Koide T, Hozumi I, Souma Y, Nagasawa H, Tuji S
Department of Neurology, Brain Research Institute, Niigata University, Japan.
Rinsho Shinkeigaku. 1995 Nov;35(11):1184-90.
We report three cases of clinically diagnosed corticobasal degeneration: a 63-year-old male, a 63-year-old female and a 62-year-old female. All the three patients exhibited asymmetric limb-kinetic apraxia and extrapyramidal signs. Neuroimaging studies with MRI, 123I-IMP SPECT and FDG-PET were performed in each of the three cases and FDOPA-PET was performed in patient 1. MRI analysis showed asymmetric cortical atrophy, especially in the parietal cortex, in all the three cases. 123I-IMP SPECT analysis revealed asymmetric reduction of the cerebral blood flow, in accordance with the MRI findings. FDG-PET analysis showed marked asymmetric reduction (> or = 10%) of cerebral metabolic rates for glucose (CMRGlc) in the lateral frontal cortex, lateral posterior frontal cortex and primary motor and sensory cortex in all the patients, although the asymmetry in the thalamus which had been described as a characteristic CBD finding in previous reports was not observed in any of the patients in our study. FDOPA-PET analysis revealed reduction of uptake in both the putamen and caudate nucleus, predominantly in the caudate nucleus, which suggests that the FDOPA-PET findings correlate with the extrapyramidal signs observed in the case of the 63-year-old male.
我们报告了3例临床诊断为皮质基底节变性的病例:1例63岁男性、1例63岁女性和1例62岁女性。所有3例患者均表现为不对称性肢体运动性失用和锥体外系体征。对这3例患者均进行了MRI、123I-IMP SPECT和FDG-PET神经影像学检查,对患者1进行了FDOPA-PET检查。MRI分析显示,所有3例患者均存在不对称性皮质萎缩,尤其是顶叶皮质。123I-IMP SPECT分析显示脑血流量不对称性减少,与MRI结果一致。FDG-PET分析显示,所有患者的外侧额叶皮质、外侧额后皮质以及初级运动和感觉皮质的脑葡萄糖代谢率均显著不对称性降低(≥10%),尽管在我们研究的任何患者中均未观察到先前报道中作为皮质基底节变性特征性表现的丘脑不对称性。FDOPA-PET分析显示壳核和尾状核摄取减少,主要是尾状核,这表明FDOPA-PET结果与63岁男性患者中观察到的锥体外系体征相关。