Metabolic network as an objective biomarker in monitoring deep brain stimulation for Parkinson’s disease: a longitudinal study

• Published in: EJNMMI research Vol. 10; no. 1; p. 131
• Main Authors: Ge, Jingjie, Wang, Min, Lin, Wei, Wu, Ping, Guan, Yihui, Zhang, Huiwei, Huang, Zhemin, Yang, Likun, Zuo, Chuantao, Jiang, Jiehui, Rominger, Axel, Shi, Kuangyu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 29.10.2020; Springer Nature B.V; SpringerOpen
• Subjects: Alternations; Analysis of covariance; Biomarkers; Brain; Cardiac Imaging; Correlation analysis; Covariance; Deep brain stimulation; Fluorine isotopes; Graph theory; Health services; Imaging; Longitudinal studies; Medicine; Medicine & Public Health; Metabolism; Monitoring; Network analysis; Nuclear Medicine; Oncology; Original Research; Orthopedics; Parkinson's disease; PD-related metabolic network pattern; Positron emission; Radiology; Spatial covariance analysis; Stimulation; Telemedicine; Tomography; Spatial covariance analysis; Graph theory; Deep brain stimulation; PD-related metabolic network pattern; Parkinson’s disease
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-020-00722-1

Background With the advance of subthalamic nucleus (STN) deep brain stimulation (DBS) in the treatment of Parkinson’s disease (PD), it is desired to identify objective criteria for the monitoring of the therapy outcome. This paper explores the feasibility of metabolic network derived from positron emission tomography (PET) with 18 F-fluorodeoxyglucose in monitoring the STN DBS treatment for PD. Methods Age-matched 33 PD patients, 33 healthy controls (HCs), 9 PD patients with bilateral DBS surgery and 9 controls underwent 18 F-FDG PET scans. The DBS patients were followed longitudinally to investigate the alternations of the PD-related metabolic covariance pattern (PDRP) expressions. Results The PDRP expression was abnormally elevated in PD patients compared with HCs ( P  < 0.001). For DBS patients, a significant decrease in the Unified Parkinson’s Disease Rating Scale (UPDRS, P  = 0.001) and PDRP expression ( P  = 0.004) was observed 3 months after STN DBS treatment, while a rollback was observed in both UPDRS and PDRP expressions (both P  < 0.01) 12 months after treatment. The changes in PDRP expression mediated by STN DBS were generally in line with UPDRS improvement. The graphical network analysis shows increased connections at 3 months and a return at 12 months confirmed by small-worldness coefficient. Conclusions The preliminary results demonstrate the potential of metabolic network expression as complimentary objective biomarker for the assessment and monitoring of STN DBS treatment in PD patients. Clinical Trial Registration ChiCTR-DOC-16008645.  http://www.chictr.org.cn/showproj.aspx?proj=13865 .