Atypical brain FDG-PET patterns increase the risk of long-term cognitive and motor progression in Parkinson's disease

Alberto Imarisio; Andrea Pilotto; Enrico Premi; Silvia Paola Caminiti; Luca Presotto; Arianna Sala; Cinzia Zatti; Alessandro Lupini; Rosanna Turrone; Barbara Paghera; Barbara Borroni; Daniela Perani; Alessandro Padovani

doi:10.1016/j.parkreldis.2023.105848

Atypical brain FDG-PET patterns increase the risk of long-term cognitive and motor progression in Parkinson's disease

Parkinsonism Relat Disord. 2023 Oct:115:105848. doi: 10.1016/j.parkreldis.2023.105848. Epub 2023 Sep 7.

Authors

Affiliations

¹ Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
² Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia University Hospital, Italy; Laboratory of Digital Neurology and Biosensors, University of Brescia, Italy. Electronic address: [email protected].
³ Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Stroke Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy.
⁴ In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁵ Department of Physics "G. Occhialini", University of Milano - Bicocca, Milan, Italy; Milan Centre for Neuroscience, University of Milano - Bicocca, Milan, Italy.
⁶ Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia University Hospital, Italy; Laboratory of Digital Neurology and Biosensors, University of Brescia, Italy.
⁷ Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia University Hospital, Italy.
⁸ Nuclear Medicine Unit, University of Brescia, Brescia, Italy.
⁹ In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy.

PMID: 37716228
DOI: 10.1016/j.parkreldis.2023.105848

Abstract

Introduction: Brain hypometabolism patterns have been previously associated with cognitive decline in Parkinson's disease (PD). Our aim is to evaluate the impact of single-subject fluorodeoxyglucose (FDG)-PET brain hypometabolism on long-term cognitive and motor outcomes in PD.

Methods: Forty-nine non-demented PD patients with baseline brain FDG-PET data underwent an extensive clinical follow-up for 8 years. The ability of FDG-PET to predict long-term cognitive and motor progression was evaluated using Cox regression and mixed ANCOVA models.

Results: Participants were classified according to FDG-PET pattern in PD with typical (n = 26) and atypical cortical metabolism (n = 23). Patients with atypical brain hypometabolic patterns showed higher incidence of dementia (60% vs 3%; HR = 18.3), hallucinations (56% vs 7%, HR = 7.3) and faster motor decline compared to typical pattern group.

Conclusion: This study argues for specific patterns of FDG-PET cortical hypometabolism in PD as a prognostic marker for long term cognitive and motor outcomes at single-subject level.

Keywords: FDG-PET; Parkinson's disease; Parkinson's disease dementia; Risk prediction; Statistical parametric mapping.