18F-FDG PET study on the idiopathic Parkinson's disease from several parkinsonian-plus syndromes.

OBJECTIVE

To investigate the difference in glucose metabolism on (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) imaging for differential diagnosis of idiopathic Parkinson's disease (IPD) from several parkinsonian-plus syndromes using SPM2 approach.

METHODS

(18)F-FDG PET was performed for 18 IPD patients, 22 multiple system atrophy (MSA) patients, 13 progressive supranuclear palsy (PSP) patients, 5 corticobasal degeneration (CBD) patients, 7 dementia with Lewy bodies (DLB) patients and 1 normal pressure hydrocephalus (NPH) patient. Imaging-based diagnosis was obtained by statistical parametric mapping (SPM2) software to analyze the differences and overlaps among these groups.

RESULTS

The (18)F-FDG PET images analyzed with SPM2 demonstrated that a reduction in glucose metabolism occurred in bilateral parietal area for IPD, in bilateral putamen for MSA-P, in bilateral cerebellum for MSA-C, in midbrain and the middle frontal cortex for PSP, in asymmetrical metabolism of the cortex and the basal ganglia for CBD, in bilateral occipital and parieto-occipital areas for DLB. The metabolic reductions in a patient of NPH group were observed in the ventricular system.

CONCLUSIONS

This study identifies different patterns of glucose metabolism in parkinsonism. (18)F-FDG PET imaging may contribute to early differential diagnosis in clinically ambiguous cases of parkinsonism.