De Volder A G, Francart J, Laterre C, Dooms G, Bol A, Michel C, Goffinet A M
Positron Tomography Laboratory, University of Louvain, Belgium.
Ann Neurol. 1989 Aug;26(2):239-47. doi: 10.1002/ana.410260210.
Nine positron emission tomography studies of regional cerebral glucose metabolism were performed in 7 patients with probable striatonigral degeneration, a disorder characterized by parkinsonian features and absent or poor response to L-dopa. When compared with values obtained in normal volunteers, mean cerebral glucose metabolism was slightly reduced in subjects with striatonigral degeneration who, in addition, had a marked (20.5%, +/- 3 SD) relative hypometabolism in putaminal and caudate nuclei. Significant hypometabolism was also found in motor/premotor as well as in prefrontal cortex. In 2 subjects who were studied twice a deterioration of relative striatal metabolism paralleled clinical evolution. Magnetic resonance imaging disclosed the presence of abnormal iron deposits in the putamen in all cases but showed no cortical anomalies. These results suggest that positron emission tomography with [18F]fluorodeoxyglucose may provide an index of cell and processes degeneration in the striatum in striatonigral degeneration and is able to detect functional deficits in frontal cortex. The presence of striatal hypometabolism might be a predictor of a poor response to L-dopa.
对7例可能患有纹状体黑质变性的患者进行了9项区域性脑葡萄糖代谢的正电子发射断层扫描研究，纹状体黑质变性是一种以帕金森氏症为特征且对左旋多巴无反应或反应不佳的疾病。与正常志愿者的数值相比，纹状体黑质变性患者的平均脑葡萄糖代谢略有降低，此外，这些患者的壳核和尾状核存在明显的（20.5%，±3标准差）相对代谢减低。在运动/运动前区以及前额叶皮质也发现了明显的代谢减低。在2例接受了两次研究的患者中，纹状体相对代谢的恶化与临床进展平行。磁共振成像显示所有病例的壳核均存在异常铁沉积，但未显示皮质异常。这些结果表明，用[18F]氟脱氧葡萄糖进行正电子发射断层扫描可能为纹状体黑质变性中纹状体的细胞和过程变性提供一个指标，并且能够检测额叶皮质的功能缺陷。纹状体代谢减低可能是对左旋多巴反应不佳的一个预测指标。
