帕金森病中丘脑底核刺激诱发淡漠：一项PET研究。
Subthalamic nucleus stimulation in Parkinson disease induces apathy: a PET study.
作者信息
Le Jeune F, Drapier D, Bourguignon A, Péron J, Mesbah H, Drapier S, Sauleau P, Haegelen C, Travers D, Garin E, Malbert C H, Millet B, Vérin M
机构信息
Service de Médecine Nucléaire, Centre Eugéne Marquis, Renne, France.
出版信息
Neurology. 2009 Nov 24;73(21):1746-51. doi: 10.1212/WNL.0b013e3181c34b34.
OBJECTIVE
Apathy may be induced by subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson disease (PD). We therefore wished to test the hypothesis that apathy induced by STN-DBS correlates with changes in glucose metabolism, using (18)FDG-PET.
METHODS
Twelve patients with PD were assessed 3 months before (M-3) and 3 months after (M+3) STN-DBS with (18)FDG-PET and the Apathy Evaluation Scale.
RESULTS
Apathy had significantly worsened at M+3 after STN-DBS. Positive correlations were observed between this variation in apathy scores and changes in glucose metabolism, especially in the right frontal middle gyrus (Brodmann area [BA] 10) and right inferior frontal gyrus (BA 46 and BA 47). Negative correlations between the two were observed in the right posterior cingulate gyrus (BA 31) and left medial frontal lobe (BA 9).
CONCLUSION
These preliminary results confirm the role of the subthalamic nucleus in associative and limbic circuitry in humans and suggest that it is a key basal ganglia structure in motivation circuitry.
目的
帕金森病（PD）患者接受丘脑底核深部脑刺激（STN-DBS）后可能会出现淡漠。因此，我们希望通过（18）氟代脱氧葡萄糖正电子发射断层扫描（（18）FDG-PET）来验证STN-DBS诱发的淡漠与葡萄糖代谢变化相关这一假说。
方法
对12例PD患者在接受STN-DBS前3个月（M-3）和后3个月（M+3）进行（18）FDG-PET检查及淡漠评估量表评估。
结果
STN-DBS术后3个月（M+3）时淡漠明显加重。淡漠评分的这种变化与葡萄糖代谢变化之间存在正相关，尤其是在右侧额中回（布罗德曼区[BA]10）和右侧额下回（BA 46和BA 47）。在右侧后扣带回（BA 31）和左侧额内侧叶（BA 9）观察到两者之间呈负相关。
结论
这些初步结果证实了丘脑底核在人类联合和边缘神经回路中的作用，并表明它是动机神经回路中的关键基底神经节结构。
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