Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
Department of Geriatric Medicine, University of Edinburgh, Edinburgh, UK.
J Neurol Neurosurg Psychiatry. 2017 Apr;88(4):310-316. doi: 10.1136/jnnp-2016-313918. Epub 2016 Oct 6.
To assess reductions of cerebral glucose metabolism in Parkinson's disease (PD) with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and their associations with cognitive decline.
FDG-PET was performed on a cohort of 79 patients with newly diagnosed PD (mean disease duration 8 months) and 20 unrelated controls. PD participants were scanned while on their usual dopaminergic medication. Cognitive testing was performed at baseline, and after 18 months using the Cognitive Drug Research (CDR) and Cambridge Neuropsychological Test Automated Battery (CANTAB) computerised batteries, the Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). We used statistical parametric mapping (SPM V.12) software to compare groups and investigate voxelwise correlations between FDG metabolism and cognitive score at baseline. Linear regression was used to evaluate how levels of cortical FDG metabolism were predictive of subsequent cognitive decline rated with the MMSE and MoCA.
PD participants showed reduced glucose metabolism in the occipital and inferior parietal lobes relative to controls. Low performance on memory-based tasks was associated with reduced FDG metabolism in posterior parietal and temporal regions, while attentional performance was associated with more frontal deficits. Baseline parietal to cerebellum FDG metabolism ratios predicted MMSE (β=0.38, p=0.001) and MoCA (β=0.3, p=0.002) at 18 months controlling for baseline score.
Reductions in cortical FDG metabolism were present in newly diagnosed PD, and correlated with performance on neuropsychological tests. A reduced baseline parietal metabolism is associated with risk of cognitive decline and may represent a potential biomarker for this state and the development of PD dementia.
使用 18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）评估帕金森病（PD）患者脑葡萄糖代谢的降低及其与认知能力下降的关系。
对 79 例新诊断为 PD（平均病程 8 个月）的患者和 20 名无关对照进行了 FDG-PET 检查。PD 参与者在服用常规多巴胺能药物时接受扫描。在基线时以及 18 个月后使用认知药物研究（CDR）和剑桥神经心理学测试自动化电池（CANTAB）计算机化电池、简易精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）进行认知测试。我们使用统计参数映射（SPM V.12）软件比较组间差异，并在基线时对 FDG 代谢与认知评分之间的体素进行相关性分析。线性回归用于评估皮质 FDG 代谢水平如何预测 MMSE 和 MoCA 评定的后续认知能力下降。
PD 参与者的枕叶和下顶叶的葡萄糖代谢较对照组减少。基于记忆的任务表现较差与顶叶和颞叶后部的 FDG 代谢减少有关，而注意力表现与更多的额叶缺陷有关。基线时顶叶至小脑 FDG 代谢比值预测 MMSE（β=0.38，p=0.001）和 MoCA（β=0.3，p=0.002），控制基线评分。
新诊断的 PD 患者存在皮质 FDG 代谢减少，与神经心理学测试的表现相关。基线时顶叶代谢减少与认知能力下降的风险相关，可能代表这种状态和 PD 痴呆的潜在生物标志物。
