Dethy S, Van Blercom N, Damhaut P, Wikler D, Hildebrand J, Goldman S
PET/Biomedical Cyclotron Unit and Service de Neurologie, ULB-Hôpital Erasme, Brussels, Belgium.
Mov Disord. 1998 Mar;13(2):275-80. doi: 10.1002/mds.870130213.
We investigated, by positron emission tomography (PET) with [18F]fluoro-2-deoxy-d-glucose (FDG) (FDG-PET), brain glucose metabolism in 19 patients with parkinsonian features. We compared local pattern of FDG uptake and asymmetry indexes in patients with therapeutic response to levodopa (L-dopa) (group 1, presumed Parkinson's disease, n = 9) and patients without L-dopa therapeutic response (group 2, presumed striatonigral degeneration, n = 10). Limb dystonia was present in 11% of patients in group 1 and in 40% of patients in group 2. Asymmetry in basal ganglia metabolism was distributed differently in the two groups (analysis of variance, p < 0.04). In superior and inferior putamen, superior and middle caudate, ventral striatum, and inferior thalamus, relative reduction in metabolism on the side contralateral to predominant parkinsonian signs was associated with L-dopa unresponsiveness. On the contrary, in middle caudate, ventral striatum, and inferior thalamus, a relative increase in metabolism on the side contralateral to the predominant side, parkinsonian signs were found in L-dopa-responsive patients. Our FDG-PET study using simple statistical procedures demonstrates inverse asymmetry of basal ganglia glucose metabolism in parkinsonian patients grouped on the sole basis of L-dopa responsiveness.
我们采用正电子发射断层扫描（PET）技术，利用[18F]氟代-2-脱氧-D-葡萄糖（FDG）（FDG-PET）对19例具有帕金森病特征的患者进行了脑葡萄糖代谢研究。我们比较了左旋多巴（L-dopa）治疗有反应的患者（第1组，疑似帕金森病，n = 9）和L-dopa治疗无反应的患者（第2组，疑似纹状体黑质变性，n = 10）的FDG摄取局部模式和不对称指数。第1组11%的患者和第2组40%的患者存在肢体肌张力障碍。两组基底节代谢的不对称分布不同（方差分析，p < 0.04）。在壳核上下部、尾状核上下中部、腹侧纹状体和丘脑下部，与主要帕金森病体征对侧的代谢相对降低与L-dopa无反应相关。相反，在尾状核中部、腹侧纹状体和丘脑下部，L-dopa反应性患者在主要体征对侧的代谢相对增加。我们使用简单统计程序的FDG-PET研究表明，仅根据L-dopa反应性分组的帕金森病患者基底节葡萄糖代谢存在反向不对称。
