Assessment of regional GABA(A) receptor binding using 18F-fluoroflumazenil positron emission tomography in spastic type cerebral palsy.
Periventricular leukomalacia (PVL) due to hypoxic-ischemic insult to the immature brain, chorioamnionitis and maternal infection are the major etiological factors of spastic type cerebral palsy (CP). Despite advances in preventing and treating certain causes of CP, the number of patients has remained essentially unchanged and the pathophysiological mechanisms related to motor dysfunction remain poorly understood. In this study, statistical parametric mapping (SPM) analysis of cerebral gamma-aminobutyric acid (GABA) receptor PET imaging using [18F]-fluoroflumazenil showed increased GABA(A) receptor binding in the bilateral motor and visual cortices in spastic diplegia (SD) type CP patients (n = 20) compared with normal controls (n = 10). As GABA(A) receptor signaling modulates biological perception and production of movement, complex motor skills and use-dependent plasticity in the motor cortex, increased GABA(A) receptor binding in the motor cortex might play a important role in poor motor control. Decreased GABA(A) receptor binding was seen in the brain stem in SD CP patients, which appears to be related to spastic symptom.
Lee
Jong Doo
JD
Division of Nuclear Medicine, Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul 120-752, Republic of Korea. jdlee@yumc.yonsei.ac.kr
Park
Hae-Jeong
HJ
Park
Eun Sook
ES
Kim
Dong Goo
DG
Rha
Dong-Wook
DW
Kim
Eung Yeop
EY
Kim
Dong Ik
DI
Kim
Jae-Jin
JJ
Yun
Mijin
M
Ryu
Young Hoon
YH
Lee
Jinu
J
Jeong
Jae Min
JM
Lee
Dong Soo
DS
Lee
Myung Chul
MC
Park
Chang Il
CI
D000293:Adolescent; D000328:Adult; D001665:Binding Sites; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000503:physiopathology; D002547:Cerebral Palsy / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002648:Child; D005260:Female; D005442:Flumazenil / Q000031:analogs & derivatives*; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D049268:Positron-Emission Tomography; D011963:Receptors, GABA-A / Q000502:physiology*
C483765:2'-fluoroflumazenil; D005462:Fluorine Radioisotopes; D011963:Receptors, GABA-A; D005442:Flumazenil