PET imaging in neurology: Alzheimer's and Parkinson's diseases.

Abstract

PET studies play an important role in the early detection of Alzheimer's and Parkinson's diseases (AD and PD). Fluorine-18 fluorodeoxyglucose (F-FDG) PET imaging of regional cerebral glucose metabolism and PET amyloid imaging are the two major PET studies for AD. F-FDG PET is highly sensitive for the early diagnosis of AD, in predicting conversion from mild cognitive impairment to AD, and in differentiating AD from other dementias. PET amyloid imaging is positive in the majority of patients with AD. Negative amyloid PET reduces the likelihood of AD. The main limitations of PET amyloid imaging is its high positivity in the normal elderly population and in other medical conditions with amyloid pathologies. Various PET tracers are available to assess motor and cognitive dysfunctions in PD. PET tracers targeting presynaptic dopaminergic function (F-DOPA, radiolabeled PET tracers assessing the availability of dopamine transporters and vesicular monoamine transporters) and postsynaptic dopamine receptors are used to assess motor dysfunction in PD. PET tracers, particularly dopamine transporters, are highly sensitive in the early diagnosis of PD. Uptake of PET tracers in the striatum is inversely correlated with disease severity. PET is valuable in differentiating PD from other movement disorders. PET studies, particularly F-FDG PET, help to evaluate cortical metabolism in PD patients with cognitive dysfunction and dementia.