Tanaka M, Kondo S, Hirai S, Sun X, Yamagishi T, Okamoto K
Department of Neurology, Gunma University School of Medicine, Japan.
J Neurol Sci. 1993 Dec 1;120(1):22-8. doi: 10.1016/0022-510x(93)90019-u.
We examined regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2) in 4 patients with progressive dementia associated with amyotrophic lateral sclerosis (ALS), in 9 patients with classical ALS without dementia, and in 13 normal controls, using positron emission tomography with oxygen-15 gas and oxygen-15 labeled carbon dioxide. The mean rCBF and rCMRO2 in the anterior cerebral hemispheres decreased significantly in patients with progressive dementia with ALS, compared to those in controls. Patients with only ALS showed very mild reductions of rCBF and rCMRO2 which were not statistically significant. These data suggest that hypoperfusion and oxygen hypometabolism in the anterior cerebral hemispheres have an etiological relationship to deterioration of intellect in patients with progressive dementia with ALS. A significant reduction in the mean rCBF was also found in the cerebellar hemispheres in progressive dementia with ALS, while a reduction of mean rCMRO2 was not significant. Remote effects analogous to crossed cerebellar diaschisis occurring bilaterally were assumed to explain the cerebellar hypoperfusion.
我们使用氧 - 15气体和氧 - 15标记的二氧化碳进行正电子发射断层扫描，对4例与肌萎缩侧索硬化症（ALS）相关的进行性痴呆患者、9例无痴呆的经典ALS患者以及13名正常对照者的局部脑血流量（rCBF）和氧代谢（rCMRO2）进行了检查。与对照组相比，进行性痴呆伴ALS患者大脑前半球的平均rCBF和rCMRO2显著降低。仅患有ALS的患者rCBF和rCMRO2仅有非常轻微的降低，无统计学意义。这些数据表明，大脑前半球的灌注不足和氧代谢减低与进行性痴呆伴ALS患者的智力衰退存在病因学关系。在进行性痴呆伴ALS患者的小脑半球中也发现平均rCBF显著降低，而平均rCMRO2的降低不显著。双侧出现类似于交叉性小脑失联络的远隔效应被认为可以解释小脑灌注不足。
