The metabolic landscape of cortico-basal ganglionic degeneration: regional asymmetries studied with positron emission tomography

J Neurol Neurosurg Psychiatry. 1991 Oct;54(10):856-62. doi: 10.1136/jnnp.54.10.856.

Abstract

Regional metabolic rate for glucose (rCMRGlc) was estimated using [18F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) in five patients (four men, one woman; mean age 68; mean disease duration 2.4 years) with clinical findings consistent with the syndrome of cortico-basal ganglionic degeneration (CBGD). Left-right rCMRGlc asymmetry, (L-R)/(L + R) x 100, was calculated for 13 grey matter regions and compared with regional metabolic data from 18 normal volunteers and nine patients with asymmetrical Parkinson's disease (PD). In the CBGD group mean metabolic asymmetry values in the thalamus, inferior parietal lobule and hippocampus were greater than those measured in normal control subjects and patients with asymmetrical PD (p less than 0.02). Parietal lobe asymmetry of 5% or more was evident in all CBGD patients, whereas in PD patients and normal controls, all regional asymmetry measures were less than 5% in absolute value. Measures of frontal, parietal and hemispheric metabolic asymmetry were found to be positively correlated with asymmetries in thalamic rCMRGlc (p less than 0.05). The presence of cortico-thalamic metabolic asymmetry is consistent with the focal neuropathological changes reported in CBGD brains. Our findings suggest that metabolic asymmetries detected with FDG/PET may support a diagnosis of CBGD in life.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Apraxias / diagnostic imaging
  • Basal Ganglia Diseases / diagnostic imaging*
  • Basal Ganglia Diseases / pathology
  • Blood Glucose / metabolism*
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / pathology
  • Deoxyglucose / analogs & derivatives
  • Deoxyglucose / metabolism
  • Dominance, Cerebral / physiology*
  • Energy Metabolism / physiology*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Muscle Rigidity / diagnostic imaging
  • Nerve Degeneration / physiology*
  • Neurologic Examination
  • Parkinson Disease, Secondary / diagnostic imaging
  • Parkinson Disease, Secondary / pathology
  • Pyramidal Tracts / diagnostic imaging
  • Pyramidal Tracts / pathology
  • Tomography, Emission-Computed*
  • Tremor / diagnostic imaging

Substances

  • Blood Glucose
  • Fluorodeoxyglucose F18
  • Deoxyglucose