Russouw H G, Roberts M C, Emsley R A, Truter R
Department of Psychiatry, University of Stellenbosch, South Africa.
Biol Psychiatry. 1997 Feb 15;41(4):467-73. doi: 10.1016/S0006-3223(96)00060-1.
Neurosyphilis can mimic virtually any psychiatric disorder. Since there are no studies measuring the relationship between its psychiatric manifestations and neuroradiological findings, we performed magnetic resonance imaging (MRI) on 20 newly diagnosed patients with neurosyphilis and 20 healthy volunteers. MRI abnormalities occurred in 13 neurosyphilis patients. These included foci of increased signal intensity of T2-weighted images, and generalized cerebral atrophy. Two control subjects showed minor focal changes. In the neurosyphilis patients, frontal lesions showed statistically significant associations with the overall degree of psychiatric morbidity as measured by the brief psychiatric rating scale (p < 0.05). Temporo-parietal lesions showed a near significant association with cognitive impairment as measured by the Mini mental-state examination (p = 0.06). Atrophy measures correlated significantly with cognitive impairment. The results suggest that the site of brain lesions may be important in determining the nature of the psychiatric symptoms in neurosyphilis.
神经梅毒几乎可以模仿任何精神障碍。由于尚无研究测量其精神症状与神经影像学结果之间的关系，我们对20例新诊断的神经梅毒患者和20名健康志愿者进行了磁共振成像（MRI）检查。13例神经梅毒患者出现MRI异常。这些异常包括T2加权图像上信号强度增加的病灶以及广泛性脑萎缩。两名对照受试者有轻微的局灶性改变。在神经梅毒患者中，额叶病变与通过简明精神病评定量表测量的总体精神疾病严重程度存在统计学上的显著关联（p < 0.05）。颞顶叶病变与通过简易精神状态检查表测量的认知障碍有近乎显著的关联（p = 0.06）。萎缩测量值与认知障碍显著相关。结果表明，脑损伤部位在确定神经梅毒精神症状的性质方面可能很重要。
