Neurology:后部原发性进行性面容失认症:结构和分子影像学

2020-04-26 zyx 神经科病例撷英拾粹

淀粉样蛋白阴性病理的原发性进行性面容失认症通常首先累及右侧颞叶尖部。

淀粉样蛋白阴性病理的原发性进行性面容失认症通常首先累及右侧颞叶尖部。69岁右利手男性,淀粉样蛋白PET成像阴性,表现为严重的进行性面容失认,伴右侧后部颞枕部皮质改变,包括梭状回面孔区,但颞叶尖部不受累。累及的脑区在MRI上可见皮质变薄,PET上可见代谢异常,tau沉积和炎症反应(图)。患者71岁时出现了皮质基底节综合征(corticobasal syndrome,CBD)的临床征象,表现为失用,运动维持不能,肌强直和核上性眼球运动障碍。患者早期皮质厚度研究中,右侧运动前区皮质受累可预示CBD(图)。


(图:最明显的皮质变薄[顶部,黄色]对应最低代谢,最高的tau沉积和炎症反应[箭])

原始出处:Pascual B, Masdeu JC, Funk Q, et al. Posterior primary progressive prosopagnosia: Structural and molecular imaging.Neurology. 2020 Feb 25;94(8):360-361.

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