Voxel-based comparison of regional cerebral glucose metabolism between PSP and corticobasal degeneration

OBJECTIVES Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are neurodegenerative disorders that may be accompanied by dementia and parkinsonism as clinical symptoms. The purpose of this study was to elucidate cerebral metabolic differences of these two diseases with cognitive impairments by [18F] fluorodeoxyglucose (FDG) and positron emission tomography (PET). METHODS A total of 12 patients with PSP (age: 62.8+/-6.0 years old, m: 7, f: 5, Mini-Mental State Examination (MMSE): 23.4+/-2.6), 12 patients with CBD (age: 64.8+/-6.3 years old, m: 6, f: 6, MMSE: 22.9+/-4.5), and age-matched healthy subjects (normal control (NC)) (age: 63.8+/-7.7 years old, m: 7, f: 5) were subjected to FDG-PET to obtain glucose metabolic images. We compared regional cerebral metabolic images by a voxel-by-voxel analysis with statistical parametric mapping (SPM) among PSP, CBD, and NC subjects, and evaluated differences of hypometabolic regions. RESULTS The patients with PSP showed reduced cerebral glucose metabolism in the medial and lateral frontal gyri, basal ganglia, and midbrain compared with NC, whereas the patients with CBD showed significant reduction in the parietal lobes (p<0.001). SPM also revealed parietal hypometabolism in CBD patients compared with PSP patients (p<0.001). CONCLUSIONS The predominant parietal glucose metabolic reduction in CBD patients was different from previously reported findings. This finding would be the characteristic substance of patients with CBD accompanying cognitive impairments. Our findings suggest that measurement of glucose metabolism by PET and a voxel-based analysis is useful to understand the pathophysiology of these two diseases with cognitive impairments.

[1]  K. Ishii,et al.  Reduction of cerebellar glucose metabolism in advanced Alzheimer's disease. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[2]  K. Ishii,et al.  Statistical brain mapping of 18F-FDG PET in Alzheimer's disease: validation of anatomic standardization for atrophied brains. , 2001, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[3]  S Minoshima,et al.  An automated method for rotational correction and centering of three-dimensional functional brain images. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[4]  D. Brooks,et al.  PET and the investigation of dementia in the parkinsonian patient. , 1997, Journal of neural transmission. Supplementum.

[5]  K. Ishii,et al.  Features of Regional Cerebral Glucose Metabolism Abnormality in Corticobasal Degeneration , 2000, Dementia and Geriatric Cognitive Disorders.

[6]  F. Mihara,et al.  Heterogeneity of glucose metabolism in corticobasal degeneration , 1998, Journal of the Neurological Sciences.

[7]  K. Ishii,et al.  Corticobasal degeneration: evaluation of cortical atrophy by means of hemispheric surface display generated with MR images. , 2000, Radiology.

[8]  S. Sakamoto,et al.  Regional difference in cerebral blood flow and oxidative metabolism in human cortex. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[9]  J. P. Brandel,et al.  Accuracy of the Clinical Diagnosis of Corticobasal Degeneration , 1997, Neurology.

[10]  H. Tachibana,et al.  Cerebral blood flow in corticobasal degeneration and progressive supranuclear palsy. , 2000, Alzheimer disease and associated disorders.

[11]  J R Moeller,et al.  The metabolic landscape of cortico-basal ganglionic degeneration: regional asymmetries studied with positron emission tomography. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[12]  R. Koeppe,et al.  Anatomic standardization: linear scaling and nonlinear warping of functional brain images. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[13]  Y Agid,et al.  Positron emission tomography study in progressive supranuclear palsy. Brain hypometabolic pattern and clinicometabolic correlations. , 1990, Archives of neurology.

[14]  M. Hallett,et al.  Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) , 1996, Neurology.

[15]  P. Ashby,et al.  Cortical‐basal ganglionic degeneration , 1990, Neurology.

[16]  M. Tabaton,et al.  Corticobasal degeneration shares a common genetic background with progressive supranuclear palsy , 2000, Annals of neurology.

[17]  J. Talairach,et al.  Co-Planar Stereotaxic Atlas of the Human Brain: 3-Dimensional Proportional System: An Approach to Cerebral Imaging , 1988 .

[18]  M. Mintun,et al.  Automated detection of the intercommissural line for stereotactic localization of functional brain images. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  Y. Kuwabara,et al.  Cerebral blood flow, oxygen and glucose metabolism with PET in progressive supranuclear palsy , 1989, Annals of nuclear medicine.

[20]  A. Destée,et al.  Voxel‐based distribution of metabolic impairment in corticobasal degeneration , 2000, Movement disorders : official journal of the Movement Disorder Society.

[21]  J. Steele Progressive supranuclear palsy. , 1972, Brain : a journal of neurology.

[22]  H. Fukuyama,et al.  Cerebral glucose metabolism in corticobasal degeneration: Comparison with progressive supranuclear palsy and normal controls , 1997, Movement disorders : official journal of the Movement Disorder Society.

[23]  Karl J. Friston,et al.  Statistical parametric maps in functional imaging: A general linear approach , 1994 .