Center for Parkinsonism and Other Movement Disorders, Departments of Neurology, University of Ulsan College of Medicine, Seoul, Korea.
Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Mov Disord. 2009 May;2(1):22-8. doi: 10.14802/jmd.09006. Epub 2009 Apr 30.
To investigate the relationship between presenting clinical manifestations and imaging features of multisystem neuronal dysfunction in MSA patients, using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET).
We studied 50 consecutive MSA patients with characteristic brain MRI findings of MSA, including 34 patients with early MSA-parkinsonian (MSA-P) and 16 with early MSA-cerebellar (MSA-C). The cerebral glucose metabolism of all MSA patients was evaluated in comparison with 25 age-matched controls. (18)F-FDG PET results were assessed by the Statistic Parametric Mapping (SPM) analysis and the regions of interest (ROI) method.
The mean time from disease onset to (18)F-FDG PET was 25.9±13.0 months in 34 MSA-P patients and 20.1±11.1 months in 16 MSA-C patients. Glucose metabolism of the putamen showed a greater decrease in possible MSA-P than in probable MSA-P (p=0.031). Although the Unified Multiple System Atrophy Rating Scale (UMSARS) score did not differ between possible MSA-P and probable MSA-P, the subscores of rigidity (p=0.04) and bradykinesia (p= 0.008) were significantly higher in possible MSA-P than in probable MSA-P. Possible MSA-C showed a greater decrease in glucose metabolism of the cerebellum than probable MSA-C (p=0.016).
Our results may suggest that the early neuropathological pattern of possible MSA with a predilection for the striatonigral or olivopontocerebellar system differs from that of probable MSA, which has prominent involvement of the autonomic nervous system in addition to the striatonigral or olivopontocerebellar system.
使用（18）F-氟脱氧葡萄糖正电子发射断层扫描（（18）F-FDG PET）研究 MSA 患者多系统神经元功能障碍的临床表现和影像学特征之间的关系。
我们研究了 50 例具有 MSA 特征性脑 MRI 表现的 MSA 连续患者，包括 34 例早期 MSA-帕金森病（MSA-P）患者和 16 例早期 MSA-小脑（MSA-C）患者。将所有 MSA 患者的大脑葡萄糖代谢与 25 名年龄匹配的对照组进行比较。使用统计参数映射（SPM）分析和感兴趣区（ROI）方法评估（18）F-FDG PET 结果。
34 例 MSA-P 患者和 16 例 MSA-C 患者从发病到（18）F-FDG PET 的平均时间分别为 25.9±13.0 个月和 20.1±11.1 个月。壳核的葡萄糖代谢在可能的 MSA-P 中比可能的 MSA-P 中减少更多（p=0.031）。尽管可能的 MSA-P 和可能的 MSA-P 之间的统一多系统萎缩评定量表（UMSARS）评分没有差异，但可能的 MSA-P 中僵硬的亚评分（p=0.04）和运动迟缓（p=0.008）明显高于可能的 MSA-P。可能的 MSA-C 的小脑葡萄糖代谢比可能的 MSA-C 减少更多（p=0.016）。
我们的结果可能表明，具有纹状体黑质或橄榄脑桥小脑系统倾向性的可能 MSA 的早期神经病理学模式与除纹状体黑质或橄榄脑桥小脑系统外还具有明显自主神经系统受累的可能 MSA 不同。
