Okada K, Kobayashi S, Yamashita K, Fukuda H, Suyama N
Third Division of Internal Medicine, Shimane Medical University.
Rinsho Shinkeigaku. 1991 Jun;31(6):597-602.
It is known that progressive supranuclear palsy (PSP) shows subcortical dementia. The diagnosis of PSP is sometimes difficult because this disorder mimics the clinical features of parkinsonian syndrome. Several PET studies demonstrated frontal hypo-metabolism in PSP patients. We studied the cerebral blood flow (CBF) pattern by single-photon-emission-computed tomography (SPECT) using 123I-isopropyl-iodoamphetamine (IMP) in 5 patients of PSP including one autopsy case. Five PSP patients were 3 men and 2 women, mean age of 67.6 years old. Control groups were 3 normal controls (Normal), 7 patients of Parkinson's disease (PD), 5 patients of olive-pontocerebellar atrophy (OPCA), and 4 patients of dementia of Alzheimer's type (DAT). CBF was measured by 123I-IMP SPECT using 400 AC/T Starcam (GE). CBF was measured by semi-quantitative methods. Regions of Interest (ROI's) were located at cerebellar, basal ganglion, and lateral ventricle levels. Each count of ROI was divided by the count of occipital ROI. In all PSP patients, the ratio of relative blood flow to occipital lobe in the frontal and fronto-temporal regions were most markedly affected, showing average reduction rates of 66.6% and 65.5%. These rates showed statistically significant differences to other control degenerative neurological diseases. Our these results correspond to the former PET studies. Moreover, frontal hypoperfusion progressed with advancing clinical stage. The results indicate that CBF study with SPECT is useful to confirm the diagnosis of PSP. It is necessary to clarify the role of the damage in basal ganglia for frontal hypometabolic pattern.
众所周知，进行性核上性麻痹（PSP）表现为皮质下痴呆。PSP的诊断有时很困难，因为这种疾病会模仿帕金森综合征的临床特征。几项PET研究表明PSP患者存在额叶低代谢。我们使用123I-异丙基碘安非他明（IMP）通过单光子发射计算机断层扫描（SPECT）研究了5例PSP患者（包括1例尸检病例）的脑血流（CBF）模式。5例PSP患者中，男性3例，女性2例，平均年龄67.6岁。对照组包括3名正常对照者（Normal）、7例帕金森病（PD）患者、5例橄榄脑桥小脑萎缩（OPCA）患者和4例阿尔茨海默病型痴呆（DAT）患者。使用400 AC/T Starcam（GE）通过123I-IMP SPECT测量CBF。通过半定量方法测量CBF。感兴趣区（ROI）位于小脑、基底神经节和侧脑室水平。每个ROI的计数除以枕叶ROI的计数。在所有PSP患者中，额叶和额颞叶区域相对于枕叶的相对血流比率受影响最为明显，平均降低率分别为66.6%和65.5%。这些比率与其他对照退行性神经疾病相比具有统计学显著差异。我们的这些结果与之前的PET研究一致。此外，额叶灌注不足随着临床分期的进展而加重。结果表明，SPECT的CBF研究有助于确诊PSP。有必要阐明基底神经节损伤在额叶低代谢模式中的作用。
