Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea.
Eur Neurol. 2011;65(5):296-301. doi: 10.1159/000326907. Epub 2011 Apr 21.
Midbrain atrophy is a well-known feature of progressive supranuclear palsy (PSP). Some clinical features of vascular parkinsonism (VP) such as pseudobulbar phenomena, lower body predominance and early postural instability suggest that the brainstem could be associated with VP. The aim of this study was to determine whether midbrain atrophy was present in patients with VP.
We measured the midbrain (Amd) and pons area (Apn) of 20 patients with VP, 15 patients with probable PSP and 30 patients with idiopathic Parkinson's disease (IPD). The Amd and Apn were measured on mid-sagittal T(1)-weighted MRI scans using a computerized image analysis system.
For the Amd, the patients with VP (99.86 mm(2)) and PSP (87.30 mm(2)) had significantly smaller areas than the patients with IPD (130.52 mm(2)). For the Apn, there was a significant difference only between the VP (407.23 mm(2)) and the IPD (445.05 mm(2)) patients. The Amd/Apn ratios of the patients with VP (0.245) and PSP (0.208) were significantly smaller than in the patients with IPD (0.292).
Our study shows that brainstem atrophy often occurs in patients with VP and the midbrain is more vulnerable than the pons to atrophic changes.
中脑萎缩是进行性核上性麻痹（PSP）的一个显著特征。血管性帕金森病（VP）的一些临床特征，如假性延髓现象、下半身为主和早期姿势不稳，表明脑干可能与 VP 有关。本研究旨在确定 VP 患者是否存在中脑萎缩。
我们测量了 20 例 VP 患者、15 例可能的 PSP 患者和 30 例特发性帕金森病（IPD）患者的中脑（Amd）和脑桥区域（Apn）。使用计算机图像分析系统在中矢状 T1 加权 MRI 扫描上测量 Amd 和 Apn。
对于 Amd，VP 患者（99.86mm²）和 PSP 患者（87.30mm²）的面积明显小于 IPD 患者（130.52mm²）。对于 Apn，仅 VP 患者（407.23mm²）和 IPD 患者（445.05mm²）之间存在显著差异。VP 患者（0.245）和 PSP 患者（0.208）的 Amd/Apn 比值明显小于 IPD 患者（0.292）。
我们的研究表明，脑干萎缩常发生在 VP 患者中，中脑比脑桥更容易发生萎缩性改变。
