Acetyl-DL-leucine in cerebellar ataxia ([ 18 F]-FDG-PET study): how does a cerebellar disorder influence cortical sensorimotor networks?

Autor: Becker-Bense S; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. Sandra.bense@med.uni-muenchen.de., Kaiser L; Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany., Becker R; Department of Neurology, University Hospital, LMU Munich, Munich, Germany., Feil K; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.; Department of Neurology, University Hospital, LMU Munich, Munich, Germany., Muth C; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.; Department of Neurology, University Hospital, LMU Munich, Munich, Germany., Albert NL; Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany., Unterrainer M; Department of Radiology, University Hospital, LMU Munich, Munich, Germany., Bartenstein P; Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany., Strupp M; Department of Neurology, University Hospital, LMU Munich, Munich, Germany., Dieterich M; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.; Department of Neurology, University Hospital, LMU Munich, Munich, Germany.; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2023 Jan; Vol. 270 (1), pp. 44-56. Date of Electronic Publication: 2022 Jul 25.
DOI: 10.1007/s00415-022-11252-2
Abstrakt: Objective: The aim of the study was to deepen our insights into central compensatory processes of brain networks in patients with cerebellar ataxia (CA) before and with treatment with acetyl-DL-leucine (AL) by means of resting-state [ 18 F]-FDG-PET brain imaging.
Methods: Retrospective analyses of [ 18 F]-FDG-PET data in 22 patients with CA (with vestibular and ocular motor disturbances) of different etiologies who were scanned before (PET A) and on AL treatment (PET B). Group subtraction analyses, e.g., for responders and non-responders, comparisons with healthy controls and correlation analyses of regional cerebral glucose metabolism (rCGM) with symptom duration, ataxia (SARA) and quality of life (QoL) scores were calculated.
Results: Prior to treatment rCGM was consistently downregulated at the cerebellar level and increased in multisensory cortical areas, e.g., somatosensory, primary and secondary visual (including V5, precuneus), secondary vestibular (temporal gyrus, anterior insula), and premotor/supplementary motor areas. With AL (PET B vs. A) cerebellar hypometabolism was deepened and sensorimotor hypermetabolism increased only in responders with clinical benefit, but not for the non-responders and the whole CA group. A positive correlation of ataxia improvement with rCGM was found in visual and vestibular cortices, a negative correlation in cerebellar and brainstem areas. QoL showed a positive correlation with rCGM in the cerebellum and symptom duration in premotor and somatosensory areas.
Conclusions: Central compensatory processes in CA mainly involve multisensory visual, vestibular, and somatosensory networks as well as premotor/primary motor areas at the cortical level. The enhanced divergence of cortical sensorimotor up- and cerebellar downregulation with AL in responders could reflect amplification of inhibitory cerebellar mechanisms.
(© 2022. The Author(s).)
Databáze: MEDLINE
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