Kondo S, Tanaka M, Sun X, Sakai Y, Hirai S
Department of Neurology, Gunma University School of Medicine.
Rinsho Shinkeigaku. 1993 Oct;33(10):1039-46.
We studied cerebral blood flow, oxygen metabolism and their relation to clinical symptoms in 45 patients with spinocerebellar degeneration (SCD) and 12 normal control subjects using positron emission tomography (PET). Regions of interest were acquired for the cerebellar hemispheres, cerebellar vermis, brainstem, thalami, and cerebral cortices. PET studies in these patients revealed that regional cerebral blood flow (CBF), regional cerebral oxygen metabolic rate (CMRO2), CBF/mean CBF of each cerebral cortex (CBF/mCBF) and CMRO2/mean CMRO2 of each cerebral cortex (CMRO2/mCMRO2) in the cerebellar hemispheres, cerebellar vermis, and brainstem showed a significant decrease in comparison with the normal control subjects, while in the cerebral cortices and thalami, SCD patients showed normal values. CBF/mCBF and CMRO2/mCMRO2 were significantly decreased in patients with olivopontocerebellar atrophy (OPCA) and Menzel type of hereditary ataxia (Menzel type) in the cerebellar hemispheres, cerebellar vermis, and brainstem, whereas patients with late cortical cerebellar atrophy (LCCA) and Holmes type of hereditary ataxia (Holmes type) revealed a significant decrease of CBF/mCBF and CMRO2/mCMRO2 in the cerebellar hemispheres and cerebellar vermis, but not in the brainstem. Patients with OPCA showed a significant decrease of CBF in the cerebellar hemispheres, cerebellar vermis, brainstem and that of CMRO2 in the cerebellar hemispheres and cerebellar vermis. Patients with LCCA showed a significant decrease of CBF in the right cerebellar hemisphere and cerebellar vermis. However, a significant reduction of CBF and CMRO2 was not observed in patients with Menzel type or Holmes type in these regions. In patients with LCCA and Holmes type, the severity of upper limb ataxia and dysdiadochokinesis were significantly correlated with CBF/mCBF and CMRO2/mCMRO2 in the cerebellar hemispheres and brainstem.(ABSTRACT TRUNCATED AT 250 WORDS)
我们使用正电子发射断层扫描(PET)研究了45例脊髓小脑变性(SCD)患者和12名正常对照者的脑血流量、氧代谢及其与临床症状的关系。获取了小脑半球、小脑蚓部、脑干、丘脑和大脑皮质的感兴趣区域。对这些患者的PET研究显示,与正常对照者相比,小脑半球、小脑蚓部和脑干的局部脑血流量(CBF)、局部脑氧代谢率(CMRO2)、每个大脑皮质的CBF/平均CBF(CBF/mCBF)和每个大脑皮质的CMRO2/平均CMRO2(CMRO2/mCMRO2)均显著降低,而大脑皮质和丘脑中,SCD患者的值正常。在小脑半球、小脑蚓部和脑干中,橄榄脑桥小脑萎缩(OPCA)患者和门泽尔型遗传性共济失调(门泽尔型)患者的CBF/mCBF和CMRO2/mCMRO2显著降低,而晚期皮质小脑萎缩(LCCA)患者和霍姆斯型遗传性共济失调(霍姆斯型)患者在小脑半球和小脑蚓部的CBF/mCBF和CMRO2/mCMRO2显著降低,但在脑干中未降低。OPCA患者小脑半球、小脑蚓部和脑干的CBF显著降低,小脑半球和小脑蚓部的CMRO2显著降低。LCCA患者右侧小脑半球和小脑蚓部的CBF显著降低。然而,门泽尔型或霍姆斯型患者在这些区域未观察到CBF和CMRO2的显著降低。在LCCA和霍姆斯型患者中,上肢共济失调和轮替运动障碍的严重程度与小脑半球和脑干的CBF/mCBF和CMRO2/mCMRO2显著相关。(摘要截断于250字)