Batista Carlos E A, Juhasz C, Muzik O, Chugani D C, Chugani H T
Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA.
Dev Med Child Neurol. 2007 Aug;49(8):567-73. doi: 10.1111/j.1469-8749.2007.00567.x.
Functional reorganization after focal brain injury can lead to altered cerebral metabolism of glucose. Sturge-Weber syndrome (SWS) with unilateral involvement is a clinical model for evaluating the effects of early focal brain injury on brain metabolism and function. In this study, 2-deoxy-2[(18)F]fluoro-D-glucose (FDG) positron emission tomography (PET) was used to measure glucose metabolism in cortex and basal ganglia, both ipsilateral and contralateral to the angioma, in 17 children (eight males, nine females; age range 1y 8mo-10y 4mo; mean 5y 7mo [SD 2y 11mo]) with unilateral SWS and epilepsy. The PET findings were compared with those of a control group of 11 age-matched children (four males, seven females; age range 3y-10y 8mo; mean 6y [SD 2y 10mo]) with partial epilepsy but normal magnetic resonance imaging and PET scans. In the SWS group, visual and parietal cortex showed decreased glucose metabolism on the side of the angioma (p=0.001) but increased metabolism on the contralateral side (p=0.002). In particular, glucose metabolism was very high in contralateral visual cortex of childrenwith SWS, showing severe occipital hypometabolism on the side of the angioma. Eight children with visual field defect showed increased metabolism in the contralateral visual cortex (p=0.012). These findings indicate that early, severe unilateral cortical damage in SWS may induce increased glucose metabolism in the contralateral visual cortex, probably reflecting reorganization.
局灶性脑损伤后的功能重组可导致脑葡萄糖代谢改变。单侧受累的斯特奇-韦伯综合征（SWS）是评估早期局灶性脑损伤对脑代谢和功能影响的临床模型。在本研究中，采用2-脱氧-2-[(18)F]氟-D-葡萄糖（FDG）正电子发射断层扫描（PET）测量了17例患有单侧SWS和癫痫的儿童（8例男性，9例女性；年龄范围1岁8个月至10岁4个月；平均5岁7个月[标准差2岁11个月]）血管瘤同侧和对侧皮质及基底节的葡萄糖代谢。将PET检查结果与11例年龄匹配的部分性癫痫但磁共振成像和PET扫描正常的儿童对照组（4例男性，7例女性；年龄范围3岁至10岁8个月；平均6岁[标准差2岁10个月]）进行比较。在SWS组中，视觉和顶叶皮质在血管瘤侧葡萄糖代谢降低（p = 0.001），但对侧代谢增加（p = 0.002）。特别是，SWS儿童对侧视觉皮质的葡萄糖代谢非常高，血管瘤侧枕叶代谢严重减低。8例有视野缺损的儿童对侧视觉皮质代谢增加（p = 0.012）。这些发现表明，SWS早期严重的单侧皮质损伤可能会诱导对侧视觉皮质葡萄糖代谢增加，这可能反映了重组情况。
