Objective: 本研究使用 FDG-PET 探索 MSA 中葡萄糖代谢和网络连接的纵向变化，以辅助早期诊断和监测疾病进展。

Background: Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disease with distinct metabolic patterns in its parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes. Longitudinal FDG-PET studies on metabolic progression and connectivity in MSA are limited.

Method: We retrospectively conducted a longitudinal FDG-PET study on 29 MSA patients and 28 healthy controls. Metabolic changes and connectivity were assessed using statistical parametric mapping and inter-regional correlation analyses. Disease progression was evaluated with the Unified Multiple System Atrophy Rating Scale (UMSARS). Nonlinear mixed-effects models and connectivity analyses tracked metabolic decline.

Results: Longitudinal FDG-PET revealed distinct metabolic trajectories: MSA-P exhibited more rapid putaminal decline, while MSA-C showed more pronounced cerebellar decline. These changes negatively correlated with UMSARS progression (putamen in MSA-P: r = −0.59, p < 0.001; cerebellum in MSA-C: r = −0.62, p < 0.001). Cognitive decline, linked to impairments in attention and executive function, was associated with hypometabolism in the left orbitofrontal cortex. Connectivity analysis revealed significant changes, particularly in the frontal cortex, basal ganglia, and their connections to the parietal and temporal cortices. Nonlinear mixed-effects modeling showed a more rapid putaminal decline in MSA-P (β= -0.033 ± 0.010) and a slower but more pronounced cerebellar decline in MSA-C (β= -0.048 ± 0.030).

Conclusion: Longitudinal FDG-PET reveals distinct metabolic decline patterns in MSA subtypes, offering insights for tracking progression and guiding clinical management.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-fdg-pet-study-of-metabolic-trajectories-and-connectivity-alterations-in-multiple-system-atrophy/