Increased Metabolic Activity in the Spinal Cord of Patients with Long-Standing Lhermitte’s Sign
| Autor: | Lajos Trón, Judit Olajos, Katalin Vönöczky, Zsolt Lengyel, Klára Stefanits, Géza Sáfrány, Olga Ésik, Tibor Csere, Szabolcs Szakáll, Gábor Bajzik, Erzsébet Lengyel |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Time Factors Central nervous system Nasopharyngeal neoplasm Radiation Tolerance Spinal Cord Diseases Lhermitte's sign Central nervous system disease Myelopathy Methionine Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Radiation Injuries Fluorodeoxyglucose Radiotherapy business.industry Nasopharyngeal Neoplasms Radiotherapy Dosage Fibroblasts medicine.disease Spinal cord Hodgkin Disease Magnetic Resonance Imaging medicine.anatomical_structure Spinal Cord Oncology Female Radiopharmaceuticals medicine.symptom business Nuclear medicine Perfusion Follow-Up Studies Tomography Emission-Computed medicine.drug |
| Zdroj: | Strahlentherapie und Onkologie. 179:690-693 |
| ISSN: | 1439-099X 0179-7158 |
| DOI: | 10.1007/s00066-003-1115-z |
| Popis: | To investigate the pathophysiology of the radiation-induced, chronic Lhermitte's sign (LS) on the basis of long-standing case histories with partial functional recovery.As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 Gy(2) (case 2) was delivered to the cervical spinal cord. Neurologic signs relating to the irradiated spinal cord segments developed after 2 months (case 1) and 5 years (case 2), with radiation-induced damage equivalent to grade 3 (case 1) and grade 2 (case 2) toxicity (Common Toxicity Criteria, Version 2.0). The clinical status improved to grade 2 (case 1) and grade 1 (case 2). Positron emission tomography (PET) and fibroblast clonogen assay were applied 25 and 7 years postirradiation, respectively, to characterize this rare clinical picture.PET demonstrated increased [(18)F]fluorodeoxyglucose (FDG) accumulation and [(15)O]butanol perfusion, but negligible [(11)C]methionine uptake in the irradiated spinal cord segments in both patients. In clonogenic assays, fibroblasts from case 1 displayed much higher radiation sensitivity than in healthy controls, while in case 2 the fibroblasts sensitivity was normal.These data suggests a close direct relationship between regional perfusion and metabolism of the spinal cord, similarly as in the brain. The postirradiation recovery may be related to energy-demanding conduction, explaining the increased metabolism and perfusion. The increased radiosensitivity and higher spinal cord BED may have contributed to the more severe sequelae in case 1. |
| Databáze: | OpenAIRE |
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