Furie R, Ishikawa T, Dhawan V, Eidelberg D
Division of Rheumatology and Allergy--Clinical Immunology, North Shore University Hospital/Cornell University Medical College, Manhasset, NY 11030.
Neurology. 1994 Nov;44(11):2197-9. doi: 10.1212/wnl.44.11.2197.
We used 18F-fluorodeoxyglucose and PET to study a 23-year-old woman with alternating hemichorea and primary antiphospholipid syndrome. There were three PET studies: (1) during an episode of right hemichorea, (2) during an asymptomatic period 6 months later, and (3) during an episode of left hemichorea occurring 2 months after that. In each study, we calculated normalized regional glucose metabolism for the caudate and lentiform nuclei and compared these values with those calculated in 12 normal volunteer subjects (mean age, 35.3 +/- 9.0). The following results were obtained: (1) during right hemichorea, left lentiform metabolism was increased by 19% (> 3 SD); (2) during the asymptomatic period, right caudate metabolism was increased by 20% (> 3 SD), and right lentiform and left striatal metabolism were normal; and (3) during left hemichorea, right caudate and lentiform metabolism were both elevated by 33% (> 3 SD). During this episode, left caudate metabolism was elevated by 20% (> 2 SD); left lentiform metabolism was normal. These results suggest that hemichorea in primary antiphospholipid syndrome may be associated with contralateral striatal hypermetabolism that may also be present during asymptomatic periods.
我们使用18F-氟脱氧葡萄糖和正电子发射断层扫描（PET）对一名患有交替性偏侧舞蹈症和原发性抗磷脂综合征的23岁女性进行了研究。共进行了三次PET研究：（1）在右侧偏侧舞蹈症发作期间；（2）6个月后的无症状期；（3）在那之后2个月出现的左侧偏侧舞蹈症发作期间。在每次研究中，我们计算了尾状核和豆状核的标准化区域葡萄糖代谢，并将这些值与12名正常志愿者受试者（平均年龄，35.3±9.0）计算的值进行比较。获得了以下结果：（1）在右侧偏侧舞蹈症发作期间，左侧豆状核代谢增加了19%（>3个标准差）；（2）在无症状期，右侧尾状核代谢增加了20%（>3个标准差），右侧豆状核和左侧纹状体代谢正常；（3）在左侧偏侧舞蹈症发作期间，右侧尾状核和豆状核代谢均升高了33%（>3个标准差）。在这次发作期间，左侧尾状核代谢升高了20%（>2个标准差）；左侧豆状核代谢正常。这些结果表明，原发性抗磷脂综合征中的偏侧舞蹈症可能与对侧纹状体代谢亢进有关，这种代谢亢进在无症状期也可能存在。
