Abnormal metabolic brain network associated with Parkinson’s disease: replication on a new European sample

• DOI: 10.1007/s00234-017-1821-3
• Publication Date: 2017-04-06T07:28:03Z
• Authors: Petra Tomše; Luka Jensterle; Marko Grmek; Katja Zaletel; Zvezdan Pirtošek; Vijay Dhawan; Shichun Peng; David Eidelberg; Yilong Ma; Maja Trošt
• Keywords: Male; Brain; Parkinson Disease; Middle Aged; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Fluorodeoxyglucose F18; Case-Control Studies; Positron-Emission Tomography; Disease Progression; Humans; Female; Radiopharmaceuticals; Aged

The purpose of this study was to identify the specific metabolic brain pattern characteristic for Parkinson's disease (PD): Parkinson's disease-related pattern (PDRP), using network analysis of [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) brain images in a cohort of Slovenian PD patients.Twenty PD patients (age 70.1 ± 7.8 years, Movement Disorder Society Unified Parkinson's Disease Motor Rating Scale (MDS-UPDRS-III) 38.3 ± 12.2; disease duration 4.3 ± 4.1 years) and 20 age-matched normal controls (NCs) underwent FDG-PET brain imaging. An automatic voxel-based scaled subprofile model/principal component analysis (SSM/PCA) was applied to these scans for PDRP-Slovenia identification.The pattern was characterized by relative hypermetabolism in pallidum, putamen, thalamus, brain stem, and cerebellum associated with hypometabolism in sensorimotor cortex, posterior parietal, occipital, and frontal cortices. The expression of PDRP-Slovenia discriminated PD patients from NCs (p < 0.0001) and correlated positively with patients' clinical score (MDS-UPDRS-III, p = 0.03). Additionally, its topography agrees well with the original PDRP (p < 0.001) identified in American cohort of PD patients. We validated the PDRP-Slovenia expression on additional FDG-PET scans of 20 PD patients, 20 NCs, and 25 patients with atypical parkinsonism (AP). We confirmed that the expression of PDRP-Slovenia manifests good diagnostic accuracy with specificity and sensitivity of 85-90% at optimal pattern expression cutoff for discrimination of PD patients and NCs and is not expressed in AP.PDRP-Slovenia proves to be a robust and reproducible functional imaging biomarker independent of patient population. It accurately differentiates PD patients from NCs and AP and correlates well with the clinical measure of PD progression.