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进行性核上性麻痹和皮质基底节综合征中脑灌注的下降速率可能受血糖变异性影响——一项初步研究

The Rate of Decrease in Brain Perfusion in Progressive Supranuclear Palsy and Corticobasal Syndrome May Be Impacted by Glycemic Variability-A Pilot Study.

作者信息

Alster Piotr, Dunalska Anna, Migda Bartosz, Madetko Natalia, Królicki Leszek

机构信息

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

Students' Scientific Circle of the Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Front Neurol. 2021 Nov 8;12:767480. doi: 10.3389/fneur.2021.767480. eCollection 2021.

Abstract

Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are tauopathic parkinsonian syndromes, presently lacking disease-modifying treatments. Patients affected by these diseases suffer due to multidimensional deteriorations resulting in motor and cognitive impairment. Previously published research has confirmed risk factors that may impact the course of PSP and CBS, among them hypertension and diabetes. Less data is available regarding prediabetes and glycemic variability. In this study, 26 patients with clinical diagnoses of PSP and CBS were examined using glycated hemoglobin and perfusion single-photon emission tomography (SPECT). Patients were divided into two groups-PSP/CBS patients with glycated hemoglobin (HbA1c) below and above 5.7%. The results of the perfusion evaluation were compared with the values from healthy volunteers from the software's database. A decrease in perfusion in certain regions of interest was observed among patients affected by increased glycemic variability. A more pronounced decrement in perfusion was observed only in some regions of interest-the hippocampus, pons, left thalamus, right insula. The results indicated that, among PSP/CBS patients, individuals with more pronounced glycemic variability had more severe hypoperfusion in certain brain regions in comparison with PSP/CBS patients without carbohydrate metabolism disorders. Due to the fact that PSP and CBS are associated with cognitive impairment, an additional decrease in perfusion in the hippocampal area may impact the rate of cognitive deterioration.

摘要

进行性核上性麻痹(PSP)和皮质基底节综合征(CBS)是tau蛋白病性帕金森综合征,目前缺乏疾病修饰治疗方法。受这些疾病影响的患者因多维度恶化而遭受痛苦,导致运动和认知障碍。先前发表的研究已经证实了可能影响PSP和CBS病程的危险因素,其中包括高血压和糖尿病。关于糖尿病前期和血糖变异性的数据较少。在本研究中,对26例临床诊断为PSP和CBS的患者进行了糖化血红蛋白和灌注单光子发射断层扫描(SPECT)检查。患者被分为两组——糖化血红蛋白(HbA1c)低于和高于5.7%的PSP/CBS患者。将灌注评估结果与软件数据库中健康志愿者的值进行比较。在血糖变异性增加的患者中,观察到某些感兴趣区域的灌注减少。仅在某些感兴趣区域——海马体、脑桥、左侧丘脑、右侧岛叶观察到更明显的灌注减少。结果表明,在PSP/CBS患者中,与没有碳水化合物代谢紊乱的PSP/CBS患者相比,血糖变异性更明显的个体在某些脑区有更严重的灌注不足。由于PSP和CBS与认知障碍有关,海马区灌注的额外减少可能会影响认知恶化的速度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d3d/8606811/1dd947efd2cd/fneur-12-767480-g0001.jpg

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