gyrus and the lateral extrastriate visual cortex reached statistical significance. We concluded that particularly the reduction of medial frontal metabolism may be a valuable diagnostic imaging parameter in distinguishing PSP from PD. For PD, a possible association between occipitotemporal FDG decrease and vulnerability to hallucinations is suggested.
进行性核上性麻痹（PSP）与帕金森病（PD）的鉴别可能存在困难，尤其是在疾病早期。正电子发射断层扫描有可能提供一种进行此类鉴别的工具。为了确定脑葡萄糖代谢空间分布的关键特征，对10例可能或疑似PSP患者的18F-氟脱氧葡萄糖（FDG）测量结果与9例PD患者的测量结果进行了直接比较。该分析采用统计参数映射法。在对全脑摄取进行标准化后，在PSP中，前扣带回尾侧（运动）部分（布罗德曼区BA 24；经多重比较校正后P < 0.05）的FDG相对摄取减少。在较低阈值下，中脑背侧也出现了额外的摄取减少。在PD中，在纹外视觉、颞叶腹外侧、顶叶后部和眶额区域可见相对代谢减低。只有右侧梭状回和外侧纹外视觉皮层的代谢减低达到统计学意义。我们得出结论，特别是内侧额叶代谢减低可能是区分PSP与PD的一个有价值的诊断成像参数。对于PD，提示枕颞叶FDG减低与幻觉易感性之间可能存在关联。
