Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan.
Parkinsonism Relat Disord. 2011 Jun;17(5):357-9. doi: 10.1016/j.parkreldis.2011.02.007. Epub 2011 Mar 3.
The objective of this study was to delineate the clinical features of patients with pure akinesia and a low heart versus mediastinum ratio below 2.0 in the delayed images of myocardial metaiodobenzylguanidine scintigraphy, a marker for the clinical diagnosis of Lewy body diseases. A total of 13 patients was enrolled. The clinical features of the patients were uniformly elderly (mean age, 73.7 years), a male gender preponderance (10 men and 3 women), relatively mild motor disability (mean Hoehn Yahr grade 2.4) without laterality, festinating gait (77%) and loss of postural reflex (69%), which were the most common; also observed were fair levodopa responses (70%), cognitive dysfunction in some (23%), common autonomic dysfunction (urinary urgency and frequency, 85%; constipation, 77%; and postural hypotension, 38%) and common occipital hypoperfusion (62%). These features may facilitate the clinical differential diagnosis of these patients from patients with pure akinesia due to progressive supranuclear palsy.
本研究旨在描述在心肌间碘苄胍闪烁显像延迟相上单纯运动不能且心脏与纵隔比值低于 2.0 的患者的临床特征，这种现象是路易体疾病的临床诊断标志物。共纳入 13 例患者。这些患者的临床特征普遍为高龄（平均年龄 73.7 岁）、男性为主（10 男 3 女）、运动障碍相对较轻（平均 Hoehn-Yahr 分级 2.4 级，无偏侧性）、出现碎步（77%）和姿势反射丧失（69%），这是最常见的症状；还观察到良好的左旋多巴反应（70%）、认知功能障碍（23%）、常见自主神经功能障碍（尿急和尿频，85%；便秘，77%；和体位性低血压，38%）和常见枕叶灌注不足（62%）。这些特征可能有助于将这些患者与单纯因进行性核上性麻痹引起的运动不能患者进行临床鉴别诊断。
