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Aging and disease    2019, Vol. 10 Issue (4) : 847-853     DOI: 10.14336/AD.2018.0814
Orginal Article |
The Metabolic Activity of Caudate and Prefrontal Cortex Negatively Correlates with the Severity of Idiopathic Parkinson’s Disease
Jun-Sheng Chu1, Ting-Hong Liu2,3,4, Kai-Liang Wang2,3, Chun-Lei Han2,3, Yun-Peng Liu2,3, Shimabukuro Michitomo2,3, Jian-Guo Zhang1,2, Tie Fang4, Fan-Gang Meng2,3,*
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
3Beijing Key Laboratory of Neurostimulation, Beijing, China
4Department of Neurosurgery, Beijing Children’s hospital, Capital Medical University, Beijing, China
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Abstract  

Positron emission tomography (PET) scan with tracer [18F]-fluorodeoxy-glucose (18F-FDG) is widely used to measure the glucose metabolism in neurodegenerative disease such as Idiopathic Parkinson’s disease (IPD). Previous studies using 18F-FDG PET mainly focused on the motor or non-motor symptoms but not the severity of IPD. In this study, we aimed to determine the metabolic patterns of 18F-FDG in different stages of IPD defined by Hoehn and Yahr rating scale (H-Y rating scale) and to identify regions in the brain that play critical roles in disease progression. Fifty IPD patients were included in this study. They were 29 men and 21 women (mean±SD, age 57.7±11.1 years, disease duration 4.0±3.8 years, H-Y 2.2±1.1). Twenty healthy individuals were included as normal controls. Following 18F-FDG PET scan, image analysis was performed using Statistical Parametric Mapping (SPM) and Resting-State fMRI Data Analysis Toolkit (REST). The metabolic feature of IPD and regions-of-interests (ROIs) were determined. Correlation analysis between ROIs and H-Y stage was performed. SPM analysis demonstrated a significant hypometabolic activity in bilateral putamen, caudate and anterior cingulate as well as left parietal lobe, prefrontal cortex in IPD patients. In contrast, hypermetabolism was observed in the cerebellum and vermis. There was a negative correlation (p=0.007, r=-0.412) between H-Y stage and caudate metabolic activity. Moreover, the prefrontal area also showed a negative correlation with H-Y (P=0.033, r=-0.334). Thus, the uptake of FDG in caudate and prefrontal cortex can potentially be used as a surrogate marker to evaluate the severity of IPD.

Keywords Parkinson's disease      Statistical Parametric Mapping      18F-FDG PET      metabolic activity     
Corresponding Authors: Meng Fan-Gang   
About author:

These authors contributed equally.

Just Accepted Date: 20 September 2018   Issue Date: 01 August 2019
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Jun-Sheng Chu
Ting-Hong Liu
Kai-Liang Wang
Chun-Lei Han
Yun-Peng Liu
Shimabukuro Michitomo
Jian-Guo Zhang
Tie Fang
Fan-Gang Meng
Cite this article:   
Jun-Sheng Chu,Ting-Hong Liu,Kai-Liang Wang, et al. The Metabolic Activity of Caudate and Prefrontal Cortex Negatively Correlates with the Severity of Idiopathic Parkinson’s Disease[J]. Aging and disease, 2019, 10(4): 847-853.
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http://www.aginganddisease.org/EN/10.14336/AD.2018.0814     OR     http://www.aginganddisease.org/EN/Y2019/V10/I4/847
CharacteristicsIPD (Mean/ SD, Range)Health control (Mean/ SD, Range)
Age, yr57.7/11.1, (31-87)55.6 ± 12.3 (29-75)
Disease duration, yr4.0/3.8, (0.5-17)-
UPDRS III27.8/8.9, (13-45)-
H-Y last-
Stage 118-
Stage 211-
Stage 2.54-
Stage 312-
Stage 42-
Stage 53-
Table 1  Clinical and Demographic characteristics of 50 patients (29 men; 21 women) and 20 health control (13 men; 7 women).
Fig 1.  The metabolism of FDG in IPD patients compared to healthy controls. Brain areas with increased/decreased glucose metabolism are superimposed on the Montreal Neurological Institute template (Top row) (p < 0.001, uncorrected) and the 3D render (Bottom row). A) Significant hypometabolism in bilateral putamen, caudate, anterior cingulate, parietal lobe and prefrontal cortex was identified. B) The relative hypermetabolism was identified in the cerebellum and vermis.
Figure 2.  The relationship between the metabolic activity of ROIs and H-Y stages

A) In caudate, the metabolic activity decreased as H-Y stages increased (p=0.004 r=-0.441). B) Similar to caudate, prefrontal metabolic activity also decreased as H-Y stages increased (p=0.004 r=-0.441). C, D, E and F, show no correlation in vermis (C), angular (D), occipital (E) and temporal lobes (F). The Pearson correlation analysis was performed using SPSS software.

RegionMNI coordinate
T scorep-value
xyz
IPD<HCCaudate121004.460.000
Frontal lobe662203.630.000
Temporal50-2-74.480.001
Occipital-20-81344.040.000
Anterior Cingulate1028225.000.001
Parietal lobe-50-56443.880.000
IPD>HCCerebelum10-62-323.630.000
Vermis-32-62524.440.000
Table 2  MNI coordinate of significant clusters.
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