Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan; Team for Neuroimaging Research, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Japan Community Health Care Organization, Mishima General Hospital, Mishima, Japan.
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan; Kiyosawa Eye Clinic, Tokyo, Japan.
Neuroimage Clin. 2019;24:101995. doi: 10.1016/j.nicl.2019.101995. Epub 2019 Aug 26.
Essential blepharospasm (EB) causes difficulty in eyelid opening because of involuntary movements of the orbicularis oculi muscle. Patients with EB have functional visual loss due to sustained eyelid closure. We examined cerebral glucose metabolism in 39 patients with EB (12 men and 27 women; mean age, 52.1 years) by using positron emission tomography with F-fluorodeoxyglucose. Forty-eight eye open healthy subjects and 48 eye close healthy subjects served as controls. We analyzed and compared the data between the patients and controls by using both statistical parametric mapping (SPM) and regions of interest (ROIs). We defined ROIs on both sides of the posterior striate cortex, anterior striate cortex, extrastriate cortex, and thalamus. In SPM analysis, glucose hypometabolism were observed in both sides of the extrastriate cortex compared to eye open controls but not to eye close controls. We also observed a significant negative correlation between the Jankovic Rating Scale (JRS) sum score and relative glucose metabolism level in the striate cortex of these patients. ROI analysis, a significant correlation was observed between the JRS sum score and glucose metabolism level in the posterior (right: r = -0.53, P = .0005; left: r = -0.65, P = .00001) and anterior (right: r = -0.33, P = .04; left: r = -0.37, P = .02) striate cortices of patients with EB. We surmise that the interruption of visual input cause glucose hypometabolism in the visual cortex of patients with EB.
特发性眼睑痉挛（Essential blepharospasm，EB）导致眼轮匝肌不自主运动，引起眼睑难以睁开。由于眼睑持续闭合，EB 患者会出现功能性视力丧失。我们使用 F-氟脱氧葡萄糖正电子发射断层扫描检查了 39 例 EB 患者（12 名男性，27 名女性；平均年龄 52.1 岁）的大脑葡萄糖代谢情况。48 名睁眼健康对照者和 48 名闭眼健康对照者作为对照。我们使用统计参数映射（SPM）和感兴趣区（ROI）对患者和对照组的数据进行了分析和比较。我们在双侧后纹状体皮层、前纹状体皮层、纹外皮层和丘脑定义了 ROI。在 SPM 分析中，与睁眼对照组相比，双侧纹外皮层的葡萄糖代谢率降低，但与闭眼对照组相比则无差异。我们还观察到这些患者纹状体皮层的 Jankovic 评分量表（JRS）总分与相对葡萄糖代谢水平之间存在显著负相关。ROI 分析显示，JRS 总分与患者纹状体后部（右侧：r=-0.53，P=0.0005；左侧：r=-0.65，P=0.00001）和前部（右侧：r=-0.33，P=0.04；左侧：r=-0.37，P=0.02）葡萄糖代谢水平之间存在显著相关性。我们推测，视觉输入的中断导致 EB 患者视觉皮层的葡萄糖代谢率降低。
