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Insular cortex involvement in mesiotemporal lobe epilepsy: A positron emission tomography study

ANNALS OF NEUROLOGY 2002年第2期51卷 202-208页

作者： Bouilleret, V Dupont, S Spelle, L Baulac, M Samson, Y Semah, F SHFJ CEA F-91406 Orsay France Hop La Pitie Salpetriere Unite Epileptol Paris France Hop La Pitie Salpetriere Urgences Cerebro Vasculaires Clin Neurol Paul Castaigne Paris France

Somesthetic and emotional symptoms that are common in patients with mesial temporal lobe epilepsy are usually related to hippocampo-amygdalar complex involvement. Recent stereo-electroencephalographic studies have shown a relationship between such symptoms and epileptic insular discharges. To further investigate this problem, we carried out a positron emission tomography study using fluorodeoxyglucose (F-18-FDG) and flumazenil (C-11-FMZ) in mesial temporal lobe epilepsy patients. The aim of our study was to assess the existence of a cortical insular involvement in order to examine its clinical correlates and the relationship between the postoperative outcome and the insular involvement. Fluorodeoxyglucose and flumazenil-positron emission tomography studies were carried out in 18 patients with mesial temporal lobe epilepsy patients. A statistical parametric mapping (SPM96) was performed to analyze the data in comparison to 18 healthy volunteers. For each set of fluorodeoxyglucose and flumazenil images a group and an individual analysis were performed. In addition, a region of interest analysis was performed to validate the results. Focusing on the metabolic abnormalities, we also investigated the role of insular cortex in the symptoms experienced by the patients and the prognostic value of insular metabolic abnormalities. Highly significant hypometabolism and BZR binding decreases were detected in the insular cortex. Results were similar using the region of interest approach. Insular involvement (mainly ipsilateral to the seizure focus) was present in 60% of the patients. Emotional symptoms correlated with hypometabolism in the anterior part of the ipsilateral insular cortex, whereas somesthetic symptoms correlated with hypometabolism in the posterior part. No relationship between postoperative outcome and ipsilateral insular hypometabolism was found. Unilateral mesial temporal lobe epilepsy is associated with insular hypometabolism and benzodiazepine receptor loss.

关键词：碳放射性同位素/诊断应用大脑皮质/代谢大脑皮质/放射性核素显像癫痫颞叶/代谢癫痫颞叶/放射性核素显像癫痫颞叶/外科学氟马西尼/诊断应用氟脱氧葡萄糖F18/诊断应用 GABA调节剂/诊断应用葡萄糖/代谢试验预期值放射性药物/诊断应用体层摄影术发射型计算机治疗结果青少年成年人女(雌)性人类男(雄)性

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Thermosensory activation of insular cortex

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NATURE NEUROSCIENCE 2000年第2期3卷 184-190页

作者： Craig, AD Chen, K Bandy, D Reiman, EM Barrow Neurol Inst Div Neurosurg Phoenix AZ 85013 USA Good Samaritan Reg Med Ctr Positron Emiss Tomog Ctr Phoenix AZ 85006 USA Arizona State Univ Dept Math Tempe AZ 85280 USA Univ Arizona Dept Psychiat Tucson AZ 85721 USA

Temperature sensation is regarded as a submodality of touch, but evidence suggests involvement of insular cortex rather than parietal somatosensory cortices. Using positron emission tomography (PEI), we found contralateral activity correlated with graded cooling stimuli only in the dorsal margin of the middle/posterior insula in humans. This corresponds to the thermoreceptive- and nociceptive-specific lamina I spinothalamocortical pathway in monkeys, and can be considered an enteroceptive area within limbic sensory cortex. Because lesions at this site can produce the poststroke central pain syndrome, this finding supports the proposal that central pain results from loss of the normal inhibition of pain by cold. Notably, perceived thermal intensity was well correlated with activation in the right (ipsilateral) anterior insular and orbitofrontal cortices.

