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目的利用123I-IodobenzovesamicolSPECT成像显示突触前囊泡乙酰胆碱载体的表达,评价进行性核上麻痹(PSP)病人大脑胆碱能通路的完整性。材料与方法经单位伦理委员会批准,所有受试者均同意并签署知情同意书。10例PSP病人与12名正常志愿者进行动态123I-Iodobenz-ovesamicolSPECT和MR成像。CT和MRI影像用于将动态123I-IodobenzovesamicolSPECT影像与蒙特利尔神经研究所的大脑模板进行配准,包括纹状体和隔-海马、无名皮质和脑桥-丘脑等胆碱能通路感兴趣区。对每个感兴趣区都建立局部活动的时间药代动力学曲线模型,以计算123I-Iodobenzovesamicol与囊泡乙酰胆碱载体的结合情况,它与乙酰胆碱载体的表达相关。结果 PSP病人与正常对照组相比,纹状体和隔-海马通路的结合情况没有发生改变,而无名皮质通路中的前扣带回结合明显减低(P=0.017),脑桥丘脑通路中的丘脑结合明显降低(P=0.014)。此外,丘脑的结合情况与脑桥核内的结合呈正相关(ρ=0.81,P<0.004),并且双侧丘脑(ρ=-0.88,P<0.001)和脚桥核(ρ=-0.80,P<0.010)的结合情况与疾病的病程呈负相关。结论进行性核上麻痹中各胆碱能通路受到不同程度影响,随着疾病在细胞体和终末突触的进展,脑桥丘脑通路明显受累,无名皮质通路轻度受累,而隔-海马和纹状体通路则保存较好。
Objective To evaluate the integrity of the cholinergic pathway in patients with progressive supranuclear palsy (PSP) using 123I-Iodobenzovesamicol SPECT imaging. Materials and Methods Approved by the Ethics Committee, all subjects agreed and signed informed consent. Ten patients with PSP and 12 normal volunteers underwent dynamic 123I-Iodobenz-ovesamicol SPECT and MR imaging. CT and MRI images are used to register dynamic 123I-Iodobenzovesamicol SPECT images with the Montreal Neurological Institute’s brain templates, including the cholinergic pathway regions of interest, including the striatum and septum-hippocampus, anonymias, and pons. The time-dependent pharmacokinetic profile of local activity was established for each region of interest to calculate the binding of 123I-Iodobenzovesamicol to the vesicular acetylcholine carrier and to the expression of the acetylcholine carrier. Results There was no change in the binding between the striatum and the septum-hippocampal pathway in PSP patients compared with the normal control group, while the anterior cingulate gyrus in the anonymous cortical pathway was significantly reduced (P = 0.017). The thalamus Binding decreased significantly (P = 0.014). In addition, thalamus binding was positively correlated with binding in the pontine nucleus (ρ = 0.81, P <0.004), and bilateral thalamus (ρ = -0.88, P <0.001) 0.010) was negatively correlated with the course of the disease. CONCLUSIONS: The cholinergic pathways in progressive supranuclear palsy are affected to varying degrees. As the disease progresses in the cell body and the terminal synapses, the pontine-thalamic pathways are significantly affected, while the anonymous cortical pathways are mildly affected, while the septum-hippocampus and veins The body pathways are better preserved.