与进行性核上性麻痹患者区域性脑萎缩相关的临床异常

作     者：Cordato N.J. Duggins A.J. Halliday G.M. 邢咏新 

作者机构：Department of Geriatric Medicine Westmead Hospital Westmead NSW 2145 Australia Dr. 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第10期

页      面：2-2页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：脑萎缩 核上性麻痹 运动障碍 神经核 影像学检查 尾状核 神经元变性 额叶皮质 皮质下 额叶皮层 

摘      要：Most cerebral imaging studies of patients with progressive supranuclear palsy (PSP) have noted subtle atrophy, although the full extent of atrophy and any cor relates to clinical features have not been determined. We used voxel-based morp hometry analysis of grey matter, white matter and CSF on MRI brain scans to map the statistical probability of regional tissue atrophy in 21 patients with PSP, 17 patients with Parkinson’s disease and 23 controls. PSP and Parkinson’s dise ase cohorts were selected to approximate the mid-stages of their respective dis ease courses. Where regions of significant tissue atrophy were identified in a d isease group relative to controls, the probability of tissue loss within those r egions was correlated with global indices of motor disability, and behavioural a nd cognitive disturbance for that disease group. Minimal regional atrophy was ob served in Parkinson’s disease. PSP could be distinguished from both controls an d Parkinson’s disease by symmetrical tissue loss in the frontal cortex (maximal in the orbitofrontal and medial frontal cortices), subcortical nuclei (midbrain , caudate and thalamic) as well as periventricular white matter. For PSP, motor deficits correlated with atrophy of the caudate and motor cingulate, while behav ioural changes related to atrophy in the orbitofrontal cortex and midbrain. Thes e data suggest that intrinsic neurodegeneration of specific subcortical nuclei a nd frontal cortical subrogions together contribute to motor and behavioural dist urbances in PSP and differentiate this disorder from Parkinson’s disease within 2-4 years of symptom onset.