Asymmetry of basal ganglia glucose metabolism and dopa responsiveness in parkinsonism.
We investigated, by positron emission tomography (PET) with [18F]fluoro-2-deoxy-d-glucose (FDG) (FDG-PET), brain glucose metabolism in 19 patients with parkinsonian features. We compared local pattern of FDG uptake and asymmetry indexes in patients with therapeutic response to levodopa (L-dopa) (group 1, presumed Parkinson's disease, n = 9) and patients without L-dopa therapeutic response (group 2, presumed striatonigral degeneration, n = 10). Limb dystonia was present in 11% of patients in group 1 and in 40% of patients in group 2. Asymmetry in basal ganglia metabolism was distributed differently in the two groups (analysis of variance, p < 0.04). In superior and inferior putamen, superior and middle caudate, ventral striatum, and inferior thalamus, relative reduction in metabolism on the side contralateral to predominant parkinsonian signs was associated with L-dopa unresponsiveness. On the contrary, in middle caudate, ventral striatum, and inferior thalamus, a relative increase in metabolism on the side contralateral to the predominant side, parkinsonian signs were found in L-dopa-responsive patients. Our FDG-PET study using simple statistical procedures demonstrates inverse asymmetry of basal ganglia glucose metabolism in parkinsonian patients grouped on the sole basis of L-dopa responsiveness.
Dethy
S
S
PET/Biomedical Cyclotron Unit and Service de Neurologie, ULB-Hôpital Erasme, Brussels, Belgium.
Van Blercom
N
N
Damhaut
P
P
Wikler
D
D
Hildebrand
J
J
Goldman
S
S
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000187:drug effects*; D001786:Blood Glucose / Q000378:metabolism*; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000187:drug effects* / Q000502:physiology; D004734:Energy Metabolism / Q000187:drug effects* / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000187:drug effects / Q000502:physiology; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging / Q000188:drug therapy; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18; D007980:Levodopa