Roelcke U, Curt A, Otte A, Missimer J, Maguire R P, Dietz V, Leenders K L
PET Program, Paul Scherrer Institute, Villigen, Switzerland.
J Neurol Neurosurg Psychiatry. 1997 Jan;62(1):61-5. doi: 10.1136/jnnp.62.1.61.
To assess the effect of a transverse spinal cord lesion on cerebral energy metabolism in view of sensorimotor reorganisation.
PET and 18F-fluorodeoxyglucose were used to study resting cerebral glucose metabolism in 11 patients with complete paraplegia or tetraplegia after spinal cord injury and 12 healthy subjects. Regions of interest analysis was performed to determine global glucose metabolism (CMRGlu). Statistical parametric mapping was applied to compare both groups on a pixel by pixel basis (significance level P = 0.001).
Global absolute CMRGlu was lower in spinal cord injury (33.6 (6.6) mumol/100 ml/min (mean (SD)) than in controls (45.6 (6.2), Mann-Whitney P = 0.0026). Statistical parametric mapping analysis disclosed relatively increased glucose metabolism particularly in the supplementary motor area, anterior cingulate, and putamen. Relatively reduced glucose metabolism in patients with spinal cord injury was found in the midbrain, cerebellar hemispheres, and temporal cortex.
It is assumed that cerebral deafferentiation due to reduction or loss of sensorimotor function results in the low level of absolute global CMRGlu found in patients with spinal cord injury. Relatively increased glucose metabolism in brain regions involved in attention and initiation of movement may be related to secondary disinhibition of these regions.
鉴于感觉运动重组，评估横贯性脊髓损伤对脑能量代谢的影响。
采用正电子发射断层扫描（PET）和18F-氟脱氧葡萄糖研究11例脊髓损伤后完全性截瘫或四肢瘫患者及12名健康受试者静息状态下的脑葡萄糖代谢。进行感兴趣区分析以确定整体葡萄糖代谢（CMRGlu）。应用统计参数映射逐像素比较两组（显著性水平P = 0.001）。
脊髓损伤患者的整体绝对CMRGlu（33.6（6.6）μmol/100 ml/min（均值（标准差））低于对照组（45.6（6.2），曼-惠特尼检验P = 0.0026）。统计参数映射分析显示葡萄糖代谢相对增加，尤其在辅助运动区、前扣带回和壳核。脊髓损伤患者中脑、小脑半球和颞叶皮质的葡萄糖代谢相对降低。
据推测，由于感觉运动功能减退或丧失导致的脑去传入作用致使脊髓损伤患者出现整体绝对CMRGlu水平降低。参与注意力和运动起始的脑区葡萄糖代谢相对增加可能与这些区域的继发性去抑制有关。
