Braun A R, Randolph C, Stoetter B, Mohr E, Cox C, Vladar K, Sexton R, Carson R E, Herscovitch P, Chase T N
NIDCD, National Institutes of Health, Bethesda, MD 20892, USA.
Neuropsychopharmacology. 1995 Oct;13(2):151-68. doi: 10.1016/0893-133X(95)00052-F.
We analyzed F-18 fluoro-deoxyglucose PET scans carried out in 18 drug-free patients with Tourette's syndrome (TS) in order to evaluate relationships between cerebral metabolism and complex cognitive and behavioural features commonly associated with this disorder. These features (obsessions and compulsions, impulsivity, coprolalia, self-injurious behavior, echophenomena, depression, and measures of attentional and visuospatial dysfunction) were associated with significant increases in metabolic activity in the orbitofrontal cortices. Similar increases, although less robust, were observed in the putamen and, in the case of attentional and visuospatial measures, in the inferior portions of the insula. On the other hand, behavioral and cognitive features were not associated with metabolic rates in other subcortical (midbrain, ventral striatum), paralimbic (parahippocampal gyrus), or sensorimotor regions (supplementary motor area, lateral premotor or Rolandic cortices), in which metabolism had, in some cases more robustly, distinguished these TS patients from controls (Braun et al., 1993). These results suggest that a subset of regions in which metabolic activity appears to be associated with the diagnosis of TS per se, may be explicitly associated with the emergence of complex behavioral and cognitive features of the illness. This is most conspicuous in the orbitofrontal cortices, and it is consistent with the observation that these features resemble the elements of a behavioral syndrome typically seen in patients with lesions of the orbitofrontal cortex.
我们分析了18名未服用药物的图雷特综合征（TS）患者进行的F-18氟脱氧葡萄糖PET扫描，以评估大脑代谢与该疾病常见的复杂认知和行为特征之间的关系。这些特征（强迫观念和强迫行为、冲动、秽语症、自伤行为、模仿现象、抑郁以及注意力和视觉空间功能障碍的测量指标）与眶额皮质代谢活动的显著增加有关。在壳核中也观察到了类似的增加，尽管程度较轻，而在注意力和视觉空间测量指标方面，在岛叶下部也观察到了类似增加。另一方面，行为和认知特征与其他皮质下区域（中脑、腹侧纹状体）、边缘旁区域（海马旁回）或感觉运动区域（辅助运动区、外侧运动前区或中央前回）的代谢率无关，在某些情况下，这些区域的代谢更有力地将这些TS患者与对照组区分开来（布劳恩等人，1993年）。这些结果表明，代谢活动似乎与TS本身的诊断相关的一部分区域，可能与该疾病复杂行为和认知特征的出现明确相关。这在眶额皮质中最为明显，并且与以下观察结果一致，即这些特征类似于眶额皮质受损患者中典型出现的行为综合征的要素。
