Antonini A, Moeller J R, Nakamura T, Spetsieris P, Dhawan V, Eidelberg D
Department of Neurology, North Shore University Hospital, Manhasset, NY 11030, USA.
Neurology. 1998 Sep;51(3):803-10. doi: 10.1212/wnl.51.3.803.
To identify regional metabolic brain networks related specifically to the presence of tremor in PD.
The pathophysiology of parkinsonian tremor is unknown. Because tremor in PD occurs mainly in repose, we used resting state PET with 18F-fluorodeoxyglucose (FDG) to identify specific metabolic brain networks associated with this clinical manifestation.
We studied two discrete groups of eight PD patients with and without tremor using FDG/PET. Both patient groups were matched for gender, age, and Unified Parkinson Disease Rating Scale ratings for akinesia and rigidity. Ten normal volunteer subjects served as controls.
Network analysis with the Scaled Subprofile Model was performed in two steps. 1) We computed the expression of the PD-related pattern (PDRP) identified by us previously in each of the PD patients and control subjects. Although PDRP subject scores were abnormally elevated in the combined PD cohort (p < 0.005), these values did not differ in the PD patient groups with and without tremor (p = 0.36). 2) We used SSM to analyze the data from the combined PD cohort comprising both patient groups. We found that PD patients with tremor were characterized by increased expression of a metabolic network comprising the thalamus, pons, and premotor cortical regions. Subject scores for this pattern were elevated in the tremor group compared with the atremulous patient group and the normal control group (p < 0.005).
The findings suggest that PD patients with tremor are characterized by distinct increases in the functional activity of thalamo-motor cortical projections. Modulation of this functional anatomic pathway is likely to be the mechanism for successful interventions for the relief of parkinsonian tremor.
识别与帕金森病（PD）震颤存在相关的特定区域代谢脑网络。
帕金森震颤的病理生理学尚不清楚。由于PD震颤主要在静息时出现，我们使用18F-氟脱氧葡萄糖（FDG）静息态PET来识别与这种临床表现相关的特定代谢脑网络。
我们使用FDG/PET研究了两组各8名有震颤和无震颤的PD患者。两组患者在性别、年龄以及帕金森病统一评分量表的运动不能和强直评分方面相匹配。10名正常志愿者作为对照。
使用比例子轮廓模型进行网络分析分两步进行。1）我们计算了我们之前在每个PD患者和对照受试者中确定的PD相关模式（PDRP）的表达。虽然在合并的PD队列中PDRP受试者评分异常升高（p < 0.005），但在有震颤和无震颤的PD患者组中这些值没有差异（p = 0.36）。2）我们使用SSM分析来自包括两组患者的合并PD队列的数据。我们发现有震颤的PD患者的特征是包含丘脑、脑桥和运动前皮质区域的代谢网络表达增加。与无震颤患者组和正常对照组相比，震颤组中这种模式的受试者评分升高（p < 0.005）。
研究结果表明，有震颤的PD患者的特征是丘脑 - 运动皮质投射的功能活动明显增加。调节这条功能解剖通路可能是成功缓解帕金森震颤干预措施的机制。
