PT  - JOURNAL ARTICLE
AU  - Pilotto, Andrea
AU  - Premi, Enrico
AU  - Paola Caminiti, Silvia
AU  - Presotto, Luca
AU  - Turrone, Rosanna
AU  - Alberici, Antonella
AU  - Paghera, Barbara
AU  - Borroni, Barbara
AU  - Padovani, Alessandro
AU  - Perani, Daniela
TI  - Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease
AID  - 10.1212/WNL.0000000000005161
DP  - 2018 Mar 20
TA  - Neurology
PG  - e1029--e1037
VI  - 90
IP  - 12
4099  - http://n.neurology.org/content/90/12/e1029.short
4100  - http://n.neurology.org/content/90/12/e1029.full
SO  - Neurology2018 Mar 20; 90
AB  - Objective To evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD).Methods Fifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis.Results The FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a “typical PD pattern” in 29 patients, whereas 25 patients presented with “atypical patterns,” namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p < 0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification.Conclusions This study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia.AD=Alzheimer disease; AUC=area under the curve; CBS=corticobasal syndrome; CI=confidence interval; DLB=dementia with Lewy bodies; FDG=fluorodeoxyglucose; FTD=frontotemporal dementia; LEDD=levodopa equivalent daily dose; LL=log likelihood; LR=likelihood ratio; MCI=mild cognitive impairment; MMSE=Mini-Mental State Examination; PD=Parkinson disease; PDD=Parkinson disease dementia; PD-NC=Parkinson disease with normal cognition; SPM=statistical parametric mapping