방사선의학 웹진

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Abstract
Purpose: While many studies have explored the link between biomarkers and cognitive decline in Parkinson's disease (PD), a more comprehensive approach is needed, combining striatal dopamine depletion, cerebral glucose metabolism, and cognitive assessments. In this study, we investigated the relationships between striatal dopamine transporter (DAT) uptake, cerebral glucose hypometabolism, and cognition, as well as the potential progression pattern of these changes in PD.

Methods: We enrolled 62 patients with PD and 33 healthy controls. The subjects underwent N-(3-[18F]fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (FP-CIT) PET/CT, [18F] fluorodeoxyglucose (FDG) PET/CT, and detailed neuropsychological testing. The mean standard uptake value ratio (SUVR) value of the regions showing significantly lower metabolism in PD patients was defined as SUVR[hypo]. The relationship between striatal DAT uptake and SUVR[hypo] was assessed using general linear models, while their impact on cognitive function was evaluated with multivariate linear regression. Additionally, the pattern of their changes was assessed using an event-based model.

Results: Compared to the control group, PD patients exhibited glucose hypometabolism in specific cortical regions. DAT uptake in the anterior and posterior putamen was positively correlated with SUVR[hypo]. Decreased DAT uptake in the anterior putamen and caudate nucleus was associated with lower z-score in visuospatial function. Decreased DAT uptake in the posterior and anterior putamen occurred first, followed by PD-related cerebral hypometabolism, and visuospatial function.

Conclusion: This study highlights the interconnectedness of dopaminergic depletion, cerebral glucose hypometabolism, and visuospatial dysfunction, proposing that striatal DAT uptake may serve as an early biomarker for cerebral hypometabolism and cognitive impairment in PD.

Affiliations

Seungbeom Seo # 1, Yeo Jun Yoon # 1, Sangwon Lee 2, Hyunkeong Lim 2, Kyobin Choo 3, Daesung Kim 4, Hyunkyung Han 5, Seongjin Kang 2, Jaekyung Park 2, Phil Hyu Lee 6, Dongwoo Kim # 7 8, Mijin Yun # 2
1Yonsei University College of Medicine, Seoul, Republic of Korea.
2Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
3Department of Computer Science, Yonsei University, Seoul, Republic of Korea.
4Department of Artificial Intelligence, Yonsei University, Seoul, Republic of Korea.
5ELTEC college of Engineering, Ewha Womans University, Seoul, Republic of Korea.
6Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
7Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. kdwoo@hallym.or.kr.
8Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. kdwoo@hallym.or.kr.
#Contributed equally.