Kitamura S, Koshi Y, Komiyama T, Sakayori O, Komaba Y, Ohyama M, Mishina M, Tsuganesawa T, Terashi A
Second Department of Internal Medicine, Nippon Medical School First Hospital, Japan.
Kaku Igaku. 1996 Jan;33(1):49-56.
This study was designed to investigate benzodiazepine receptors (BZR) and cerebral blood flow (CBF) in patients with early Alzheimer's disease. Imaging of BZR and measurement of CBF were performed by SPECT using 123I-Iomazenil (IMZ) and 123I-IMP respectively, in seven patients with early Alzheimer's disease and five patients with unilateral left cerebral infarction as controls. The values for the normal cerebral hemisphere (ratio to the contralateral cerebellum) in patients with cerebral infarction were adopted as control values. In patients with Alzheimer's disease, the CBF (ratio to cerebellum) decreased significantly in the frontal cortex and the parietal cortex compared with the control values. There was no significant difference in late IMZ SPECT counts (ratio to cerebellum) and washout (the ratio of late-to-early IMZ SPECT counts) between patients with Alzheimer's disease and the controls. However, the late IMZ SPECT counts and washout decreased in one patient with moderate dementia. There was a significant correlation between the severity of dementia and the late IMZ SPECT counts in the temporal cortex and the parietal cortex. These results suggest that benzodiazepine binding sites are relatively well preserved in patients with early Alzheimer's disease, and reduction of the CBF is caused by neuronal dysfunction rather than by neuronal loss. IMZ SPECT study is useful and necessary for clarifying the pathophysiological state in Alzheimer's disease.
本研究旨在调查早期阿尔茨海默病患者的苯二氮䓬受体(BZR)和脑血流量(CBF)。分别使用123I-碘美普尔(IMZ)和123I-异丁基安非他明(IMP)通过单光子发射计算机断层扫描(SPECT)对7例早期阿尔茨海默病患者和5例左侧单侧脑梗死患者进行BZR成像和CBF测量,后者作为对照。脑梗死患者正常脑半球(与对侧小脑的比值)的值被用作对照值。在阿尔茨海默病患者中,与对照值相比,额叶皮质和顶叶皮质的CBF(与小脑的比值)显著降低。阿尔茨海默病患者与对照组之间的晚期IMZ SPECT计数(与小脑的比值)和洗脱率(晚期与早期IMZ SPECT计数的比值)无显著差异。然而,1例中度痴呆患者的晚期IMZ SPECT计数和洗脱率降低。痴呆严重程度与颞叶皮质和顶叶皮质的晚期IMZ SPECT计数之间存在显著相关性。这些结果表明,早期阿尔茨海默病患者的苯二氮䓬结合位点相对保存完好,CBF降低是由神经元功能障碍而非神经元丢失引起的。IMZ SPECT研究对于阐明阿尔茨海默病的病理生理状态是有用且必要 的。