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嗅觉刺激期间特发性嗅觉减退患者脑代谢变化与临床参数的关系:一项初步研究。

Cerebral metabolic changes related to clinical parameters in idiopathic anosmic patients during olfactory stimulation: a pilot investigation.

作者信息

Micarelli Alessandro, Chiaravalloti Agostino, Danieli Roberta, Schillaci Orazio, Alessandrini Marco

机构信息

Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 6° floor, E Sud Tower, 00133, Rome, Italy.

Neuroscience Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2649-2655. doi: 10.1007/s00405-017-4524-9. Epub 2017 Mar 10.

Abstract

Idiopathic olfactory loss neural consequences have been studied especially by means of magnetic resonance imaging. Since other functional neuroimaging technique findings are lacking in the literature, present study used a validated F-2-fluoro-2-deoxy-D-glucose (FDG) functional positron emission tomography procedure under olfactory stimulation (OS) to assess brain changes in idiopathic anosmic patients (IAPs) in comparison with healthy subjects (HS). A voxel-based analysis between these groups was used to evaluate FDG uptake in the brain and perform a correlation analysis between metabolic responses and the Sniffin' stick test as well as intensity visuo-analogue scores and disease duration (DD). A significant relative decrease of glucose metabolism in the right and left frontal lobes, left insula, right parietal lobe, and left occipital, temporal and parietal lobes was found in IAPs during OS. The same condition resulted in a relative higher glucose metabolism in the right cerebellum in IAPs. Moreover, a negative correlation between DD and FDG uptake in the left temporo-parietal joint was found in IAPs. Such a correlation suggested a possible involvement of this area metabolic decrease in self-consciousness impairment, which is known to affect IAPs. Present preliminary functional results could be of interest to further deepen such neural impairments possibly useful for future perspective in pharmaceutical and rehabilitative protocols.

摘要

特发性嗅觉丧失的神经后果尤其通过磁共振成像进行了研究。由于文献中缺乏其他功能神经影像学技术的研究结果,本研究采用经过验证的F-2-氟-2-脱氧-D-葡萄糖(FDG)功能正电子发射断层扫描程序,在嗅觉刺激(OS)下评估特发性嗅觉丧失患者(IAPs)与健康受试者(HS)相比的脑变化。对这些组进行基于体素的分析,以评估大脑中的FDG摄取,并对代谢反应与嗅觉棒测试以及视觉模拟评分强度和病程(DD)之间进行相关性分析。发现在OS期间,IAPs的左右额叶、左侧岛叶、右侧顶叶以及左侧枕叶、颞叶和顶叶的葡萄糖代谢显著相对降低。相同情况下,IAPs右侧小脑的葡萄糖代谢相对较高。此外,在IAPs中发现病程与左侧颞顶关节的FDG摄取之间存在负相关。这种相关性表明该区域代谢降低可能参与了已知会影响IAPs的自我意识损害。目前的初步功能结果可能有助于进一步深入了解这种神经损伤,这可能对未来药物和康复方案的前景有用。

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