Hypermetabolism in the cerebellum and brainstem and cortical hypometabolism are independently associated with cognitive impairment in Parkinson's disease

Autor: Walter Maetzler, Christian la Fougère, Daniela Berg, Inga Liepelt-Scarfone, Matthias Reimold, Andrea Pilotto, Dominik Blum
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Cerebellum
Parkinson's disease
diagnostic imaging [Cognitive Dysfunction]
etiology [Cognitive Dysfunction]
0302 clinical medicine
Nuclear Medicine and Imaging
diagnostic imaging [Cerebral Cortex]
diagnostic imaging [Parkinson Disease]
Parkinson
Cerebral Cortex
diagnostic imaging [Brain Stem]
medicine.diagnostic_test
Parkinson Disease
General Medicine
Neuropsychological test
metabolism [Cerebellum]
Middle Aged
medicine.anatomical_structure
Cognitive impairment
Hypermetabolism
Cardiology
Female
Brainstem
complications [Parkinson Disease]
Radiology
medicine.medical_specialty
03 medical and health sciences
Fluorodeoxyglucose F18
Internal medicine
medicine
metabolism [Brain Stem]
Dementia
Humans
Radiology
Nuclear Medicine and imaging
Cognitive Dysfunction
ddc:610
Aged
business.industry
metabolism [Cerebral Cortex]
medicine.disease
diagnostic imaging [Cerebellum]
Pons
030104 developmental biology
Case-Control Studies
Positron-Emission Tomography
Cerebellar vermis
FDG PET
Radiology
Nuclear Medicine and Imaging
Radiopharmaceuticals
business
030217 neurology & neurosurgery
Brain Stem
Zdroj: European journal of nuclear medicine and molecular imaging 45(13), 2387-2395 (2018). doi:10.1007/s00259-018-4085-1
ISSN: 1619-7089
DOI: 10.1007/s00259-018-4085-1
Popis: Cognitive impairment (CI) in Parkinson’s disease (PD) is associated with a widespread reduction in cortical glucose metabolism and relative increases in the cerebellum and brainstem as measured using 18F-fluorodesoxyglucose (FDG) PET. We separately analysed CI-related hypermetabolism and hypometabolism in comparison with neuropsychological test performance and investigated whether increased FDG uptake is a true feature of the disease or a normalization effect. The study included 29 subjects (12 patients with PD, 10 patients with PD dementia and 7 healthy controls") who underwent FDG PET and comprehensive neuropsychological testing. Test performance across various cognitive domains was summarized in a cognitive staging score. Metabolic indices reflecting associated changes in regional cerebral glucose metabolism (rCGM) were calculated: index(−) for CI-related hypometabolism, and index(+) for CI-related hypermetabolism. We tested whether index(+) offered additional value in predicting the severity of CI in multiple regression analysis. At higher stages of CI, increased rCGM was found in the posterior cerebellar vermis and pons, associated with impaired attention, executive function and memory. Reduced rCGM was found in various cortical regions in agreement with the literature. In multiple regression analysis, both indices independently predicted the severity of CI with a whole-model R2 of 0.68 (index(−), p = 0.0006; index(+), p = 0.013), confirmed by alternative analyses combining different reference tissues in the multiple regression. We found CI-related hypermetabolism in cerebellar regions that are known to be involved in several cognitive functions and in the pons. These alterations may represent compensatory activation of cognitive networks including cerebropontocerebellar tracts.
Databáze: OpenAIRE
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