Assessment of disease severity in parkinsonism with fluorine-18-fluorodeoxyglucose and PET

J Nucl Med. 1995 Mar;36(3):378-83.

Abstract

Fluorine-18-fluorodeoxyglucose (FDG) and PET have been used to identify an abnormal regional metabolic covariance pattern in Parkinson's disease (PD). To examine the potential use of this covariance pattern as a metabolic imaging marker for PD, we describe the Topographic Profile Rating (TPR), which is a method for calculating subject scores for this pattern in individual PD patients. We then assess the relationship between these metabolic measures and objective independent disease severity ratings.

Methods: Two independent groups of PD patients were studied with FDG-PET. Group A consisted of 23 patients (mean age 60.2 +/- 12.2; mean Hoehn and Yahr stages 2.4 +/- 1.3) and Group B had 14 patients (mean age 49.0 +/- 12.1; mean Hoehn and Yahr stage 3.2 +/- 1.2). The regional cerebral metabolic rates for glucose (rCMRGlc) in all patients in each group were measured. TPR was used to calculate subject scores for the disease-related covariance pattern on a patient-by-patient basis.

Results: In both PD patient groups, subject scores correlated with Hoehn and Yahr disease severity ratings (Group A: r = 0.59, p < 0.004; Group B: 0.57, p < 0.04), quantitative ratings for bradykinesia (Group A: r = 0.63, p < 0.002; Group B: r = 0.61, p < 0.03), rigidity (Group A: r = 0.59, p < 0.004; Group B: r = 0.59, p < 0.04), but not with tremor.

Conclusion: These findings indicate that regional metabolic covariance patterns are robust imaging markers of disease severity. FDG-PET may be useful clinically in assessing parkinsonian disability and disease progression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Deoxyglucose / analogs & derivatives*
  • Female
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / diagnostic imaging*
  • Severity of Illness Index
  • Tomography, Emission-Computed

Substances

  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose