Functional brain imaging in pure akinesia with gait freezing: [18F] FDG PET and [18F] FP-CIT PET analyses

Authors

  • Hee K. Park MD,

    1. Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
    2. Department of Neurology, College of Medicine, Hanyang University, Seoul, South Korea
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  • Jae S. Kim MD, PhD,

    1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Ki C. Im PhD,

    1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Seung J. Oh PhD,

    1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Mi J. Kim MD,

    1. Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Jae-Hong Lee MD, PhD,

    1. Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Sun J. Chung MD, PhD,

    Corresponding author
    1. Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
    • Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-dong, Songpa-gu, Seoul, 138-736, South Korea
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  • Myoung C. Lee MD

    1. Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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  • Potential conflict of interest: None reported.

Abstract

Pure akinesia with gait freezing (PAGF) has characteristic features, including freezing of gait and prominent speech disturbance without rigidity or tremor. The purpose of this study was to investigate changes in brain glucose metabolism and presynaptic dopaminergic function in PAGF. By using [18F] fluorodeoxyglucose (FDG) PET, 11 patients with PAGF were compared with 14 patients with probable progressive supranuclear palsy (PSP), 13 patients with Parkinson's disease (PD), and 11 normal controls. [18F] N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) PET was performed in 11 patients with PAGF and with 10 normal controls. The PAGF patients showed decreased glucose metabolism in the midbrain when compared with normal controls. PSP patients showed a similar topographic distribution of glucose hypometabolism with additional areas, including the frontal cortex, when compared with normal controls. The FP-CIT PET findings in patients with PAGF revealed severely decreased uptake bilaterally in the basal ganglia. These findings suggest that both PAGF and PSP may be part of the same pathophysiologic spectrum of disease. However, the reason why PAGF manifests clinically in a different manner needs to be further elucidated. © 2008 Movement Disorder Society

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