关键词：脑图大脑皮质/血液供给大脑皮质/生理学大脑皮质/放射性核素显像脑血管循环/生理学冷辨别阈/生理学手/神经支配手/生理学线性模型疼痛测定物理刺激前脑/血液供给前脑/生理学前脑/放射性核素显像温度觉/生理学体层摄影术发射型计算机成年人女(雌)性人类男(雄)性中年人

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Cortical activation induced by intraoral stimulation with water in humans

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CHEMICAL SENSES 2000年第3期25卷 267-275页

作者： Zald, DH Pardo, JV Vet Affairs Med Ctr Psychiat Serv Cognit Neuroimaging Unit Minneapolis MN 55417 USA Univ Minnesota Dept Psychiat Div Neurosci Res Minneapolis MN 55455 USA

Studies of gustatory processing frequently utilize water as a control stimulus. However, the neural representations of intraoral stimulation with water have received little attention. We report a series of positron emission tomography studies involving intraoral stimulation with deionized distilled water. Attempting to taste water produced large, bilateral activations in insular opercular, Rolandic and cerebellar cortices relative to resting with eyes closed or 'smelling' odorless air. The magnitude and volume of activation was substantially reduced when tasting water was contrasted with voluntary swallowing. This indicates that much of the activity induced by water reflects intraoral somatosensory or motor processing. Nevertheless, portions of the insula, operculum, post-central gyrus and cerebellum remained significantly activated in the contrast between 'tasting' water and swallowing. This activity appears to represent a specific neural correlate of fluid stimulation, and may reflect aspects of trigeminal, gustatory or thermal coding. These findings emphasize the large volume of cortex dedicated to intraoral processing, and highlight the importance of controlling for nongustatory factors in studies of gustation.

关键词：投药口服大脑皮质/血液供给大脑皮质/生理学大脑皮质/放射性核素显像体层摄影术发射型计算机水/投药和剂量青少年成年人女(雌)性人类男(雄)性

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Presynaptic and postsynaptic dopaminergic binding densities in the nigrostriatal and mesocortical systems in early Parkinson's disease: A double-tracer positron emission tomography study

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ANNALS OF NEUROLOGY 1999年第5期46卷 723-731页

作者： Ouchi, Y Kanno, T Okada, H Yoshikawa, E Futatsubashi, M Nobezawa, S Torizuka, T Sakamoto, M Hamamatsu Med Ctr Positron Med Ctr Hirakuchi Hamakita 4340041 Japan Hamamatsu Med Ctr Dept Neurol Hirakuchi Hamakita 4340041 Japan Hamamatsu Photon KK Cent Res Labs Hirakuchi Japan

To investigate changes in the relation between presynaptic and postsynaptic dopaminergic functions in vivo in both nigrostriatal and mesocortical systems in Parkinson's disease (PD), 10 drug-naive early PD patients were studied twice using positron emission tomography with [C-11]CFT (dopamine transporter probe) followed by [C-11]SCH 23390 (D1 receptor probe). Regional binding potentials (k(3)/k(4)) of [C-11]CFT and [C-11]SCH 23390 in the striatum (nigrostriatal system) and the orbitofrontal cortex (mesocortical system) were estimated by compartment analyses. Levels of [C-11]CFT k(3)/k(4) in the two projection areas were shown to be significantly lower in PD, whereas [C-11]SCH 23390 levels remained unchanged. Regression analysis showed that estimates of CFT k(3)/k(4) were positively correlated with those of SCH 23390 k(3)/k(4) in the striatum in normal control, whereas the two binding estimates were less positively correlated in the caudate and inversely correlated in the putamen in PD. No significant correlation was observed in the orbitofrontal cortex in both groups. These results indicated that dopamine transporters and D1 receptors change in parallel in the normal striatal synapses, but the association becomes asymmetrical because of reduction in presynaptic and relative elevation in postsynaptic markers in PD. Alterations in synaptic parallel regulation in the nigrostriatal system might reflect early pathophysiology in the parkinsonian brain.

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Cerebral blood flow correlates of higher brain dysfunctions in corticobasal degeneration

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JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY 1999年第4期12卷 189-193页

作者： Okuda, B Tachibana, H Kawabata, K Takeda, M Sugita, M Hyogo Coll Med Dept Internal Med 5 Div Neurol Nishinomiya Hyogo Japan

To investigate clinicoanatomic correlations of higher brain dysfunctions in corticobasal degeneration, regional cerebral blood flow (rCBF) was semiquantitatively measured with single-photon emission computed tomography in 9 patients with corticobasal degeneration and 12 age-matched control subjects. The patients showed significant reductions of relative tracer uptake in widespread cortical areas, as well as the basal ganglia and thalamus. Interhemispheric difference of hypoperfusion was significant in the sensorimotor and posterior parietal cortices. Asymmetric limb apraxia and cortical sensory disturbance corresponded to either sensorimotor cortical or posterior parietal cortical hypoperfusion or both. Compared with the patients without dementia, those with dementia showed significant reductions of relative rCBF in the inferior prefrontal region in the more affected hemisphere. The unique correlation of cortical signs with regional hypoperfusion may be useful in distinguishing between corticobasal degeneration and other neurodegenerative diseases.

关键词：基底神经节/血液供给基底神经节/放射性核素显像基底神经节疾病/病理生理学基底神经节疾病/放射性核素显像血流速度/生理学脑/血液供给脑/放射性核素显像脑图大脑皮质/血液供给大脑皮质/放射性核素显像半球优势大脑/生理学神经变性疾病/病理生理学神经变性疾病/放射性核素显像额叶前皮质/血液供给额叶前皮质/放射性核素显像局部血流/生理学体层摄影术发射型计算机单光子老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Technetium-99m-HmPAO brain SPECT in infantile Gaucher's disease

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PEDIATRIC NEUROLOGY 1999年第1期20卷 66-69页

作者： Lin, DS Lin, SP Liang, DC Ho, CS Wu, MC Mackay Mem Hosp Dept Pediat Div Genet Taipei Taiwan Mackay Mem Hosp Dept Pediat Div Hematol Taipei Taiwan Mackay Mem Hosp Dept Pediat Div Neurol Taipei Taiwan Mackay Mem Hosp Dept Nucl Med Taipei Taiwan

The authors report serial technetium-99m hexamethyl-propylene-amine-oxime brain single photon emission computed tomography (SPECT) findings in two infants with Gaucher's disease type 2. Detailed neurologic and laboratory examinations, including bone marrow biopsies and enzymatic assays, were described. Serial brain magnetic resonance imaging studies in one patient illustrated the progressive cerebral atrophy in the frontal and temporal lobes. The SPECT in both cases demonstrated positive findings of initial scattered hypoperfusion, with extending to hypoperfusion of the entire cerebrum after 4 months of clinical deterioration. These changes in the SPECT findings may reflect progressive degeneration of the cerebrum in Gaucher's disease type 2. Brain SPECT may provide useful information on cerebral flow and metabolic distribution corresponding to the neurologic deficits of neuronopathic Gaucher's disease. (C) 1999 by Elsevier Science Inc. All rights reserved.

关键词：萎缩/放射性核素显像脑/病理学脑/放射性核素显像大脑皮质/病理学大脑皮质/放射性核素显像脑血管循环疾病恶化戈谢病/放射性核素显像纵向研究磁共振成像放射性药物/诊断应用 99m锝依沙美肟/诊断应用体层摄影术发射型计算机单光子人类婴儿男(雄)性

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Subcortical and cortical brain activity during the feeling of self-generated emotions

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NATURE NEUROSCIENCE 2000年第10期3卷 1049-1056页

作者： Damasio, AR Grabowski, TJ Bechara, A Damasio, H Ponto, LLB Parvizi, J Hichwa, RD Univ Iowa Coll Med Dept Neurol Div Cognit Nauroscu Iowa City IA 52242 USA Univ Iowa Coll Med PET Imaging Ctr Iowa City IA 52242 USA

In a series of [O-15]PET experiments aimed at investigating the neural basis of emotion and feeling, 41 normal subjects recalled and re-experienced personal life episodes marked by sadness, happiness, anger or fear. We tested the hypothesis that the process of feeling emotions requires the participation of brain regions, such as the somatosensory cortices and the upper brainstem nuclei, that are involved in the mapping and/or regulation of internal organism states. Such areas were indeed engaged, underscoring the close relationship between emotion and homeostasis. The findings also lend support to the idea that the subjective process of feeling emotions is partly grounded in dynamic neural maps, which represent several aspects of the organism's continuously changing internal state.

关键词：动作电位/生理学发怒/生理学脑干/生理学脑干/放射性核素显像大脑皮质/生理学大脑皮质/放射性核素显像情绪/生理学恐惧/生理学幸福自我刺激/生理学体层摄影术发射型计算机成年人人类

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