Brain, Vol 120, Issue 12 2197-2206, Copyright © 1997 by Oxford University Press
JR Moeller and D Eidelberg
We have used [18F]fluorodeoxyglucose (FDG) with PET to identify regional
metabolic covariance patterns associated with Parkinson's disease and
normal ageing. In this study we utilized these patterns as metabolic
markers to assess the relative roles of these processes in the progression
of parkinsonism. We studied 37 Parkinson's disease patients and 20 normal
volunteer subjects with FDG/PET to calculate regional metabolic rates for
glucose. We applied the Parkinson's disease and normal ageing regional
covariance patterns separately to these data to compute the expression of
both these markers in each subject on an individual case basis. The
measured expression of the normal ageing pattern provided an estimate of
subject age, based entirely upon the FDG/PET data. The normalized
difference between this metabolic estimate and chronological age (delta)
was then computed, where delta = (metabolic age - real age)/(real age). We
found that delta values were negative and significantly reduced in the
Parkinson's disease cohort compared with normal subjects (P < 0.005)
indicating a consistent underestimation of chronological age by FDG/PET in
parkinsonism. In the Parkinson's disease group, delta correlated negatively
with disease duration (r = -0.38, P < 0.04); extrapolation of this
linear relationship to delta = 0 yielded an estimate of the mean
preclinical period of 4.5 years. These findings suggest that the
Parkinson's disease process is likely to be associated with a progressive
disruption of the normal age-metabolism relationship, rather than with an
exaggeration of the normal ageing process. Our metabolic data also suggest
that the preclinical period in Parkinson's disease is of relatively short
duration.
ARTICLES
Divergent expression of regional metabolic topographies in Parkinson's disease and normal ageing
Department of Psychiatry, New York State Psychiatric Institute, Columbia College of Physicians and Surgeons, New York, New York, USA.
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