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Carli, G.* ; Meles, S.K.* ; Janzen, A.* ; Sittig, E.* ; Kogan, R.V.* ; Perani, D.* ; Oertel, W.H. ; Leenders, K.L.*

Occipital hypometabolism is a risk factor for conversion to Parkinson’s disease in isolated REM sleep behaviour disorder.

Eur. J. Nucl. Med. Mol. Imaging 50, 3290-3301 (2023)
Publ. Version/Full Text DOI PMC
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Purpose: Isolated REM sleep behaviour disorder (iRBD) patients are at high risk of developing clinical syndromes of the α-synuclein spectrum. Progression markers are needed to determine the neurodegenerative changes and to predict their conversion. Brain imaging with 18F-FDG PET in iRBD is promising, but longitudinal studies are scarce. We investigated the regional brain changes in iRBD over time, related to phenoconversion. Methods: Twenty iRBD patients underwent two consecutive 18F-FDG PET brain scans and clinical assessments (3.7 ± 0.6 years apart). Seventeen patients also underwent 123I-MIBG and 123I-FP-CIT SPECT scans at baseline. Four subjects phenoconverted to Parkinson’s disease (PD) during follow-up. 18F-FDG PET scans were compared to controls with a voxel-wise single-subject procedure. The relationship between regional brain changes in metabolism and PD-related pattern scores (PDRP) was investigated. Results: Individual hypometabolism t-maps revealed three scenarios: (1) normal 18F-FDG PET scans at baseline and follow-up (N = 10); (2) normal scans at baseline but occipital or occipito-parietal hypometabolism at follow-up (N = 4); (3) occipital hypometabolism at baseline and follow-up (N = 6). All patients in the last group had pathological 123I-MIBG and 123I-FP-CIT SPECT. iRBD converters (N = 4) showed occipital hypometabolism at baseline (third scenario). At the group level, hypometabolism in the frontal and occipito-parietal regions and hypermetabolism in the cerebellum and limbic regions were progressive over time. PDRP z-scores increased over time (0.54 ± 0.36 per year). PDRP expression was driven by occipital hypometabolism and cerebellar hypermetabolism. Conclusions: Our results suggest that occipital hypometabolism at baseline in iRBD implies a short-term conversion to PD. This might help in stratification strategies for disease-modifying trials.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords 18 F-fdg Pet ; Isolated Rem Sleep Behaviour Disorder ; Occipital Hypometabolism ; Short-term Conversion; Positron-emission-tomography; Metabolic Network Activity; Fdg-pet; Differential-diagnosis; Alzheimers-disease; Lewy Bodies; Dementia; Neurodegeneration; Validation; Biomarkers
ISSN (print) / ISBN 1619-7070
e-ISSN 1432-105X
Journal European Journal of Nuclear Medicine and Molecular Imaging
Quellenangaben Volume: 50, Issue: 11, Pages: 3290-3301 Article Number: , Supplement: ,
Publisher Springer
Publishing Place One New York Plaza, Suite 4600, New York, Ny, United States
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Neurogenomics (ING)
Grants Charitable Hertie Foundation, Frankfurt/Main, Germany
German "ParkinsonFonds Deutschland"
Dutch "Stichting ParkinsonFonds"