Category: Neuroimaging (Non-PD)
Objective: To define and cross-validate the brain glucose metabolic abnormalities in patients with a diagnosis of different PSP variants.
Background: It remains unclear whether the supportive imaging features described in the diagnostic criteria for progressive supranuclear palsy (PSP) are suitable for the full clinical spectrum of the disease.
Method: We performed a retrospective, multicenter cohort study on 73 PSP patients who were referred for a FDG-PET scan: Richardson’s Syndrome (PSP-RS), n=46; parkinsonian variant (PSP-P), n=19; and progressive gait freezing, n=8. We included 55 healthy controls (HC) and 58 Parkinson’s disease (PD) patients as reference groups. We analyzed the regional differences in metabolism between the groups using two analytical approaches (statistical parametric mapping (SPM) and Scaled Subprofile Model/Principal Component Analysis (SSM/PCA)). Additionally, we obtained a PSP related pattern (PSPRP) and then cross-validated in independent populations at the individual level.
Results: Compared to HC, analyses showed relative hypometabolism in the midbrain, basal ganglia, thalamus and frontoinsular cortices, and relative hypermetabolism in the cerebellum, sensorimotor and posterior insula cortices associated with PSP. Compared to PD, the metabolic abnormalities in PSP were similar but involved more severe hypometabolism in the putamen and globus pallidus, and hypermetabolism in the occipital cortices (figure 1). The PSPRP obtained showed optimal diagnostic accuracy to distinguish between PSP and HC (identification population: Sensitivity 100% Specificity 100% ; cross-validation population: Sensitivity 80.4% Specificity 96.9%) and between PSP and PD (Sensitivity 80.4%, Specificity 90.7%). Moreover, PSP-RS and PSP-P patients showed significantly more PSPRPs expression than PD and HC.
Conclusion: The glucose metabolism assessed by FDG-PET is a useful and reproducible supportive diagnostic tool for PSP in different populations and PSP variants.
To cite this abstract in AMA style:G. Martí-Andrés, L. Van Bommel, S. Meles, M. Riverol, R. Valentí, R.V Kogan, R.J Renken, V. Gurvits, T. Van Laar, M. Pagani, E. Prieto, M.R Luquin, K.L Leenders, J. Arbizu. Progressive supranuclear palsy: Common metabolic pattern in different variants [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/progressive-supranuclear-palsy-common-metabolic-pattern-in-different-variants/. Accessed December 11, 2023.
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