Östberg Anna, Virta Jere, Rinne Juha O, Oikonen Vesa, Luoto Pauliina, Någren Kjell, Arponen Eveliina, Tenovuo Olli
The Division of Clinical Neurosciences (Drs Östberg, Rinne, and Tenovuo), and Turku Positron Emission Tomography Centre (Drs Virta and Rinne, Messrs Oikonen and Luoto, and Ms Arponen), Turku University Hospital, Finland; and Department of Nuclear Medicine, PET and Cyclotron Unit, Odense University Hospital, Denmark (Dr Någren).
J Head Trauma Rehabil. 2018 Jan/Feb;33(1):25-32. doi: 10.1097/HTR.0000000000000279.
To investigate quantitative positron emission tomography (PET) findings and to study whether the cholinergic function differs between respondents to cholinergic medication versus nonrespondents.
Outpatient clinic and university PET imaging center.
We studied 17 subjects for more than 1 year after at least moderate traumatic brain injury. Ten of the subjects were respondents and 7 nonrespondents to cholinergic medication.
Cholinergic function was assessed with [methyl-C] N-methylpiperidyl-4-acetate-PET (C-MP4A-PET), which reflects the activity of the acetylcholinesterase (AChE) enzyme. The subjects were PET scanned twice: without medication and after a 4-week treatment with rivastigmine 1.5 mg twice a day.
Regional cerebral AChE activity was measured with PET.
At baseline Statistical Parametric Mapping analyses showed significantly lower AChE activity in respondents bilaterally in the frontal cortex as compared with nonrespondents. Region of interest (ROI) analysis revealed that the difference was most pronounced in the lateral frontal cortex (-9.4%, P = .034) and anterior cingulate (-6.0%, P = .049). After rivastigmine treatment, AChE activity was notably lower throughout the cortex in both respondents and nonrespondents, without significant differences between them.
Our study suggests that frontal cholinergic dysfunction is associated with the clinical response to cholinergic stimulation in patients with traumatic brain injury.
研究正电子发射断层扫描（PET）定量结果，并探讨胆碱能药物应答者与无应答者之间胆碱能功能是否存在差异。
门诊及大学PET影像中心。
我们对至少中度创伤性脑损伤后1年以上的17名受试者进行了研究。其中10名受试者对胆碱能药物有应答，7名无应答。
采用[甲基-C]N-甲基哌啶基-4-乙酸-PET（C-MP4A-PET）评估胆碱能功能，该方法可反映乙酰胆碱酯酶（AChE）的活性。受试者接受两次PET扫描：一次在未用药时，另一次在每天两次服用1.5 mg卡巴拉汀治疗4周后。
用PET测量局部脑AChE活性。
在基线时，统计参数映射分析显示，与无应答者相比，应答者双侧额叶皮质的AChE活性显著降低。感兴趣区（ROI）分析显示，外侧额叶皮质（-9.4%，P = 0.034）和前扣带回（-6.0%，P = 0.049）的差异最为明显。卡巴拉汀治疗后，应答者和无应答者整个皮质的AChE活性均显著降低，两者之间无显著差异。
我们的研究表明，额叶胆碱能功能障碍与创伤性脑损伤患者对胆碱能刺激的临床反应相关。
