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Regional Cerebral Glucose Metabolic Abnormality in Prader–Willi Syndrome: A ¹⁸F-FDG PET Study Under Sedation

¹ Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea; ² Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; ³ Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and ⁴ Clinical Research Center, Samsung Medical Center and Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: For correspondence or reprints contact: Dong-Kyu Jin, MD, PhD, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 IlWon-Dong, Kangnam-Gu, Seoul, 135-710, Korea. E-mail: jindk{at}smc.samsung.co.kr

Prader–Willi syndrome (PWS) is a genetic disorder caused by the nonexpression of paternal genes in the PWS region of chromosome 15q11-13 and is the most common cause of human syndromic obesity. Methods: We investigated regional brain metabolic impairment in children with PWS by ¹⁸F-FDG PET. Sixteen children with PWS (9 males, 7 females; mean age ± SD, 4.2 ± 1.1 y) and 7 healthy children (4 males, 3 females; mean age ± SD, 4.0 ± 1.7 y) underwent brain ¹⁸F-FDG PET in the resting state. The images of PWS children were compared using statistical parametric mapping analysis with those of healthy children in a voxelwise manner. Results: Group comparison showed that children with PWS had decreased glucose metabolism in the right superior temporal gyrus and left cerebellar vermis, regions that are associated with taste perception/food reward and cognitive and emotional function, respectively. Metabolism was increased in the right orbitofrontal, bilateral middle frontal, right inferior frontal, left superior frontal, and bilateral anterior cingulate gyri, right temporal pole, and left uncus, regions that are involved in cognitive functions related to eating or obsessive–compulsive behavior. Interestingly, no significant metabolic abnormality was found in the hypothalamus, the brain region believed to be most involved in energy intake and expenditure. Conclusion: This study describes the neural substrate underlying the abnormal eating behavior and psychobehavioral problems of PWS.

Key Words: Prader–Willi syndrome • glucose metabolism • PET • eating behavior • obsessive–compulsive behavior

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