Boelmans Kai, Kaufmann Jörn, Bodammer Nils, Ebersbach Georg, Behlau Guido, Heinze Hans-Jochen, Niehaus Ludwig
Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Mov Disord. 2009 Jan 30;24(2):168-75. doi: 10.1002/mds.22193.
Corticobasal syndrome (CBS) is a progressive parkinsonian disease characterized by cortical and subcortical neuronal loss. Although motor disabilities are a core feature of CBS, the involvement of motor pathways in this condition has not been completely clarified. We used magnetic resonance diffusion tensor imaging (DTI) to study corticospinal and transcallosal motor projections in CBS, and applied fiber tractography to analyze the axonal integrity of white matter projections. Ten patients with CBS were compared with 10 age-matched healthy controls. Fiber tracts were computed using a Monte-Carlo simulation approach. Tract-specific mean values of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were determined. CBS patients showed a reduction of corticospinal tract (CST) fibers on the first affected side with significantly increased ADC and reduced FA values. In the corpus callosum (CC), particularly in the posterior trunk, patients also had significantly reduced fiber projections, with a higher ADC and lower FA than controls. This pattern indicates changes of the white matter integrity in both CST and CC. Thus, magnetic resonance DTI can be used to assess motor pathway involvement in CBS patients.
皮质基底节综合征（CBS）是一种以皮质和皮质下神经元丢失为特征的进行性帕金森病。虽然运动功能障碍是CBS的核心特征，但这种情况下运动通路的受累情况尚未完全阐明。我们使用磁共振扩散张量成像（DTI）研究CBS患者的皮质脊髓束和胼胝体运动投射，并应用纤维束成像分析白质投射的轴突完整性。将10例CBS患者与10例年龄匹配的健康对照进行比较。使用蒙特卡罗模拟方法计算纤维束。确定各纤维束的表观扩散系数（ADC）和分数各向异性（FA）的特定束平均值。CBS患者首次受累侧的皮质脊髓束（CST）纤维减少，ADC值显著增加，FA值降低。在胼胝体（CC）中，特别是在胼胝体后干，患者的纤维投射也显著减少，ADC高于对照组，FA低于对照组。这种模式表明CST和CC中白质完整性均发生了变化。因此，磁共振DTI可用于评估CBS患者的运动通路受累情况。
