DAT-SPECT 特异性结合比值的偏侧性在鉴别退行性帕金森综合征中的作用。
Laterality of specific binding ratios on DAT-SPECT for differential diagnosis of degenerative parkinsonian syndromes.
机构信息
Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
出版信息
Sci Rep. 2020 Sep 25;10(1):15761. doi: 10.1038/s41598-020-72321-y.
Motor symptoms of Parkinson's disease (PD) occur unilaterally and progress with asymmetry, while progressive supranuclear palsy (PSP) and multiple system atrophy of the parkinsonism subtype (MSA-P) lack this tendency. We assessed the laterality of specific binding ratios (SBRs) on dopamine transporter single-photon emission computed tomography (DAT-SPECT) for the differential diagnosis of these diseases in 311 PD, 33 PSP, 20 MSA-P, and 137 control patients. The average SBR in PD was higher than that in PSP (P = 0.035). Compared with Hoehn-Yahr (HY) stages, the average SBR in PD with HY stage I was only higher than that in PSP (P < 0.001). SBR laterality in PD with HY stage I was significantly higher than that in PSP (P = 0.001). This difference was not observed in PD with HY stage II. The average and laterality of SBRs in MSA-P were similar to those in PD and PSP. The asymmetry indices were similar among PD, PSP, and MSA-P. These data suggest that PSP shows a pattern of SBRs different from that in PD, attributed to HY stage I in PD. The limited usefulness of DAT-SPECT may be explained by the low discrimination between PD with bilateral motor symptoms and PSP.
帕金森病（PD）的运动症状呈单侧性，且进展具有不对称性，而进行性核上性麻痹（PSP）和多系统萎缩帕金森型（MSA-P）则缺乏这种趋势。我们评估了多巴胺转运体单光子发射计算机断层扫描（DAT-SPECT）上特定结合比（SBR）的偏侧性，以对这些疾病进行鉴别诊断，纳入了 311 例 PD、33 例 PSP、20 例 MSA-P 和 137 例对照患者。PD 的平均 SBR 高于 PSP（P=0.035）。与 Hoehn-Yahr（HY）分期相比，HY 分期 I 的 PD 的平均 SBR 仅高于 PSP（P<0.001）。HY 分期 I 的 PD 的 SBR 偏侧性明显高于 PSP（P=0.001）。在 HY 分期 II 的 PD 中未观察到这种差异。MSA-P 的平均 SBR 和偏侧性与 PD 和 PSP 相似。PD、PSP 和 MSA-P 的不对称指数相似。这些数据表明，PSP 显示的 SBR 模式与 PD 不同，这归因于 PD 的 HY 分期 I。DAT-SPECT 的有限实用性可能是由于双侧运动症状的 PD 与 PSP 之间的鉴别能力较低所致。
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