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Posterior parietooccipital hypometabolism may differentiate mild cognitive impairment from dementia in Parkinson’s disease

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Patients with Parkinson’s disease (PD) may have normal cognition, mild cognitive impairment (MCI) or dementia. We investigated differences in cerebral metabolism associated with these three cognitive states and the relationship between metabolism and cognitive dysfunction.

Methods

FDG PET and a battery of neuropsychological tests were used to study PD patients with dementia (n = 19), MCI (n = 28) and normal cognition (n = 21), and control subjects (n = 20). Regional glucose metabolism in patients and controls was analysed using statistical parametric mapping (SPM8) corrected for age, motor severity and depression. Correlations between the mini-mental state examination score and Z-score values of the different cognitive domains with respect to cerebral FDG uptake were assessed using SPM8.

Results

PD patients with MCI (PD-MCI patients) exhibited decreased FDG uptake in the frontal lobe, and to a lesser extent in parietal areas compared with cognitively normal patients. Patients with dementia showed reduced metabolism in the parietal, occipital and temporal areas and a less extensive reduction in the frontal lobe compared with PD-MCI patients, while widespread hypometabolism was seen in comparison with patients with normal cognition. PD-MCI patients exhibited reduced FDG uptake in the parietal and occipital lobes and in localized areas of the frontal and temporal lobes compared with controls, whereas patients with dementia showed a widespread reduction of cortical metabolism. Mini-mental state examination score correlated positively with metabolism in several lobes, executive function with metabolism in the parietooccipitotemporal junction and frontal lobe, memory with temporoparietal metabolism, visuospatial function with occipitoparietal and temporal metabolism, and language with frontal metabolism.

Conclusion

PD patients with MCI exhibited hypometabolism in several cortical regions compared with controls, and in the frontal and parietal regions compared with cognitively normal patients. Hypometabolism was higher in patients with dementia than in those with MCI, mainly in the posterior cortical areas where it was correlated with visuospatial, memory and executive functions.

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Acknowledgments

This study was supported by a grant from the Government of Navarra (32/2007), by a grant from FIS (ISCIII), and CIBERNED, Spain. We thank Ainara Estanga for her critical review of the article.

Conflicts of interest

Maria C. Rodriguez-Oroz is on the advisory board of UCB Spain. She has received payment for lectures, as well as travel and accommodation to attend scientific meetings from GlaxoSmithKline, UCB, Lundbeck and Medtronic. She has received research funding from national and regional government bodies in Spain. Jose Obeso has served previously on the Advisory Board of GSK (UK), and received honorarium for lectures given at meetings organized by GSK (Spain), Lundbeck-TEVA and UCB. Grants/Research: Funding from Spanish Science and Education Ministry and European Union (REPLACES). The other authors have no conflicts of interest to report concerning the research dealt with in this manuscript.

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Author notes

  1. Maria C. Rodriguez-Oroz

    Present address: Department of Neurology and Neuroscience, University Hospital Donostia, BioDonostia Research Institute, San Sebastian, Spain

Authors and Affiliations

  1. Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain

    David Garcia-Garcia, Pedro Clavero, Carmen Gasca Salas, Isabel Lamet, Rafael Gonzalez-Redondo, Jose A. Obeso & Maria C. Rodriguez-Oroz

  2. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain

    David Garcia-Garcia, Carmen Gasca Salas, Rafael Gonzalez-Redondo, Jose A. Obeso & Maria C. Rodriguez-Oroz

  3. Department of Nuclear Medicine, Clínica, University of Navarra, Pamplona, Spain

    Javier Arbizu

  4. Ikerbasque, Basque Foundation for Science, Bilbao, Spain

    Maria C. Rodriguez-Oroz

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  1. David Garcia-Garcia
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Correspondence to Maria C. Rodriguez-Oroz.

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David Garcia-Garcia and Pedro Clavero contributed equally to this work.

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Garcia-Garcia, D., Clavero, P., Gasca Salas, C. et al. Posterior parietooccipital hypometabolism may differentiate mild cognitive impairment from dementia in Parkinson’s disease. Eur J Nucl Med Mol Imaging 39, 1767–1777 (2012). https://doi.org/10.1007/s00259-012-2198-5

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