Department of Pediatric Neurology, Istanbul University, Arpaemini/Fatih, İstanbul 34093, Turkey.
J Clin Neurosci. 2013 Mar;20(3):373-6. doi: 10.1016/j.jocn.2012.03.034. Epub 2012 Dec 7.
The purpose of this study was to evaluate positron emission tomography (PET) findings in patients diagnosed with infantile spasms and autism. This study includes 90 patients who were diagnosed with infantile spasms at the Department of Pediatric Neurology in the Istanbul University Medical Faculty between 1995 and 2007. Of the 90 patients, 15 patients who were diagnosed with autism using the Autism Behaviour Checklist and Childhood Autism Rating Scale and a control group of nine patients without autism but with infantile spasms underwent PET examination. Mean patient age (± standard error, SE) varied between 3 years and 16 years (7.8 ± 4 years), while the mean follow-up time (±SE) varied between 2 years and 16 years (average: 7.1 ± 4 years). Autism was present in 11 patients with symptomatic spasms and in four patients with cryptogenic spasms (p=0.009). On the PET scans of the 15 patients with autism, 13 (86.7%) had significantly decreased metabolic activity in the temporal lobe (p<0.001), nine (60%) had significantly decreased activity in the frontal lobe (p=0.004), and seven (46.7%) had significantly decreased activity in the parietal lobe (p=0.022). In our opinion, hypometabolism in the frontal and parietal lobes, in addition to that previously reported in the temporal lobe, plays a role in the development of autism in patients with infantile spasms.
本研究旨在评估诊断为婴儿痉挛症和自闭症患者的正电子发射断层扫描(PET)结果。本研究包括 1995 年至 2007 年在伊斯坦布尔大学医学院儿科神经病学系诊断为婴儿痉挛症的 90 例患者。在这 90 例患者中,有 15 例患者通过自闭症行为检查表和儿童自闭症评定量表诊断为自闭症,另外 9 例非自闭症但患有婴儿痉挛症的患者作为对照组接受了 PET 检查。患者平均年龄(±标准误差,SE)为 3 至 16 岁(7.8±4 岁),平均随访时间(±SE)为 2 至 16 岁(平均:7.1±4 岁)。症状性痉挛症中有 11 例和隐源性痉挛症中有 4 例存在自闭症(p=0.009)。在 15 例自闭症患者的 PET 扫描中,13 例(86.7%)颞叶代谢活性明显降低(p<0.001),9 例(60%)额叶活性明显降低(p=0.004),7 例(46.7%)顶叶活性明显降低(p=0.022)。我们认为,除了先前报道的颞叶之外,额叶和顶叶的代谢低下也与婴儿痉挛症患者自闭症的发生有关。