Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China.
Department of Radiology, Hospital, Hubei University, Wuhan 430062, China.
Neuroimage. 2022 Oct 15;260:119487. doi: 10.1016/j.neuroimage.2022.119487. Epub 2022 Jul 16.
This study aimed to explore the glucose metabolic profile of extrapyramidal system in patients with crossed cerebellar diaschisis (CCD). Furthermore, the metabolic connectivities in cortico-ponto-cerebellar and cortico-rubral pathways associated with CCD were also investigated. A total of 130 CCD positive (CCD+) and 424 CCD negative (CCD-) patients with unilateral cerebral hemisphere hypometabolism on F-fluorodeoxyglucose positron emission tomography (F-FDG PET) were enrolled. Besides, the control group consisted of 56 subjects without any brain structural and metabolic abnormalities. Apart from the "autocorrelation", metabolic connectivity pattern of right or left affected cerebellar hemisphere involved unilateral (left or right, respectively) caudate, pallidum, putamen, thalamus and red nucleus, in CCD+ patients with left or right supratentorial lesions, respectively (P < 0.001, cluster size > 200). CCD+ group had significantly lower asymmetry index (AI) in cortico-ponto-cerebellar pathway (including ipsilateral cerebral white matter, ipsilateral pons, contralateral cerebellum white matter and contralateral cerebellum exterior cortex) and cortico-rubral pathway (including ipsilateral caudate, thalamus proper, pallidum, putamen, ventral diencephalon and red nucleus) than those of both CCD- and control groups (all P < 0.05). AI in contralateral cerebellum exterior cortex was significantly positively correlated with that in ipsilateral caudate, putamen, pallidum, thalamus proper, ventral diencephalon, red nucleus and pons among CCD+ group (all P < 0.01), but only with that in ipsilateral caudate and putamen among CCD- group (both P < 0.001). These results provide additional insight into the involvement of both cortico-ponto-cerebellar and cortico-rubral pathways in the presence of CCD, underlining the need for further investigation about the role of their aberrant metabolic connectivities in the associated symptoms of CCD.
本研究旨在探讨交叉小脑失联络（CCD）患者的锥体外系葡萄糖代谢特征。此外，还研究了与 CCD 相关的皮质-桥脑-小脑和皮质-红核通路的代谢连接。共纳入 130 例 F-氟脱氧葡萄糖正电子发射断层扫描（F-FDG PET）显示单侧大脑半球代谢低下的 CCD 阳性（CCD+）患者和 424 例 CCD 阴性（CCD-）患者。此外，对照组由 56 例无任何脑结构和代谢异常的受试者组成。除了“自相关”外，在 CCD+患者中，左或右侧大脑半球病变分别涉及右侧或左侧受累小脑半球的代谢连接模式包括同侧尾状核、苍白球、壳核、丘脑和红核（P<0.001，簇大小>200）。与 CCD-组和对照组相比，CCD+组皮质-桥脑-小脑通路（包括同侧大脑白质、同侧脑桥、对侧小脑白质和对侧小脑外皮层）和皮质-红核通路（包括同侧尾状核、丘脑、苍白球、壳核、腹侧间脑和红核）的不对称指数（AI）明显较低（均 P<0.05）。CCD+组对侧小脑外皮层的 AI 与同侧尾状核、壳核、苍白球、丘脑、腹侧间脑、红核和脑桥之间呈显著正相关（均 P<0.01），但仅与同侧尾状核和壳核之间呈正相关（均 P<0.001）。这些结果为 CCD 存在时涉及皮质-桥脑-小脑和皮质-红核通路提供了更多的见解，强调需要进一步研究它们异常代谢连接在相关 CCD 症状中的作用。
