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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 2-2页

作者： Cordato N.j. duggins a.j. Halliday G.M. 邢咏新 Department of Geriatric Medicine Westmead Hospital Westmead NSW 2145 Australia Dr.

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.

关键词：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

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