Goldstein D S
National Institutes of Health, Bethesda, Maryland.
Curr Opin Neurol Neurosurg. 1993 Aug;6(4):524-6.
Several modifications have improved the sensitivity and specificity of neurochemical tests to diagnose and distinguish multiple system atrophy and pure autonomic failure. These include [3H]-norepinephrine infusion to estimate plasma norepinephrine clearance; neuroendocrine stimulation tests; and simultaneous measurements of levels of levodopa, catecholamines, and catecholamine metabolites. New clinical imaging approaches have the potential to visualize alterations in neurotransmitter function in the brain and periphery. Patients with multiple system atrophy have decreased striatal radioactivity after injection of positron-emitting ligands at dopamine receptors or uptake sites, and patients with diffuse sympathetic denervation have decreased myocardial radioactivity after injection of radioactive sympathoneural imaging agents.
多项改进提高了神经化学检测在诊断和区分多系统萎缩与单纯自主神经功能衰竭方面的敏感性和特异性。这些改进包括输注[3H]-去甲肾上腺素以评估血浆去甲肾上腺素清除率；神经内分泌刺激试验；以及同时测量左旋多巴、儿茶酚胺和儿茶酚胺代谢物的水平。新的临床成像方法有可能使大脑和外周神经递质功能的改变可视化。多系统萎缩患者在多巴胺受体或摄取位点注射正电子发射配体后纹状体放射性降低，而弥漫性交感神经去神经支配患者在注射放射性交感神经成像剂后心肌放射性降低。
