Yamauchi H, Fukuyama H, Ouchi Y, Nagahama Y, Kimura J, Asato R, Konishi J
Department of Neurology, Kyoto University, Japan.
J Neurol Sci. 1995 Dec;134(1-2):189-96. doi: 10.1016/0022-510x(95)00220-6.
Recent studies have suggested widespread involvement of the cerebral regions other than the primary motor cortex in amyotrophic lateral sclerosis. To investigate atrophy of the corpus callosum as a measure of cerebral pathology, we studied 25 right-handed patients with sporadic amyotrophic lateral sclerosis using magnetic resonance imaging. Five patients had cognitive decline or emotional and personality changes. The ratios of mid-sagittal corpus callosum areas to the midline internal skull surface area on T1-weighted images were analysed. Compared with 25 age- and sex-matched right-handed control subjects, the patients had significantly decreased callosal/skull area ratio, with anterior predominance of the degree of atrophy. The patients with cognitive decline or psychiatric symptoms had substantial atrophy of the anterior fourth of the corpus callosum. These findings suggest that atrophy of the corpus callosum, especially in the anterior half, is present in amyotrophic lateral sclerosis, and that severe atrophy in the anterior fourth is associated with cognitive decline and psychiatric symptoms. Callosal atrophy may reflect the widespread distribution of pathological changes in the cerebral cortex, which are accentuated in the frontal cortex.
最近的研究表明，肌萎缩侧索硬化症除主要运动皮层外，大脑其他区域也广泛受累。为了研究胼胝体萎缩作为大脑病理变化的一项指标，我们使用磁共振成像对25例右利手散发性肌萎缩侧索硬化症患者进行了研究。5例患者有认知功能减退或情绪及性格改变。分析了T1加权图像上胼胝体中矢状面面积与中线颅骨内表面面积的比值。与25名年龄和性别匹配的右利手对照者相比，患者的胼胝体/颅骨面积比值显著降低，萎缩程度以前部为主。有认知功能减退或精神症状的患者胼胝体前部四分之一明显萎缩。这些发现表明，肌萎缩侧索硬化症患者存在胼胝体萎缩，尤其是在前半部，且前部四分之一的严重萎缩与认知功能减退和精神症状有关。胼胝体萎缩可能反映了大脑皮层病理变化的广泛分布，额叶皮层的变化更为明显。
