Analysis of positron emission tomography hypometabolic patterns and neuropsychiatric symptoms in patients with dementia syndromes

CNS Neurosci Ther. 2023 Aug;29(8):2193-2205. doi: 10.1111/cns.14169. Epub 2023 Mar 16.

Abstract

Aims: To estimate the proportions of specific hypometabolic patterns and their association with neuropsychiatric symptoms (NPS) in patients with cognitive impairment (CI).

Methods: This multicenter study with 1037 consecutive patients was conducted from December 2012 to December 2019. 18 F-FDG PET and clinical/demographic information, NPS assessments were recorded and analyzed to explore the associations between hypometabolic patterns and clinical features by correlation analysis and multivariable logistic regression models.

Results: Patients with clinical Alzheimer's disease (AD, 81.6%, 605/741) and dementia with Lewy bodies (67.9%, 19/28) mostly had AD-pattern hypometabolism, and 76/137 (55.5%) of patients with frontotemporal lobar degeneration showed frontal and anterior temporal pattern (FT-P) hypometabolism. Besides corticobasal degeneration, patients with behavioral variant frontotemporal dementia (36/58), semantic dementia (7/10), progressive non-fluent aphasia (6/9), frontotemporal lobar degeneration and amyotrophic lateral sclerosis (3/5), and progressive supranuclear palsy (21/37) also mostly showed FT-P hypometabolism. The proportion of FT-P hypometabolism was associated with the presence of hallucinations (R = 0.171, p = 0.04), anxiety (R = 0.182, p = 0.03), and appetite and eating abnormalities (R = 0.200, p = 0.01) in AD.

Conclusion: Specific hypometabolic patterns in FDG-PET are associated with NPS and beneficial for the early identification and management of NPS in patients with CI.

Keywords: cognitive impairment; fluorodeoxyglucose positron emission tomography; frontotemporal lobar degeneration; hypometabolism; neuropsychiatric symptom.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alzheimer Disease* / complications
  • Alzheimer Disease* / diagnostic imaging
  • Brain / diagnostic imaging
  • Fluorodeoxyglucose F18
  • Frontotemporal Dementia* / complications
  • Frontotemporal Dementia* / diagnostic imaging
  • Frontotemporal Lobar Degeneration*
  • Humans
  • Positron-Emission Tomography
  • Syndrome

Substances

  • Fluorodeoxyglucose F18