Abstract
This study explored the association between cerebral metabolic rates of glucose (CMRGlc) and the severity of Vascular Parkinsonism (VP) and Parkinson's disease (PD). A cross-sectional study was performed to compare CMRGlc in normal subjects vs. VP and PD patients. Twelve normal subjects, 22 VP, and 11 PD patients were evaluated with the H&Y and MMSE, and underwent 18F-FDG measurements. Pearson's correlations were used to identify potential associations between the severity of VP/PD and CMRGlc. A pronounced reduction of CMRGlc in the frontal lobe and caudate putamen was detected in patients with VP and PD when compared with normal subjects. The VP patients displayed a slight CMRGlc decrease in the caudate putamen and frontal lobe in comparison with PD patients. These decreases in CMRGlc in the frontal lobe and caudate putamen were significantly correlated with the VP patients' H&Y, UPDRS II, UPDRS III, MMSE, cardiovascular, and attention/memory scores. Similarly, significant correlations were observed in patients with PD. This is the first clinical study finding strong evidence for an association between low cerebral glucose metabolism and the severity of VP and PD. Our findings suggest that these changes in glucose metabolism in the frontal lobe and caudate putamen may underlie the pathophysiological mechanisms of VP and PD. As the scramble to find imaging biomarkers or predictors of the disease intensifies, a better understanding of the roles of cerebral glucose metabolism may give us insight into the pathogenesis of VP and PD.
Highlights
This study explored the association between cerebral metabolic rates of glucose (CMRGlc) and the severity of Vascular Parkinsonism (VP) and Parkinson’s disease (PD)
We found a pronounced reduction of CMRGlc in the frontal lobe and caudate putamen in patients with VP and PD when compared with normal subjects
The VP patients displayed a slight CMRGlc decrease in the caudate putamen and in the frontal lobes in comparison with PD patients. These decreases in CMRGlc in the frontal lobe and caudate putamen were significantly correlated with their Hoehn and Yahr staging scale (H&Y), UPDRS II, UPDRS III, MiniMental State Examination (MMSE), cardiovascular, and attention/memory scores in patients with VP and in PD patients
Summary
This study explored the association between cerebral metabolic rates of glucose (CMRGlc) and the severity of Vascular Parkinsonism (VP) and Parkinson’s disease (PD). Significant correlations were observed in patients with PD This is the first clinical study finding strong evidence for an association between low cerebral glucose metabolism and the severity of VP and PD. A reliable predictor is urgently needed to predict or evaluate the development of VP as well as PD It would be extremely useful if gross changes in cerebral glucose metabolism are correlated with certain NMS and if these changes could act as a biomarker for the evaluation of VP and PD progression and severity. Quite possibly, these changes could serve as an indicator in disease screening. We aimed to assess whether CMRGlc in VP and PD was associated with poor motor function and to identify an association between NMS domains and CMRGlc levels
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