Atypical brain FDG-PET patterns increase the risk of long-term cognitive and motor progression in Parkinson's disease

Imarisio, Alberto; Pilotto, Andrea; Premi, Enrico; Caminiti, Silvia Paola; Presotto, Luca; Sala, Arianna; Zatti, Cinzia; Lupini, Alessandro; Turrone, Rosanna; Paghera, Barbara; Borroni, Barbara; Perani, Daniela; Padovani, Alessandro

doi:10.1016/j.parkreldis.2023.105848

Cited by 2 publications

(1 citation statement)

References 57 publications

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“…Correlations of reduced metabolism in the areas with event-related potentials confirmed the important role of EF disorders [ 362 ]. Patients with atypical brain hypometabolism showed a higher incidence of dementia (60% vs. 3%) and hallucinations (56% vs. 7%) [ 363 ].…”

Section: Brain Positron Emission Tomography Studies In Pd-cimentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.

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Section: Brain Positron Emission Tomography Studies In Pd-cimentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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White Matter Microstructural Alterations and Brain Metabolism distributions in Parkinson's Disease

Wang,

Fu,

Han

et al. 2024

Preprint

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This study aimed to use simultaneous 18F-FDG PET/MRI based on Automated Fiber Quantification (AFQ) to determine whether there is a relationship between white matter microstructure changes and glucose metabolism distribution in PD.The study involved 38 subjects, including 23 PD patients and 15 age and sex-matched healthy controls（HC）. Primary clinical data and cognitive assessments were collected. All subjects underwent a simultaneous 18F-FDG PET/MR scan. AFQ was utilized to calculate tract-wise diffusion properties of 20 major white matter tracts. PD patients showed reduced mean Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）scores compared to HC subjects (P < 0.05). PD patients showed higher mean diffusivity (MD) (P = 0.047) and axial diffusivity (AD) (P = 0.02) along the right corticospinal tract (CST) compared to HC. The microstructural change of CST was mainly located in the parietal part (node 67-100). Compared to HC, PD patients had FDG hypermetabolism in the right paracentral lobule (P = 0.0204) and bilateral putamen (left: P = 0.0075; right: P = 0.0155) and hypometabolism in the right calcarine (P = 0.0489). Hypermetabolism was found in the right paracentral lobule, which connects with the cortex of the right CST, and positively correlated with MD (r = 0.612, P < 0.001) and AD (r = 0.516, P < 0.001).We observed microstructural changes and glucose metabolism distribution characteristics in PD patients. These results may provide imaging evidence for studying the pathology of PD.

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Atypical brain FDG-PET patterns increase the risk of long-term cognitive and motor progression in Parkinson's disease

Cited by 2 publications

References 57 publications

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

White Matter Microstructural Alterations and Brain Metabolism distributions in Parkinson's Disease

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