Rosenthal G, Gilman S, Koeppe R A, Kluin K J, Markel D S, Junck L, Gebarski S S
Department of Neurology, University of Michigan, Ann Arbor 48109.
Ann Neurol. 1988 Sep;24(3):414-9. doi: 10.1002/ana.410240310.
We compared the severity of motor dysfunction with local cerebral metabolic rates for glucose (lCMRGlc) and the degree of tissue atrophy in 30 patients with olivopontocerebellar atrophy (OPCA). We devised a scale to quantitate the degree of ataxia in the neurological examinations. lCMRGlc was measured with 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography (PET). Tissue atrophy was assessed by visual rating of computed tomographic scans. PET studies revealed marked hypometabolism in the cerebellar vermis, cerebellar hemispheres, and brainstem of OPCA patients compared with 30 control subjects. A significant correlation was found between severity of motor impairment and lCMRGlc within the cerebellar vermis, both cerebellar hemispheres, and the brainstem. A significant but weaker relationship was noted between the degree of tissue atrophy in these regions and clinical severity. Partial correlation analysis revealed that motor dysfunction in OPCA correlated more strongly with lCMRGlc than with the amount of tissue atrophy. These results suggest that the clinical manifestations of OPCA are more closely related to the metabolic state of the tissue than to the structural changes in the cerebellum.
我们比较了30例橄榄体脑桥小脑萎缩（OPCA）患者的运动功能障碍严重程度与局部脑葡萄糖代谢率（lCMRGlc）以及组织萎缩程度。我们设计了一个量表来量化神经学检查中的共济失调程度。lCMRGlc通过18F-2-氟-2-脱氧-D-葡萄糖和正电子发射断层扫描（PET）进行测量。组织萎缩通过计算机断层扫描的视觉评分进行评估。与30名对照受试者相比，PET研究显示OPCA患者的小脑蚓部、小脑半球和脑干存在明显的代谢减低。在小脑蚓部、双侧小脑半球和脑干内，运动损伤严重程度与lCMRGlc之间存在显著相关性。在这些区域的组织萎缩程度与临床严重程度之间存在显著但较弱的关系。偏相关分析显示，OPCA中的运动功能障碍与lCMRGlc的相关性比与组织萎缩量的相关性更强。这些结果表明，OPCA的临床表现与组织代谢状态的关系比与小脑结构变化的关系更为密切。
