The metabolic anatomy of Parkinson's disease: Complementary [18F]fluorodeoxyglucose and [18F]fluorodopa positron emission tomographic studies

Authors

  • Dr. D. Eidelberg,

    Corresponding author
    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
    3. Department of Neurology, North Shore University Hospital, Manhasset, New York, U.S.A.
    • Department of Neurology, North Shore University Hospital, Cornell University Medical College, 300 Community Drive, Manhasset, NY 11030, U.S.A.
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  • Dr. J. R. Moeller,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    Current affiliation:
    1. Department of Psychiatry, Columbia University College of Physicians and Surgeons, Psychiatric Institute, New York, NY
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  • V. Dhawan,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
    3. Department of Neurology, North Shore University Hospital, Manhasset, New York, U.S.A.
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  • Dr. J. J. Sidtis,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
    Current affiliation:
    1. Department of Neurology, University of Minnesota, Minneapolis, MN
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  • J. Z. Ginos,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
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  • Dr. S. C. Strother,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
    Current affiliation:
    1. PET Imaging Service, Veteran's Administration Medical Center, One Veterans Drive, Minneapolis, MN
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  • J. Cedarbaum,

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Department of Neurology, Burke Rehabilitation Hospital, White Plains, New York, U.S.A.
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  • P. Greene,

    1. Department of Neurology, Columbia University College of Physicians and Surgeons, Neurological Institute, New York, New York, U.S.A.
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  • S. Fahn,

    1. Department of Neurology, Columbia University College of Physicians and Surgeons, Neurological Institute, New York, New York, U.S.A.
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  • Dr. D. A. Rottenberg

    1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
    2. Cornell University Medical College, New York, New York, U.S.A.
    Current affiliation:
    1. PET Imaging Service, Veteran's Administration Medical Center, One Veterans Drive, Minneapolis, MN
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Abstract

We studied the metabolic anatomy of typical Parkinson's disease (PD) using [18F]fluorodeoxyglucose (FDG) and [18F]fluorodopa (FDOPA) and positron emission tomography (PET). Fourteen PD patients (mean age 49 years) had FDG/PET scans, of which 11 were scanned with both FDOPA and FDG. After the injection of FDOPA, brain uptake and arterial plasma radioactivity were monitored for 2 h. Striatal FDOPA uptake was analyzed with regard to a two-compartment model, and target-to-background ratios (TBRs) and TBR-versus-time slopes were also calculated. Regional patterns of metabolic covariation were extracted from FDG/PET data using the Scaled Subprofile Model (SSM). SSM pattern weights, FDOPA uptake constants (Ki), TBRs, and TBR slopes were correlated with clinical measures for bradykinesia, rigidity, tremor, gait disturbance, left-right asymmetry, dementia, and overall disease severity. In PD patients, rate constants for FDOPA uptake correlated with individual measures of bradykinesia (p = 0.001) and gait disability (p < 0.05). SSM analysis revealed a distinct pattern of regional metabolic asymmetries, which correlated with motor asymmetries (p < 0.001) and left-right differences in Ki (p < 0.01). Our data suggest that in PD patients, FDG/PET and FDOPA/PET may provide unique and complementary information about underlying disease processes.

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