Metabolic abnormalities associated with mild cognitive impairment in Parkinson disease
1Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, 350 Community Drive, Manhasset, NY 11030, USA.
Objective:
To use (18)F-fluorodeoxyglucose (FDG) and PET to investigate changes in regional metabolism associated with mild cognitive impairment (MCI) in Parkinson disease (PD). Cognitive abnormalities are common in PD. However, little is known about the functional abnormalities that underlie the manifestations of MCI in this disorder.
Methods:
We used FDG PET to measure regional glucose metabolism in patients with PD with multiple-domain MCI (MD-MCI; n = 18), with single-domain MCI (SD-MCI; n = 15), and without MCI (N-MCI; n = 18). These patients were matched for age, education, disease duration, and motor disability. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM). We also computed the expression of a previously validated cognition-related spatial covariance pattern (PDCP) in the patient groups and in an age-matched healthy control cohort (n = 15). PDCP expression was compared across groups using analysis of variance.
Results:
SPM revealed decreased prefrontal and parietal metabolism (p < 0.001) in MD-MCI relative to N-MCI, as well as an increase in brainstem/cerebellar metabolism (p < 0.001) in this group. In these regions, SD-MCI occupied an intermediate position between the two other groups. PDCP expression was abnormally elevated in the N-, SD-, and MD-MCI groups (p < 0.05), increasing stepwise with worsening cognitive impairment (p < 0.01).
Conclusions:
Early cognitive decline in Parkinson disease as defined by mild cognitive impairment is associated with discrete regional changes and abnormal metabolic network activity. The quantification of these alterations with (18)F-fluorodeoxyglucose PET may allow for the objective assessment of the progression and treatment of this disease manifestation.
Insights
Mild cognitive impairment (MCI) in Parkinson disease (PD) is linked to altered brain metabolism. (18)F-fluorodeoxyglucose Positron Emission Tomography (FDG PET) can objectively assess these changes for tracking disease progression and treatment.
Area of Science:
- Neuroscience
- Medical Imaging
- Neurology
Background:
- Cognitive abnormalities, including mild cognitive impairment (MCI), are prevalent in Parkinson disease (PD).
- The specific functional brain alterations underlying MCI in PD remain incompletely understood.
- Understanding these changes is crucial for managing PD progression and associated cognitive decline.
Purpose of the Study:
- To investigate regional brain metabolism changes in Parkinson disease patients with mild cognitive impairment using (18)F-fluorodeoxyglucose Positron Emission Tomography (FDG PET).
- To differentiate metabolic patterns associated with single-domain MCI (SD-MCI) and multiple-domain MCI (MD-MCI) in PD.
- To assess the utility of FDG PET for objectively evaluating cognitive changes in PD.
Main Methods:
- FDG PET was employed to measure glucose metabolism in three groups of PD patients: MD-MCI (n=18), SD-MCI (n=15), and no MCI (N-MCI; n=18).
- Patients were matched for age, education, disease duration, and motor disability.
- Statistical parametric mapping (SPM) compared regional metabolism maps, and a cognition-related pattern (PDCP) was analyzed across groups, including healthy controls (n=15).
Main Results:
- MD-MCI patients showed decreased prefrontal and parietal metabolism and increased brainstem/cerebellar metabolism compared to N-MCI patients (p < 0.001).
- SD-MCI patients exhibited intermediate metabolic changes between the N-MCI and MD-MCI groups.
- PDCP expression was significantly elevated in all MCI groups, increasing with cognitive impairment severity (p < 0.05).
Conclusions:
- Early cognitive decline in Parkinson disease, characterized by MCI, is associated with distinct regional metabolic alterations and abnormal brain network activity.
- (18)F-fluorodeoxyglucose PET imaging offers a potential method for the objective assessment of these cognitive changes.
- FDG PET may aid in monitoring the progression and evaluating treatment efficacy for MCI in Parkinson disease.
Related Concept Videos
01:24Parkinson Disease ll: Pathophysiology
01:24Parkinson Disease l: Introduction
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:15Parkinson's Disease: Overview
01:11Alterations in Muscle Tone lll
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...