Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease

A Pilotto, E Premi, SP Caminiti, L Presotto, Rosanna Turrone, Antonella Alberici, Barbara Paghera, B Borroni, A. Padovani, D Perani

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Abstract

OBJECTIVE: To evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD). METHODS: Fifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis. RESULTS: The FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a "typical PD pattern" in 29 patients, whereas 25 patients presented with "atypical patterns," namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p <0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification. CONCLUSIONS: This study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia. © 2018 American Academy of Neurology.
Original languageEnglish
Pages (from-to)e1029-e1037
Number of pages9
JournalNeurology
Volume90
Issue number12
DOIs
Publication statusPublished - 2018

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Parkinson Disease
Dementia
Lewy Body Disease
Frontotemporal Dementia
Age of Onset
Disease Progression
Alzheimer Disease
Demography
Sensitivity and Specificity
Brain

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Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease. / Pilotto, A; Premi, E; Caminiti, SP; Presotto, L; Turrone, Rosanna; Alberici, Antonella; Paghera, Barbara; Borroni, B; Padovani, A.; Perani, D.

In: Neurology, Vol. 90, No. 12, 2018, p. e1029-e1037.

Research output: Contribution to journalArticle

Pilotto, A, Premi, E, Caminiti, SP, Presotto, L, Turrone, R, Alberici, A, Paghera, B, Borroni, B, Padovani, A & Perani, D 2018, 'Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease', Neurology, vol. 90, no. 12, pp. e1029-e1037. https://doi.org/10.1212/WNL.0000000000005161
Pilotto, A ; Premi, E ; Caminiti, SP ; Presotto, L ; Turrone, Rosanna ; Alberici, Antonella ; Paghera, Barbara ; Borroni, B ; Padovani, A. ; Perani, D. / Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease. In: Neurology. 2018 ; Vol. 90, No. 12. pp. e1029-e1037.
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AU - Pilotto, A

AU - Premi, E

AU - Caminiti, SP

AU - Presotto, L

AU - Turrone, Rosanna

AU - Alberici, Antonella

AU - Paghera, Barbara

AU - Borroni, B

AU - Padovani, A.

AU - Perani, D

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N2 - OBJECTIVE: To evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD). METHODS: Fifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis. RESULTS: The FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a "typical PD pattern" in 29 patients, whereas 25 patients presented with "atypical patterns," namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p <0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification. CONCLUSIONS: This study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia. © 2018 American Academy of Neurology.

AB - OBJECTIVE: To evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD). METHODS: Fifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis. RESULTS: The FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a "typical PD pattern" in 29 patients, whereas 25 patients presented with "atypical patterns," namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p <0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification. CONCLUSIONS: This study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia. © 2018 American Academy of Neurology.

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