Pozzilli C, Passafiume D, Bernardi S, Pantano P, Incoccia C, Bastianello S, Bozzao L, Lenzi G L, Fieschi C
University of Rome, Department of Neurological Science, Italy.
J Neurol Neurosurg Psychiatry. 1991 Feb;54(2):110-5. doi: 10.1136/jnnp.54.2.110.
Seventeen patients with relapsing remitting multiple sclerosis (MS) and mild physical disability had neuropsychological testing, magnetic resonance imaging (MRI) and single photon emission computerised tomography (SPECT) using technetium 99m (99mTc) hexamethyl-propyleneamine oxime (HMPAO). Performance in verbal fluency, naming and memory testing appeared to be impaired in MS patients compared with 17 age-sex and education matched normal controls. Weighted periventricular and confluent lesion scores and the width of the third ventricle, proved to be the most sensitive MRI measures in differentiating more cognitively impaired patients from those who were relatively unimpaired. Ratios of regional to whole brain activity, measured by SPECT, showed significant reduction in the frontal lobes and in the left temporal lobe of MS patients. A relationship was found between left temporal abnormality in 99mTc-HMPAO uptake and deficit in verbal fluency and verbal memory. Finally, asymmetrical lobar activity indicated a predominant left rather than right temporo-parietal involvement.
17例复发缓解型多发性硬化（MS）且有轻度身体残疾的患者接受了神经心理学测试、磁共振成像（MRI）以及使用锝99m（99mTc）六甲基丙烯胺肟（HMPAO）的单光子发射计算机断层扫描（SPECT）。与17名年龄、性别和教育程度相匹配的正常对照相比，MS患者在言语流畅性、命名和记忆测试中的表现似乎受损。加权脑室周围和融合病灶评分以及第三脑室宽度，被证明是区分认知功能受损较重患者与相对未受损患者的最敏感MRI指标。通过SPECT测量的区域与全脑活动比率显示，MS患者的额叶和左侧颞叶有显著降低。在99mTc-HMPAO摄取的左侧颞叶异常与言语流畅性和言语记忆缺陷之间发现了一种关系。最后，不对称的脑叶活动表明主要是左侧而非右侧颞顶叶受累。
