Feng Tao, Wang Yongjun, Ouyang Qiaohong, Duan Zhongxiang, Li Wei, Lu Linlong, Xiang Weiwei
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Neurol Res. 2008 May;30(4):377-82. doi: 10.1179/174313208X300396.
To investigate the difference in the regional cerebral glucose metabolism between multiple system atrophy Parkinsonian type (MSA-P) and Parkinson's disease (PD).
Fifteen patients with MSA-P, 32 patients with PD and eight cases of healthy control underwent positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) showing glucose metabolism. Glucose metabolism ratios of various cerebral regions were compared as an indicator of regional cerebral glucose metabolic patterns.
The metabolism ratios of frontal lobe/occipital lobe, parietal lobe/occipital lobe, temporal lobe/occipital lobe and corpus striatum/occipital lobe in patients with MSA-P were lower than those in patients with PD and control, respectively (p<0.01). For patients with MSAP, the metabolism ratio in thalamus was higher than those in lenticular nucleus and anterior cortical brain, respectively (p<0.01) and the changes of metabolism ratio in cortex, corpus striatum and thalamus were symmetric. For patients with PD, the metabolism ratio in corpus striatum was higher than that in thalamus and two side of the basal ganglia show asymmetric change of metabolism (p<0.01).
This study suggests that significant differences exist in the patterns of regional cerebral glucose metabolism between MSA-P and PD. (18)F-FDG PET might be a useful adjunctive method for differential diagnosis between MSA-P and PD.
探讨帕金森型多系统萎缩(MSA-P)与帕金森病(PD)脑区葡萄糖代谢的差异。
15例MSA-P患者、32例PD患者及8例健康对照者接受了用(18)F-氟脱氧葡萄糖((18)F-FDG)显示葡萄糖代谢的正电子发射断层扫描(PET)。比较各脑区的葡萄糖代谢率,作为脑区葡萄糖代谢模式的指标。
MSA-P患者额叶/枕叶、顶叶/枕叶、颞叶/枕叶及纹状体/枕叶的代谢率分别低于PD患者和对照组(p<0.01)。对于MSA-P患者,丘脑的代谢率分别高于豆状核和大脑前皮质(p<0.01),皮质、纹状体和丘脑的代谢率变化呈对称分布。对于PD患者,纹状体的代谢率高于丘脑,基底节两侧代谢呈不对称变化(p<0.01)。
本研究提示MSA-P与PD在脑区葡萄糖代谢模式上存在显著差异。(18)F-FDG PET可能是MSA-P与PD鉴别诊断的一种有用辅助方法。