Synaptic Density and Glucose Consumption in Patients with Lewy Body Diseases: An [11C]UCB‐J and [18F]FDG PET Study

• Published in: Movement disorders Vol. 38; no. 5; pp. 796 - 805
• Main Authors: Andersen, Katrine B., Hansen, Allan K., Schacht, Anna Christina, Horsager, Jacob, Gottrup, Hanne, Klit, Henriette, Danielsen, Erik H., Poston, Kathleen L., Pavese, Nicola, Brooks, David J., Borghammer, Per
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.05.2023; Wiley Subscription Services, Inc
• Subjects: [11C]UCB‐J; [18F]FDG PET; Brain - diagnostic imaging; Brain - metabolism; dementia; Dementia disorders; Fluorodeoxyglucose F18; Glucose; Glucose - metabolism; Humans; Lewy bodies; Lewy Bodies - metabolism; Lewy body disease; Lewy Body Disease - diagnostic imaging; Lewy Body Disease - metabolism; Movement disorders; Neurodegeneration; Neurodegenerative diseases; Parkinson's disease; Positron emission tomography; synapse; Synapses; Synaptic density; [18F]FDG PET; dementia; Parkinson's disease; [11C]UCB-J; synapse
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.29375

Background Patients with Lewy body diseases exhibit variable degrees of cortical and subcortical hypometabolism. However, the underlying causes behind this progressive hypometabolism remain unresolved. Generalized synaptic degeneration may be one key contributor. Objective The objective of this study was to investigate whether local cortical synaptic loss is proportionally linked to the magnitude of hypometabolism in Lewy body disease. Method Using in vivo positron emission tomography (PET) we investigated cerebral glucose metabolism and quantified the density of cerebral synapses, as measured with [18F]fluorodeoxyglucose ([18F]FDG) PET and [11C]UCB‐J, respectively. Volumes‐of‐interest were defined on magnetic resonance T1 scans and regional standard uptake value ratios‐1 values were obtained for 14 pre‐selected brain regions. Between‐group comparisons were conducted at voxel‐level. Results We observed regional differences in both synaptic density and cerebral glucose consumption in our cohorts of non‐demented and demented patients with Parkinson's disease or dementia with Lewy bodies compared to healthy subjects. Additionally, voxel‐wise comparisons showed a clear difference in cortical regions between demented patients and controls for both tracers. Importantly, our findings strongly suggested that the magnitude of reduced glucose uptake exceeded the magnitude of reduced cortical synaptic density. Conclusion Here, we investigated the relationship between in vivo glucose uptake and the magnitude of synaptic density as measured using [18F]FDG PET and [11C]UCB‐J PET in Lewy body patients. The magnitude of reduced [18F]FDG uptake was greater than the corresponding decline in [11C]UCB‐J binding. Therefore, the progressive hypometabolism seen in Lewy body disorders cannot be fully explained by generalized synaptic degeneration. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.