Effects of disease duration on the clinical features and brain glucose metabolism in patients with mixed type multiple system atrophy
Identifieur interne : 000C00 ( Main/Exploration ); précédent : 000B99; suivant : 000C01Effects of disease duration on the clinical features and brain glucose metabolism in patients with mixed type multiple system atrophy
Auteurs : C. H. Lyoo [Finlande] ; Y. Jeong [Finlande] ; Y. H. Ryu [Finlande] ; S. Y. Lee [Finlande] ; T. J. Song [Finlande] ; J. H. Lee [Finlande] ; J. O. Rinne [Finlande] ; M. S. Lee [Finlande]Source :
- Brain [ 0006-8950 ] ; 2008-02.
Abstract
To study the effect of disease duration on the clinical, neuropsychological and [18F]-deoxyglucose (FDG) PET findings in patients with mixed type multiple system atrophy (MSA), this study included 16 controls and 37 mixed-type MSA patients with a shorter than a 3-year history of cerebellar or parkinsonian symptoms. We classified the patients into three groups according to the duration of parkinsonian or cerebellar symptoms (Group I = ≤1 year; II = 13–24 months; III = 25–36 months). We performed UPDRS, international cooperative ataxia rating scale (ICARS), and a neuropsychological test battery. We compared the FDG PET findings of each group of patients with controls. Group I patients frequently had memory and frontal executive dysfunction. They showed hypometabolism in the frontal cortex, anterior cerebellar hemisphere and vermis. They had parkinsonian motor deficits, but no basal ganglia hypometabolism. Group II and III patients frequently had multiple domain cognitive impairments, and showed hypometabolism in the frontal and parieto-temporal cortices. Hypometabolism of the bilateral caudate and the left posterolateral putamen was observed in Group II, and whole striatum in Group III. In summary, the cortical hypometabolism begins in the frontal cortex and spreads to the parieto-temporal cortex in MSA. This spreading pattern coincides with the progressive cognitive decline. Early caudate hypometabolism may also contribute to the cognitive impairment. Parkinsonian motor deficits precede putaminal hypometabolism that begins in its posterolateral part. Cerebellar hypometabolism occurs early in the clinical courses and seems to be a relevant metabolic descriptor of cerebellar deficits.
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DOI: 10.1093/brain/awm328
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Ryu</name><affiliation wicri:level="3"><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Neurology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Department of Brain and Bioengineering, KAIST, Daejeon, Department of Radiology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea and Turku PET Center, University of Turku, Turku</wicri:regionArea><placeName><settlement type="city">Turku</settlement><region type="région" nuts="2">Finlande occidentale</region></placeName></affiliation></author><author><name sortKey="Lee, S Y" sort="Lee, S Y" uniqKey="Lee S" first="S. Y." last="Lee">S. Y. 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Song</name><affiliation wicri:level="3"><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Neurology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Department of Brain and Bioengineering, KAIST, Daejeon, Department of Radiology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea and Turku PET Center, University of Turku, Turku</wicri:regionArea><placeName><settlement type="city">Turku</settlement><region type="région" nuts="2">Finlande occidentale</region></placeName></affiliation></author><author><name sortKey="Lee, J H" sort="Lee, J H" uniqKey="Lee J" first="J. H." last="Lee">J. H. 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We classified the patients into three groups according to the duration of parkinsonian or cerebellar symptoms (Group I = ≤1 year; II = 13–24 months; III = 25–36 months). We performed UPDRS, international cooperative ataxia rating scale (ICARS), and a neuropsychological test battery. We compared the FDG PET findings of each group of patients with controls. Group I patients frequently had memory and frontal executive dysfunction. They showed hypometabolism in the frontal cortex, anterior cerebellar hemisphere and vermis. They had parkinsonian motor deficits, but no basal ganglia hypometabolism. Group II and III patients frequently had multiple domain cognitive impairments, and showed hypometabolism in the frontal and parieto-temporal cortices. Hypometabolism of the bilateral caudate and the left posterolateral putamen was observed in Group II, and whole striatum in Group III. In summary, the cortical hypometabolism begins in the frontal cortex and spreads to the parieto-temporal cortex in MSA. This spreading pattern coincides with the progressive cognitive decline. Early caudate hypometabolism may also contribute to the cognitive impairment. Parkinsonian motor deficits precede putaminal hypometabolism that begins in its posterolateral part. Cerebellar hypometabolism occurs early in the clinical courses and seems to be a relevant metabolic descriptor of cerebellar deficits.</div></front></TEI><affiliations><list><country><li>Finlande</li></country><region><li>Finlande occidentale</li></region><settlement><li>Turku</li></settlement></list><tree><country name="Finlande"><region name="Finlande occidentale"><name sortKey="Lyoo, C H" sort="Lyoo, C H" uniqKey="Lyoo C" first="C. H." last="Lyoo">C. H. Lyoo</name></region><name sortKey="Jeong, Y" sort="Jeong, Y" uniqKey="Jeong Y" first="Y." last="Jeong">Y. Jeong</name><name sortKey="Lee, J H" sort="Lee, J H" uniqKey="Lee J" first="J. H." last="Lee">J. H. Lee</name><name sortKey="Lee, M S" sort="Lee, M S" uniqKey="Lee M" first="M. S." last="Lee">M. S. Lee</name><name sortKey="Lee, S Y" sort="Lee, S Y" uniqKey="Lee S" first="S. Y." last="Lee">S. Y. Lee</name><name sortKey="Rinne, J O" sort="Rinne, J O" uniqKey="Rinne J" first="J. O." last="Rinne">J. O. Rinne</name><name sortKey="Ryu, Y H" sort="Ryu, Y H" uniqKey="Ryu Y" first="Y. H." last="Ryu">Y. H. Ryu</name><name sortKey="Song, T J" sort="Song, T J" uniqKey="Song T" first="T. J." last="Song">T. J. Song</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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