Cortical dysfunction in non-demented Parkinson's disease patients: a combined (31)P-MRS and (18)FDG-PET study.

摘要: Regional cerebral phosphorus-31 magnetic resonance spectroscopy ((31)P-MRS) was performed in 10 non- demented Parkinson's disease patients and nine age-matched control subjects. Five of the undergoing (31)P-MRS four additional had 2-[(18)F]fluoro-2-deoxy-D-glucose PET ((18)FDG-PET), results which were compared with those eight All underwent neuropsychological testing including performance verbal subtests Wechsler Adult Intelligence Scale-Revised, Boston Naming Test, Controlled Oral Word Association test (FAS Test) California Learning Test to exclude clinical dementia. (31)P MR spectra from right left temporo-parietal cortex, occipital cortex a central voxel incorporating basal ganglia brainstem obtained. peak area ratios signals phosphomonoesters (PMEs), inorganic phosphate (P(i)), phosphodiesters (PDEs), alpha-ATP, gamma-ATP phosphocreatine (PCr) relative beta-ATP measured. Relative percentage areas PMEs, P(i), PDEs, PCr, alpha-, beta- also measured respect total signal. Significant bilateral increases P(i)/beta-ATP ratio found temporoparietal (P = 0.002 P 0.014 cortex) for non-demented controls. In there significant increase mean P(i) 0.001). (18)FDG-PET revealed absolute reductions glucose metabolism after partial volume effect correction posterior parietal temporal cortical grey matter < 0.01 0.05, respectively) group, using both interest analysis statistical parametric mapping. There correlations between estimated IQ (r 0.96, Left correlated full scale -0.82, 0.006, r -0.86, 0.003, respectively). summary, hypometabolism seen (18)FDG-PET, suggesting that glycolytic oxidative pathways are impaired. This dysfunction may reflect either presence primary pathology or deafferentation striato-cortical projections. provide useful predictors future cognitive impairment subset who go on develop