Striatal hypometabolism distinguishes striatonigral degeneration from Parkinson's disease

Abstract

Regional and global metabolic rates for glucose were estimated using 18F-fluorodeoxyglucose and positron emission tomography in 10 patients with a clinical likelihood of striatonigral degeneration (2 men and 8 women; mean age, 61.8 +/- 6.9 years; mean disease duration, 4.7 +/- 2.2 years; mean Hoehn and Yahr score, 3.5 +/- 0.8). Measures of brain glucose metabolism in these patients were compared with those for 10 age-matched normal volunteers, 10 disease severity-matched patients with Parkinson's disease (PD), and 10 disease duration-matched patients with PD. Normalized glucose metabolism was significantly reduced in the caudate (p < 0.03) and putamen (p < 0.003) as compared with that in normal and PD control subjects, and discriminated patients with striatonigral degeneration from control subjects (p < 0.002). Putamenal hypometabolism in patients with striatonigral degeneration correlated significantly with quantitative ratings of motor disability (p < 0.02). These results suggest that quantitative 18F-fluorodeoxyglucose positron emission tomography techniques may be useful in supporting a diagnosis of striatonigral degeneration in life, and in objectively assessing disease severity and potential therapeutic interventions.

Network correlates of disease severity in multiple system atrophy

“…13,25 However, in contrast to the network-based MSARP measurements, these regional changes exhibited only a weak correlation with clinical motor ratings. While patients with MSA can have clinical parkinsonism without ataxia, and vice versa, data from a recent clinicopathologic study from 100 patients with MSA suggest that basal ganglia and cerebellar regional pathology do not exist in isolation.…”

“…12 These particular regions were selected because of prior data demonstrating consistent reductions in local glucose utilization in these brain regions in metabolic scans from patients with MSA. [13][14][15] For each region, glucose metabolism was averaged across hemispheres. To reduce intersubject variability, both regional measures were normalized by the global metabolic rate.…”

Cerebral Mitochondrial Metabolism in Early Parkinson's Disease

“…Thus, although defects in mitochondrial ETS may be present in some patients with PD, the absence of such defects in these 12 patients with early PD indicates that they cannot be essential to the pathogenesis of neuronal death in early PD. (Kuhl et al, 1984;Leenders et al, 1985;Eidelberg et al, 1993Eidelberg et al, , 1994Piert et al, 1996). In one of these studies, reductions in global CMRglc were seen only after L-DOPA was administered, suggesting that the reduction in metabolism may be at least, in part, because of medication effects (Piert et al, 1996).…”

Imaging Approaches to Parkinson Disease

“…In typical idiopathic PD, lentiform nucleus glucose metabolism is preserved or raised, whereas it is reduced in most atypical cases ( Fig. 5) (43,(52)(53)(54).…”