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Glucose hypometabolism in medial frontal cortex of patients with apraxia of lid opening

  • Clinical Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine whether regional cerebral functional abnormalities exist in patients with apraxia of lid opening (ALO).

Methods

Cerebral glucose metabolism was examined by positron emission tomography (PET) in 11 patients (8 women and 3 men, age 48–69 years); 10 with ALO accompanied by blepharospasm and 1 patient with pure ALO. Eleven normal volunteers (6 women and 5 men, age 45–66 years) were examined as controls. A comprehensive ophthalmological examination, magnetic resonance imaging (MRI), and PET were performed. The cerebral glucose metabolism was evaluated by the relative uptake of [fluorine-18]fluorodeoxyglucose by PET. The mean ± two standard deviations of the normal controls was defined as the normal range for cerebral glucose metabolism.

Results

MRI revealed no particular lesion except for an infarction in the unilateral basal ganglia in two patients. Decreased glucose metabolism was observed in a wide area of the medial frontal lobe (six cases) and primary visual cortex (PVC) (four cases). Group multiple comparisons revealed a significant decrease (P<0.0035) in the bilateral anterior cingulate gyrus, left supplementary motor area (SMA), and bilateral PVC.

Conclusion

The results support the hypothesis that ALO is associated with hypofunction in the SMA and/or anterior cingulate gyrus.

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References

  1. Aramideh M, Ongerboer de Visser BW (1994) Electromyographic features of levator palpebrae superioris and orbicularis oculi muscles in blepharospasm. Brain 117:27–38

    PubMed  Google Scholar 

  2. Aramideh M, Ongerboer de Visser BW, Devriese PP et al (1994) Clinical and electromyographic features of levator palpebrae superioris muscle dysfunction in involuntary eyelid closure. Mov Disord 9:395–402

    CAS  PubMed  Google Scholar 

  3. Ardekani BA, Braun M, Hurton DF et al (1995) "A fully automatic multimodality image registration algorithm." J Comput Assist Tomogr 19:615–623

    Google Scholar 

  4. Ball T, Schreiber A, Feige B et al (1999) The role of higher-order motor areas in voluntary movement as revealed by high-resolution EEG and fMRI. Neuroimage 10:682–694

    CAS  PubMed  Google Scholar 

  5. Basso MA, Evinger C (1996) An explanation for reflex blink hyperexcitability in Parkinson's disease. 2. Nucleus raphe magnus. J Neurosci 16:7318–7330

    CAS  PubMed  Google Scholar 

  6. Bodis-Wollner I, Bucher SF, Seelos KC (1999) Cortical activation patterns during voluntary blinks and voluntary saccades. Neurology 53:1800–1805

    CAS  PubMed  Google Scholar 

  7. Ceballos-Baumann AO, Sheean G, Passingham RE et al (1995) Cerebral activation with stereotyped writing in patients with writer's cramp before and after botulinum toxin treatment: a PET study. Neurology 45: A393

    Google Scholar 

  8. Della SS, Francescani A, Spinnler H et al (2002) Gait apraxia after bilateral supplementary motor area lesion. J Neurol Neurosurg Psychiatry 72:77–85

    Article  PubMed  Google Scholar 

  9. Esmaeli GB, Nahmias C, Thompson M et al (1999) Positron emission tomography in patients with benign essential blepharospasm. Ophthalmic Plastic Reconstruct Surg 15:23–27

    Google Scholar 

  10. Esteban A, Gimenez-Roldan S (1988) Involuntary closure of eyelids in parkinsonism. Electrophysiological evidence for prolonged inhibition of the levator palpebrae muscles. J Neurol Sci 85:333–345

    Article  CAS  PubMed  Google Scholar 

  11. Galardi G, Perani D, Grassi F et al (1996) Basal ganglia and thalamo-cortical hypermetabolism in patients with spasmodic torticollis. Acta Neurol Scand 94:172–176

    CAS  PubMed  Google Scholar 

  12. Goffinet AM, De Volder AG, Gillain C et al (1989) Positron tomography demonstrates frontal lobe hypometabolism in progressive supranuclear palsy. Ann Neurol 25:131–139

    CAS  PubMed  Google Scholar 

  13. Goldstein JE, Cogan DG (1965) Apraxia of lid opening. Arch Ophthalmol: 73:155–159

    Google Scholar 

  14. Graham MM, Peterson LM, Hayward RM (2000) Comparison of simplified quantitative analyses of FDG uptake. Nucl Med Biol 27:647–655

    CAS  PubMed  Google Scholar 

  15. Guze BH, Hoffman JM, Baxter LR et al (1991) Functional brain imaging and Alzheimer-type dementia. Alzheimer Dis Assoc Disord 5:215–230

