Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease
Creators
- 1. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia; Parkinson's Disease Rehabilitation Centre , FERB ONLUS S.Isidoro Hospital, Trescore Balneario, Italy
- 2. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia; Neurovascular Unit, Brescia Hospital, Brescia, Italy
- 3. Vita-Salute San Raffaele University, Milan, Italy.
- 4. Nuclear Medicine Unit, San Raffaele Hospital, Division of Neuroscience, San Raffaele Scientific Institute, Nuclear Medicine Unit, San Raffaele Hospital (L.P., D.P.), Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
- 5. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- 6. Nuclear Medicine Unit, Brescia Hospital, Brescia, Italy
- 7. Vita-Salute San Raffaele University and Nuclear Medicine Unit, San Raffaele Hospital, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
Description
Abstract
Objective To evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD).
Methods Fifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis.
Results The FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a “typical PD pattern” in 29 patients, whereas 25 patients presented with “atypical patterns,” namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p < 0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification.
Conclusions This study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia.
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