Patterns of cerebral glucose utilization in Parkinson's disease and Huntington's disease

Kuhl, David E.; Metter, E. Jeffrey; Riege, Walter H.; Markham, Charles H.

doi:10.1002/ana.410150723

Cited by 138 publications

(46 citation statements)

References 15 publications

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“…Increases (12) and decreases (27,28) of glucose uptake within the basal ganglia have been reported in PD. Cortical metabolic abnormalities were reported in frontotemporal and parietooccipital areas (12,14,(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

et al. 2015

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Parkinson disease with and without dementia (PDD and PD, respectively), dementia with Lewy bodies (DLB), and Alzheimer dementia (AD) traditionally have been viewed as distinct clinical and pathologic entities. However, intriguing overlaps in biochemical, clinical, and imaging findings question the concept of distinct entities and suggest a continuous spectrum in which individual patients express PD-typical patterns and AD-typical patterns to a variable degree. Methods: Following this concept, we built a topological map based on regional patterns of the cerebral metabolic rate of glucose as measured with 18 F-FDG PET to rank and localize single subjects' disease status according to PD-typical (PD vs. controls) and ADtypical (AD vs. controls) pattern expression in patients clinically characterized as PD, PDD, DLB, amnestic mild cognitive impairment, and AD. Results: The topology generally confirmed an indivisible spectrum of disease manifestation according to 2 separable expression patterns. The expression values derived from the first pattern were highly correlated with individual cognitive, but not motor, disability. The opposite was found for the corresponding expression values of the second pattern. Conclusion: The metabolic imaging analysis supports the notion that there is a continuous spectrum of neurodegeneration between AD and PD. Furthermore, PDD and DLB may in fact represent 1 overlapping disease entity, characterized by the presence of mixed neuropathology and only different by the time course.Key Words: Alzheimer; Parkinson; FDG PET; dementia; motor deficits J Nucl Med 2015; 56:1916 56: -1921 56: DOI: 10.2967 Age-related neuropsychiatric disorders such as Parkinson disease with and without dementia (PDD and PD, respectively), dementia with Lewy bodies (DLB), amnestic mild cognitive impairment (aMCI), and Alzheimer disease dementia (AD) represent a growing socioeconomic challenge. However, these disorders show substantial clinical and neuropathologic overlap, limiting diagnostic accuracy and questioning the concept of distinct clinical entities (1-3). Indeed, the notion that PD and AD may be extremes of a spectrum of neurodegenerative diseases-with DLB and PDD presenting overlapping neuropathologic and clinical features within this spectrum-has received growing attention in recent years (4).Although pathophysiologically and clinically different, PD and AD share some aspects in common: both are age-related neurodegenerative disorders characterized by aggregation of pathologic proteins leading to dysfunction of cerebral networks and distinct patterns of metabolic changes (3-6). Cases characterized by pure PD (a-synuclein aggregation) or pure AD (amyloid and tau aggregation) pathology do not represent most affected patients. Biologically and histopathologically, there is an overlap of these age-associated proteinopathies. They form a continuum with concomitant amyloid-, tau-, and a-synuclein aggregation as well as microvascular changes (6,7).aMCI represents an intermediate clinical state of cognitive de...

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Section: Discussionmentioning

confidence: 99%

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

et al. 2015

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“…Preliminary studies show hypoperfusion (hypoconcentration) in degenerative choreas and hyperperfusion in infectious choreas, such as SC (9,10). SPECT was introduced at the beginning of the 80s and has permitted the assessment of regional cerebral perfusion.…”

Section: Introductionmentioning

confidence: 99%

Brain SPECT imaging in Sydenham's chorea

Barsottini

Ferraz

Seviliano

et al. 2002

Braz J Med Biol Res

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The objective of the present study was to determine whether brain single-photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities. Ten Sydenhams chorea (SC) patients, eight females and two males, 8 to 25 years of age (mean 13.4), with a clinical diagnosis of SC were submitted to brain SPECT imaging. We used HMPAO labeled with technetium-99m at a dose of 740 MBq. Six examinations revealed hyperperfusion of the basal ganglia, while the remaining four were normal. The six patients with abnormal results were females and their data were not correlated with severity of symptoms. Patients with abnormal brain SPECT had a more recent onset of symptoms (mean of 49 days) compared to those with normal SPECT (mean of 85 days) but this difference did not reach statistical significance. Brain SPECT can be a helpful method to determine abnormalities of the basal ganglia in SC patients but further studies on a larger number of patients are needed in order to detect the phase of the disease during which the examination is more sensitive.

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“…The pure akinetic type has been considered to be a different clinical entity from idiopathic Parkinson's disease by some investigators. ' (1)(2)(3)(4)(5)(6)(7)(8) and patients with atypical Parkinsonism (PKM) (9- I I I II III III III III II III III II II III III Case 9 A 54 year old right handed man started to complain of writing difficulty at the age of 50. This was followed by dysarthria (microphonia).…”

Section: Introductionmentioning

confidence: 99%

Striatal blood flow, glucose metabolism and 18F-dopa uptake: difference in Parkinson's disease and atypical parkinsonism.

Otsuka

Ichiya

Hosokawa

et al. 1991

Journal of Neurology, Neurosurgery & Psychiatry

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Patterns of cerebral glucose utilization in Parkinson's disease and Huntington's disease

Cited by 138 publications

References 15 publications

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

Brain SPECT imaging in Sydenham's chorea

Striatal blood flow, glucose metabolism and 18F-dopa uptake: difference in Parkinson's disease and atypical parkinsonism.

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