Abe Yoshitake, Kimura Noriyuki, Goto Megumi, Aso Yasuhiro, Matsubara Etsuro
Department of Neurology, Faculty of Medicine, Oita University, Yufu, Japan.
Dement Geriatr Cogn Dis Extra. 2016 Apr 15;6(1):133-41. doi: 10.1159/000443329. eCollection 2016 Jan-Apr.
Brain perfusion may differ between patients with corticobasal syndrome (CBS) with and without aphasia.
Twenty-six (9 males and 17 females; mean age 76 ± 5.3 years) patients with CBS were enrolled in the study. Brain MRI and single-photon emission computed tomography were performed in all subjects. Language was evaluated using the Standard Language Test of Aphasia. The patients were divided into two subgroups according to the presence or absence of progressive aphasia. Differences in the regional cerebral blood flow (rCBF) between the two groups were detected based on voxel-by-voxel group analysis using Statistical Parametric Mapping 8.
All patients exhibited asymmetric motor symptoms and signs, including limb apraxia, bradykinesia, and akinetic rigidity. Of 26 patients, 9 had a clinically obvious language disturbance, characterized as nonfluent aphasia. Almost all CBS patients with aphasia exhibited cortical atrophy predominantly in the left frontal and temporal lobes with widening of the Sylvian fissure on MRI. The rCBF in the left middle frontal gyrus differed significantly between CBS patients with and without aphasia.
CBS patients with aphasia exhibit motor symptoms predominantly on the right side and cortical atrophy mainly in the left perisylvian cortices. In particular, left frontal dysfunction might be related to nonfluent aphasia in CBS.
患有和未患有失语症的皮质基底节综合征(CBS)患者的脑灌注可能存在差异。
26例(9例男性和17例女性;平均年龄76±5.3岁)CBS患者纳入本研究。所有受试者均进行了脑部MRI和单光子发射计算机断层扫描。使用失语症标准语言测试评估语言能力。根据是否存在进行性失语将患者分为两个亚组。使用统计参数映射8基于逐体素组分析检测两组之间的局部脑血流量(rCBF)差异。
所有患者均表现出不对称的运动症状和体征,包括肢体失用、运动迟缓及运动不能性强直。26例患者中,9例有临床上明显的语言障碍,表现为非流利性失语。几乎所有患有失语症的CBS患者在MRI上均表现为主要在左侧额叶和颞叶的皮质萎缩,大脑外侧裂增宽。患有和未患有失语症的CBS患者在左侧额中回的rCBF存在显著差异。
患有失语症的CBS患者主要在右侧出现运动症状,皮质萎缩主要发生在左侧大脑外侧裂周围皮质。特别是,左侧额叶功能障碍可能与CBS中的非流利性失语有关。