    CAS  PubMed  Google Scholar 

  16. Hutchinson M, Nakamura T, Moeller JR et al (2000) The metabolic topography of essential blepharospasm. A focal dystonia with general implications. Neurology 55:673–677

    CAS  PubMed  Google Scholar 

  17. Kawashima R, Fukuda H (1998) Cortical control of voluntary movements: PET studies. Rinshyo Nouha 40:32–35

    Google Scholar 

  18. Keane JR (1988) Lid-opening apraxia in Wilson's disease. J Clin Neuro-ophthalmology 8:31–33

    Google Scholar 

  19. Kimbrell TA, Ketter TA (2002) Regional cerebral glucose utilization in patients with a range of severities of unipolar depression. Biol Psychiatry 2002 51:237–252

    Article  CAS  Google Scholar 

  20. Krack P, Marion MH (1994) "Apraxia of lid opening," a focal eyelid dystonia: clinical study of 32 patients. Mov Disord 9:610–605

    CAS  PubMed  Google Scholar 

  21. Lepore FE, Duvoisin RC (1985) "Apraxia" of eyelid opening: an involuntary levator inhibition. Neurology 35:423–427

    CAS  PubMed  Google Scholar 

  22. May M, Galetta S (1990) The facial nerve and related disorders of the face. In: Glaser JS (ed) Neuro-ophthalmology, 2nd edn. 239–277

  23. Piccione F, Mancini E, Tchin et al (1997) Botulinum toxin treatment of apraxia of eyelid opening in progressive supranuclear palsy: report of two cases. Arch Phys Med Rehabil 78: 525–529

    CAS  PubMed  Google Scholar 

  24. Ridding MC, Sheean G, Rothwell JC (1995) Changes in the balance between motor cortical excitation and inhibition in focal, task specific dystonia. J Neurol Neurosurg Psychiatry 59:493–498

    CAS  PubMed  Google Scholar 

  25. Shima K, Aya K, Mushiake H et al (1991) Two movement-related foci in the primate cingulate cortex observed in signal-triggered and self-paced forelimb movements. J Neurophysiol 65:188–202

    CAS  PubMed  Google Scholar 

  26. Sibony PA, Evinger C (1997) Normal and abnormal eyelid function. In: Walsh and Hoyt's Clinical neuro-ophthalmology, 5th edn. 1509–1593

  27. Smith D, Ishikawa T, Dhawan V et al (1995) Lid opening apraxia is assosiated with medial frontal hypometabolism. Mov Disord 10:341–344

    CAS  PubMed  Google Scholar 

  28. Van Eimeren T, Boecker H, Konkiewitz EC et al (2001) Right lateralized motor cortex activation during volitional blinking. Ann Neurol 49:813–816

    Article  PubMed  Google Scholar 

  29. Verghese J, Milling C, Rosenbaum DM (1999) Ptosis, blepharospasm, and apraxia of eyelid opening secondary to putaminal hemorrhage. Neurology 53:652

    CAS  Google Scholar 

  30. Wessel K, Zeffiro T, Toro C et al (1997) Self-paced versus metronome-paced finger movements. J Neuroimaging 7:145–151

    CAS  PubMed  Google Scholar 

  31. Yazawa S, Ikeda A, Kunieda et al (2000) Human presupplementary motor area is active before voluntary movement: subdural recording of Bereitschaftspotential from medial frontal cortex. Exp Brain Res 131:165–177

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, School of Medicine, Tokyo Medical and Dental University, Yushima 1-chome 5-45, Bunkyo-ku, 113-8519 , Tokyo, Japan

    Yukihisa Suzuki, Motohiro Kiyosawa, Naonori Ohno & Manabu Mochizuki

  2. Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    Yukihisa Suzuki, Motohiro Kiyosawa, Kenji Ishii & Michio Senda

  3. Laboratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Akira Inaba

  4. Department of Neurology, Tokyo Medical and Dental University, Tokyo, Japan

    Hidehiro Mizusawa

Authors
  1. Yukihisa Suzuki
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  2. Motohiro Kiyosawa
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  3. Naonori Ohno
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  4. Manabu Mochizuki
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  5. Akira Inaba
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  6. Hidehiro Mizusawa
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  7. Kenji Ishii
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  8. Michio Senda
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Correspondence to Motohiro Kiyosawa.

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Suzuki, Y., Kiyosawa, M., Ohno, N. et al. Glucose hypometabolism in medial frontal cortex of patients with apraxia of lid opening. Graefe's Arch Clin Exp Ophthalmol 241, 529–534 (2003). https://doi.org/10.1007/s00417-003-0682-0

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  • DOI: https://doi.org/10.1007/s00417-003-0682-0

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