Hermann W, Hesse S
Abteilung Neurologie, SRO Langenthal, St. Urbanstr. 67, 4900, Langenthal, Schweiz.
Klinik und Poliklinik für Nuklearmedizin, Universität Leipzig, Leipzig, Deutschland.
Nervenarzt. 2023 Apr;94(4):327-334. doi: 10.1007/s00115-022-01390-3. Epub 2022 Sep 23.
Wilson's disease is an autosomal recessive disorder of copper metabolism and is caused by a genetic defect on chromosome 13. Nuclear medicine methods can prove the metabolic defect and contribute to the assessment of central neurological deficits.With high specificity and sensitivity, the intravenous radiocopper test enables the diagnosis to be confirmed as the basis for initiating treatment. The oral radiocopper test is used to monitor zinc treatment.[I]β-CIT-SPECT and [I]IBZM-SPECT provide functional information of the nigrostriatal system.[I]β-CIT-SPECT also allows the determination of SERT availability in the hypothalamus/brain stem as a surrogate parameter of depression.Metabolic parameters of the cortex, basal ganglia and cerebellum can be assessed by [F]FDG-PET studies.SPECT and [F]FDG-PET studies show significant differences between neurological and non-neurological Wilson patients. Overall, only noninvasive in vivo nuclear medicine enables a deeper insight into the pathophysiology of neurological processes in Wilson's disease.
威尔逊病是一种常染色体隐性铜代谢紊乱疾病,由13号染色体上的基因缺陷引起。核医学方法能够证实代谢缺陷,并有助于评估中枢神经功能缺损。静脉注射放射性铜试验具有高特异性和敏感性,可作为确诊依据以启动治疗。口服放射性铜试验用于监测锌治疗。[I]β-CIT-SPECT和[I]IBZM-SPECT可提供黑质纹状体系统的功能信息。[I]β-CIT-SPECT还可测定下丘脑/脑干中5-羟色胺转运体(SERT)的可用性,作为抑郁症的替代参数。[F]FDG-PET研究可评估皮质、基底神经节和小脑的代谢参数。SPECT和[F]FDG-PET研究显示,神经型和非神经型威尔逊病患者之间存在显著差异。总体而言,只有非侵入性体内核医学能够更深入地洞察威尔逊病神经过程的病理生理学。