Kluin K J, Gilman S, Markel D S, Koeppe R A, Rosenthal G, Junck L
Department of Physical Medicine, University of Michigan, Ann Arbor 48109-0316.
Ann Neurol. 1988 Jun;23(6):547-54. doi: 10.1002/ana.410230604.
We compared the severity of ataxic and spastic dysarthria with local cerebral metabolic rates for glucose (lCMRGlc) in 30 patients with olivopontocerebellar atrophy (OPCA). Perceptual analysis was used to examine the speech disorders, and rating scales were devised to quantitate the degree of ataxia and spasticity in the speech of each patient. lCMRGlc was measured with 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography (PET). PET studies revealed marked hypometabolism in the cerebellar hemispheres, cerebellar vermis, and brainstem of OPCA patients compared with 30 control subjects. With data normalized to the cerebral cortex, a significant inverse correlation was found between the severity of ataxia in speech and the lCMRGlc within the cerebellar vermis, cerebellar hemispheres, and brainstem, but not within the thalamus. No significant correlation was found between the severity of spasticity in speech and lCMRGlc in any of these structures. The findings support the view that the severity of ataxia in speech in OPCA is related to the functional activity of the cerebellum and its connections in the brainstem.
我们比较了30例橄榄脑桥小脑萎缩（OPCA）患者的共济失调性和痉挛性构音障碍的严重程度与局部脑葡萄糖代谢率（lCMRGlc）。采用感知分析来检查言语障碍，并设计评分量表以量化每位患者言语中共济失调和痉挛的程度。使用18F - 2 - 氟 - 2 - 脱氧 - D - 葡萄糖和正电子发射断层扫描（PET）测量lCMRGlc。PET研究显示，与30名对照受试者相比，OPCA患者的小脑半球、小脑蚓部和脑干存在明显的代谢减低。将数据标准化至大脑皮层后，发现言语中共济失调的严重程度与小脑蚓部、小脑半球和脑干内的lCMRGlc之间存在显著的负相关，但与丘脑内的lCMRGlc无显著相关性。在言语中痉挛的严重程度与这些结构中任何一个的lCMRGlc之间均未发现显著相关性。这些发现支持了以下观点，即OPCA患者言语中共济失调的严重程度与小脑及其在脑干中的连接的功能活动有关。
