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[皮质基底节综合征:最新进展与未来方向]

[Corticobasal syndrome: recent advances and future directions].

作者信息

Aiba Ikuko

机构信息

Department of Neurology, National Hospital Organization Higashinagoya National Hospital, Meitou-ku, Nagoya, Japan.

出版信息

Brain Nerve. 2012 Apr;64(4):462-73.

Abstract

Corticobasal degeneration (CBD) is a progressive neurodegenerative disorder described by Rebeiz et al. It is characterized by progressive, asymmetric, cortical (eg, apraxia, alien limb phenomena, cortical sensory loss, and myoclonus), and extrapyramidal (eg, rigidity, bradykinesia, dystonia, and tremor) dysfunction. However, CBD has many clinical phenotypes, and the features used for predicting CBD have low sensitivity. Therefore, the term corticobasal syndrome (CBS) has been used to characterize such clinical features, whereas the term CBD is used to refer to the pathological disorder. The most frequent causes of CBS are CBD, followed by Alzheimer's disease, progressive supranuclear palsy, frontotemporal lobar degeneration with TDP-43 pathology (sporadic and familial), Pick's disease, Lewy body disease, frontotemporal lobar degeneration with fused in sarcoma-positive inclusions, Creutzfeldt-Jakob disease, and mutations in the microtubule-associated protein tau (MAPT) and progranulin (GRN) genes. The topography of neurodegeneration dictates the clinical syndrome not according to the underlying pathology. Researchers have attempted to develop fluid biomarkers or imaging analysis for diagnosing CBS. The aim of this review was to highlight recent advances in CBS diagnosis and discuss future directions.

摘要

皮质基底节变性(CBD)是一种由雷贝兹等人描述的进行性神经退行性疾病。其特征为进行性、不对称的皮质功能障碍(如失用症、异己肢体现象、皮质感觉丧失和肌阵挛)以及锥体外系功能障碍(如僵硬、运动迟缓、肌张力障碍和震颤)。然而,CBD有许多临床表型,用于预测CBD的特征敏感性较低。因此,术语“皮质基底节综合征(CBS)”被用于描述此类临床特征,而术语“CBD”则用于指代病理疾病。CBS最常见的病因是CBD,其次是阿尔茨海默病、进行性核上性麻痹、伴有TDP-43病理改变的额颞叶变性(散发性和家族性)、匹克病、路易体病、伴有肉瘤融合阳性包涵体的额颞叶变性、克雅氏病以及微管相关蛋白tau(MAPT)和原颗粒蛋白(GRN)基因突变。神经变性的部位决定临床综合征,而非根据潜在病理情况。研究人员已尝试开发用于诊断CBS的生物标志物或影像学分析方法。本综述的目的是强调CBS诊断的最新进展并讨论未来方向。

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