Objective: To evaluate the accuracy of single-subject FDG-PET in predicting motor and cognitive long-term progression in Parkinson’s disease

Background: The progression of Parkinson’s disease is still not easily predictable on short and long term. Recently, a SPM -based single-subject SPM pattern analyses predicted the development of dementia at in PD patients at 4-year follow-up at single subject level.

Method: Forty-nine out of the initial cohort of 54 PD patients with FDG-PET underwent follow-up at 8 years. The correlation between single-subject pattern and the following milestones have been evaluated for each patient: dementia, hallucinations, falls, inability to walk, motor function (assessed by changes in UPDRS-III and levodopa equivalent daily dose, LEDD).

Results: Patients were classified according to their baseline FDG-PET pattern: normal PD pattern (n=26); DLB-like (n=12), AD-like (n=6), CBS-like (n=3), and FTD-like (n=2). At 8-years follow-up 16 patients (of whom 15 with atypical patterns, p<0.005) converted to dementia. Patients with atypical FDG-PET patterns showed also higher incidence of hallucinations (p=0.001), falls (p=0.033) and inability to walk (p=0.018). Patients with atypical pattern (especially with AD-like pattern) showed worse long-term motor progression (i.e. UPDRS-III changes), independently from dementia and LEDD (p=0.04).

Conclusion: This study suggests FDG-PET as promising progression marker at single-subject level for its ability to predict long term disability in PD. The association between worse motor progression and cortical hypometabolism might indicate that reduced cortical reserve could impact on motor function in PD independently from dementia. This issue need further investigations in PD patients without dementia with extensive biomarkers and longitudinal assessment.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/cortical-fdg-pet-patterns-predict-long-term-motor-progression-and-disability-milestones-in-parkinsons-disease/