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Objective To investigate the relationship between metabolism of dopamine transporter and levodopa-responsiveness in patients with Parkinson's disease(PD).Methods Thirteen patients with PD of Hohen-Yahr stage Ⅱ were enrolled in this study.The acute consecutive levedopa/benserazide (50.0/12.5 mg,100.0/25.0 mg,150.0/37.5 mg)tests were used to assess the patients' motor responses.The dopamine transporter binding were assessed with 11C-CFT PET specific in putamen,eaudate nucleus and occipital cortex.The correlation between the improvement of UPDRS Ⅲ and 11C-CFT PET the uptaking capability was analyzed.Results The marked reduction of 11 C-CFT uptake was observed in posterior putamen in patients with PD.The reduction of tracers uptake in posterior putamen contralateral to onset side was more significant than the posterior putamen ipsilateral to onset side (P＜0.01 ).There was significant correlation between 11C-CFF uptake in posterior putamen contralateral to onset side and the improvement of UPDRS motor subscale in test with levedopa/benserazide 100.0/25.0 mg or 150.0/37.5 mg(r=0.513,r=0.572,P＜0.01 ).There was also significant correlation between 11C-CFT uptake in posterior putamen ipsilateral to onset side and the improvement of UPDRS motor subscale in test with levedopa/benserazide 100.0/25.0 mg or 150.0/37.5 mg (r=0.452,r=0.478,P＜0.01 ).There was no correlation between 11C-CFT uptake in basal ganglia and the improvement of UPDTRS motor subscale in test with levedopa/benserazide 100/25mg or 150/37.5 mg(P＞0.05 ).Conclusion There is correlation between metabolism of dopamine transporter and levedopa responsiveness in PD patients of Hoben-Yahr Ⅱ ,which is helpful for the investigation of the pathophysiology.
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Objective To investigate the feature of cerebral glucose metabolism of Alzheimer's disease (AD)and dementia with lewy bodies (DLB).Methods 28 patients with AD and 25 patients with DLB underwent positron emission tomography (PET)with 18 F-fluorodeoxyglucose (18F-FDG)showing glucose metabolism.The region of interest (ROI)was selected from frontal cortex,temporal cortex,parietal cortex,occipital cortex,cerebellum cortex and corpora striata.The 18 F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results The FDG metabolism ratio of parietal cortex and temporal cortex decreased similarly in AD.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and caudate nucleus in AD was [(0.861 ± 0.173),(0.625 ± 0.149),(0.598 ± 0.185 ),(0.914 ± 0.214),( 1.030 ± 0.084)and ( 0.997 ± 0.102 )].The FDG metabolism ratio of frontal cortex,parietal cortex,occipital cortex,temporal cortex and corpus striatum decreased similarly in DLB.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and candate nucleus in DLB was [ (0.538 ±0.147),(0.615 ±0.138),( 0.587 ±0.142),(0.415 ±0.107 ),(0.685 ± 0.094)and (0.547 ± 0.103 )].The FDG metabolism ratio of frontal cortex,occipital cortex and corpus striatum decreased more significantly in DLB than in AD (P＜0.01 ).Conclusion There are discrepancies in cerebral glucose metabolism between AD and DLB.These features may be useful in differential diagnosis of these two kinds of dementia.
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@# Objective To investigate the feature of cerebral glucose metabolism of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Methods Twenty-five DLB patients and Thirty-one PDD patients underwent positron emission tomography(PET) with 18F-fluorodeoxyglucose (18F-FDG) showing glucose metabolism. The region of interest (ROI) was selected from frontal cortex, temporal cortex, parietal cortex, occipital cortex, cerebellum cortex and corpora striata. 18F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results FDG metabolism ratio of frontal cortex, occipital cortex, parietal cortex, temporal cortex and corpus striatum decreased similarly in DLB and PPD (P>0.05). FDG metabolism ratio of occipital cortex decreased more significantly in DLB than in PDD (P<0.01). The decrease of FDG metabolism in corpus striatum of DLB was symmetric. For patients with PDD, FDG metabolism in corpus striatum contralateral to onset side decreased more significantly than that of corpus striatum ipsilateral to onset side (P<0.05). Conclusion There are similarities and discrepancies in cerebral glucose metabolism between DLB and PDD. These features may be useful in differential diagnosis between these two kinds of Lewy body disease.
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Objective To investigate the MRI abnormalities and feature of FDG metabolism in the brain of patients with progressive supranuclear palsy.Methods Eleven patients with PSP and 178 patients with PD were prospectively studied with mid-sagittal plain MRI;five patients with PSP and 48 patients with PD were prospectively studied with 18F-FDG PET.Results The atrophy of the midbrain tegmentum and hummingbird sign were demonstrated in all of the PSP patients studied,but were not observed in PD patients.The area of the midbrain on mid-sagittal plain MRI in the patients with PSP was significantly smaller than that in those with PD.The patients with PSP had more prominent decrease of glucose metabolism symmetrically in frontal cortices and lentiform compared with PD.The lentiform in PD showed significant glucose hypermetabolism compared with thalamus.The regional glucose metabolism of PSP was symmetrical while that of PD was asymmetrical in lentiform and thalamus.Conclusion The assessment of the mid-sagittal plain MRI and 18F-FDG PET images may be a useful adjunct to a clinical examination when making a differential diagnosis of PSP with PD.
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Objective To investigate the clinical heterogeneity of Parkinson's disease in the early stages.Methods Clinical data of demographic,motor phenotype,disease progression,cognitive,mood,autonomic and hallucination variables were collected from 143 patients with PD in the early stages.The patients' subtypes were explored with statistical cluster analysis of the clinical data.Results The analysis indicated four main subtypes:1.the younger-onset subtype(n=40);2.The tremor dominant subtype(n=57);3.the non-tremor dominant subtype with fast progression(n=17);4.The non-tremor dominant subtype with mild depression(n=29).Age at onset,posture-instability scores,the ratio of tremor scores to non-tremor scores,rate of progression and apathy scores all differentiated patients of respective subgroups.Conclusion The patients with early Parkinson's disease have marked heterogeneity in the clinical phenotype.
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Objective To investigate the relationship between glucose metabolism and dopamine transporter in patients with Parkinson's disease.Methods Eleven patients at stage 2~3 of PD and three patients with essential tremor were examined by 18F-FDG PET and 11C-CFT PET in two separate days within four weeks.The regional glucose binding and dopamine transporter binding were assessed with PET specific software in anterior putamen,posterior putamen,caudate nucleus,thalamus and occipital cortex.The tracer uptake rate between the region of interest and occipital cortex was analyzed as the main variables.Results The marked reduction of 18F-FDG uptake and 11C-CFT uptake was observed in posterior putamen in patients with PD.The reduction of tracers uptake in posterior putamen contralateral to onset side was more significant than the posterior putamen ipsilateral to onset side (P