Document Detail

Effects of disease duration on the clinical features and brain glucose metabolism in patients with mixed type multiple system atrophy.
MedLine Citation:
PMID:  18178568     Owner:  NLM     Status:  MEDLINE    
To study the effect of disease duration on the clinical, neuropsychological and [(18)F]-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 = <or=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.
C H Lyoo; Y Jeong; Y H Ryu; S Y Lee; T J Song; J H Lee; J O Rinne; M S Lee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-04
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  131     ISSN:  1460-2156     ISO Abbreviation:  Brain     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  438-46     Citation Subset:  AIM; IM    
Department of Neurology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Brain / metabolism*,  pathology,  radionuclide imaging
Brain Mapping / methods
Cognition Disorders / etiology,  metabolism,  pathology
Fluorodeoxyglucose F18 / diagnostic use
Follow-Up Studies
Glucose / metabolism*
Magnetic Resonance Imaging / methods
Middle Aged
Multiple System Atrophy / metabolism*,  pathology,  psychology,  radionuclide imaging
Neuropsychological Tests
Parkinson Disease, Secondary / etiology,  metabolism,  pathology
Positron-Emission Tomography
Radiopharmaceuticals / diagnostic use
Time Factors
Reg. No./Substance:
0/Radiopharmaceuticals; 50-99-7/Glucose; 63503-12-8/Fluorodeoxyglucose F18

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