Objective:
To investigate the difference in glucose metabolism on (18)f-fluorodeoxyglucose positron emission tomography ((18)f-fdg pet) imaging for differential diagnosis of idiopathic parkinson's disease (ipd) from several parkinsonian-plus syndromes using spm2 approach.
Methods:
(18)f-fdg pet was performed for 18 ipd patients, 22 multiple system atrophy (msa) patients, 13 progressive supranuclear palsy (psp) patients, 5 corticobasal degeneration (cbd) patients, 7 dementia with lewy bodies (dlb) patients and 1 normal pressure hydrocephalus (nph) patient. imaging-based diagnosis was obtained by statistical parametric mapping (spm2) software to analyze the differences and overlaps among these groups.
Results:
The (18)f-fdg pet images analyzed with spm2 demonstrated that a reduction in glucose metabolism occurred in bilateral parietal area for ipd, in bilateral putamen for msa-p, in bilateral cerebellum for msa-c, in midbrain and the middle frontal cortex for psp, in asymmetrical metabolism of the cortex and the basal ganglia for cbd, in bilateral occipital and parieto-occipital areas for dlb. the metabolic reductions in a patient of nph group were observed in the ventricular system.
Conclusions:
This study identifies different patterns of glucose metabolism in parkinsonism. (18)f-fdg pet imaging may contribute to early differential diagnosis in clinically ambiguous cases of parkinsonism.