Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Mov Disord. 2011 Feb 15;26(3):493-8. doi: 10.1002/mds.23471. Epub 2011 Jan 12.
Behavioral changes occur in progressive supranuclear palsy. This study aimed to identify the anatomic correlate of behavioral severity in progressive supranuclear palsy.
We performed standardized tests of behavioral severity (Frontal Behavioral Inventory), cognitive severity (Mini-Mental State Examination), motor severity (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Part III), and a 3.0-T volumetric head magnetic resonance imaging scan in 18 prospectively recruited subjects meeting National Institute of Neurological Diseases and Stroke-Society of Progressive Supranuclear Palsy criteria for probable progressive supranuclear palsy. Atlas-based parcellation was utilized to obtain regional gray matter volumes of frontal, temporal, and parietal lobe, and caudate and putamen, and voxel-based morphometry was used to assess voxel-level gray matter loss. We performed correlation analyses between total Frontal Behavioral Inventory score and gray matter volume, as well as assessed gray matter volume across three groups defined according to behavioral severity (mild, moderate, and severe) based on total Frontal Behavioral Inventory score.
Specific behaviors, with the exception of apathy that occurred in 83% of the subjects, were relatively infrequent. There was no association between Frontal Behavioral Inventory and cognitive or motor severity. Regions of the frontal lobe, particularly, the lateral posterior frontal cortex, significantly correlated with the total Frontal Behavioral Inventory score when using both regional volume and voxel-level analyses. The groupwise analyses also supported these findings. The presence of apathy correlated with atrophy of the putamen.
Behavioral severity in progressive supranuclear palsy appears to be associated with volume loss of frontostriatal regions, in particular, lateral posterior frontal lobe and putamen.
进行性核上性麻痹会出现行为改变。本研究旨在确定进行性核上性麻痹患者行为严重程度的解剖学相关因素。
我们对 18 名符合国家神经疾病与中风研究所-进行性核上性麻痹协会可能进行性核上性麻痹标准的前瞻性招募患者进行了行为严重程度（额叶行为量表）、认知严重程度（简易精神状态检查）、运动严重程度（运动障碍协会修订的统一帕金森病评定量表第三部分）以及头部 3.0T 容积磁共振成像扫描。采用基于图谱的分区方法获取额叶、颞叶和顶叶以及尾状核和壳核的区域灰质体积，并采用基于体素的形态计量学方法评估体素水平的灰质丢失。我们进行了额叶行为量表总分与灰质体积之间的相关性分析，以及根据额叶行为量表总分将患者分为轻度、中度和重度三个行为严重程度组，评估各组的灰质体积。
除了 83%的患者出现的淡漠外，特定行为相对较少。额叶行为量表与认知或运动严重程度之间没有关联。额叶区域，特别是外侧后额叶皮质，与额叶行为量表总分存在显著相关性，无论是采用区域体积还是体素水平分析方法都是如此。组间分析也支持了这些发现。淡漠的存在与壳核萎缩相关。
进行性核上性麻痹的行为严重程度似乎与额纹状体区域的体积丢失有关，特别是外侧后额叶和壳核。
