RT Journal Article
SR Electronic
T1 Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e1029
OP e1037
DO 10.1212/WNL.0000000000005161
VO 90
IS 12
A1 Pilotto, Andrea
A1 Premi, Enrico
A1 Paola Caminiti, Silvia
A1 Presotto, Luca
A1 Turrone, Rosanna
A1 Alberici, Antonella
A1 Paghera, Barbara
A1 Borroni, Barbara
A1 Padovani, Alessandro
A1 Perani, Daniela
YR 2018
UL http://n.neurology.org/content/90/12/e1029.abstract
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