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Increased striatal glucose consumption in Sydenham's chorea
A Weindl1, T Kuwert, K L Leenders
1Department of Neurology, Technical University of München, Germany.
Summary
Positron emission tomography revealed increased glucose metabolism in the striatum of patients with Sydenham's chorea. This finding contrasts with other choreatic disorders and suggests a unique pathophysiology.
Area of Science:
- Neuroscience
- Medical Imaging
- Metabolic Disorders
Background:
- Sydenham's chorea is a neurological disorder characterized by involuntary hyperkinetic movements.
- Understanding the cerebral metabolic underpinnings of Sydenham's chorea is crucial for diagnosis and treatment.
- Previous studies on choreatic disorders often show decreased striatal glucose metabolism.
Observation:
- Regional cerebral glucose consumption was measured using 18F-fluorodeoxyglucose positron emission tomography.
- Two patients with Sydenham's chorea were studied: a 15-year-old with acute symptoms and a 74-year-old with residual symptoms.
- Cerebellar, thalamic, and cortical glucose consumption were normal; however, lentiform and caudate glucose consumption were elevated.
Findings:
- Striatal glucose consumption was significantly increased in both hemispheres of the younger patient and contralaterally in the older patient.
- In the younger patient, striatal glucose metabolism normalized after chorea resolved with antibiotic treatment.
- This pattern of increased striatal glucose consumption in Sydenham's chorea differs from decreased metabolism seen in most other choreatic disorders.
Implications:
- The findings challenge current understanding of chorea pathophysiology in humans.
- Positron emission tomography measurement of cerebral energy metabolism may aid in the differential diagnosis of choreatic disorders.
- This research highlights potential unique metabolic pathways involved in Sydenham's chorea.