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(99m)锝-乙基半胱氨酸二聚体脑单光子发射计算机断层扫描在路易体痴呆早期及帕金森病患者中的表现:与神经心理学测试的相关性

(99m)Tc-ethyl cysteinate dimer brain SPECT findings in early stage of dementia with Lewy bodies and Parkinson's disease patients: a correlation with neuropsychological tests.

作者信息

Chang C-C, Liu J-S, Chang Y-Y, Chang W-N, Chen S-S, Lee C-H

机构信息

Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Eur J Neurol. 2008 Jan;15(1):61-5. doi: 10.1111/j.1468-1331.2007.02001.x. Epub 2007 Nov 27.

Abstract

We examined clinical presentations, neuropsychological findings, and perfusion patterns of (99m)Tc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients with early stage dementia with Lewy bodies (DLB) (n = 17) and Parkinson's disease (PD) (n = 16), with age-matched healthy controls (n = 10). Seven paired regions of interest (ROIs) were drawn manually including inferior frontal, temporal, parietal, occipital, parieto-occipital junction, striatum and thalamus for semiquantitative measurement. Neuropsychological tests were applied for clinical correlation. The SPECT results showed significant hypoperfusion in DLB group in frontal, parietal, thalamus, temporal ROIs compared with controls (P < 0.01) whilst signals in temporal areas was significantly reduced compared with PD group (P < 0.05). Neuropsychological tests showed that DLB patients had deficits in mental manipulation, short-term memory, abstract thinking, drawing and semantic verbal fluencies (P < 0.05, compared with control). In addition, DLB group had lower scores than those with PD in mental manipulation, drawing and semantic verbal fluency (P < 0.05). Our study showed that even in early stages of DLB, neuropsychological and perfusion patterns were evident and may be different from PD group, despite they shared certain similarities both in neuropsychological and image findings compared with age-matched controls.

摘要

我们对17例早期路易体痴呆(DLB)患者、16例帕金森病(PD)患者以及10例年龄匹配的健康对照者进行了临床症状、神经心理学检查结果以及锝-99m-乙基半胱氨酸二聚体(ECD)单光子发射计算机断层扫描(SPECT)灌注模式的研究。手动绘制了7对感兴趣区域(ROI),包括额下回、颞叶、顶叶、枕叶、顶枕交界、纹状体和丘脑,用于半定量测量。应用神经心理学测试进行临床相关性分析。SPECT结果显示,与对照组相比,DLB组在额叶、顶叶、丘脑、颞叶ROI存在明显灌注减低(P < 0.01),而与PD组相比,颞叶区域信号明显降低(P < 0.05)。神经心理学测试表明,DLB患者在心理操作、短期记忆、抽象思维、绘图和语义言语流畅性方面存在缺陷(与对照组相比,P < 0.05)。此外,DLB组在心理操作、绘图和语义言语流畅性方面的得分低于PD组(P < 0.05)。我们的研究表明,即使在DLB的早期阶段,神经心理学和灌注模式也很明显,并且可能与PD组不同,尽管与年龄匹配的对照组相比,它们在神经心理学和影像学检查结果上有一定的相似性。

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