Abnormal Metabolic Network Activity in Parkinson'S Disease: Test—Retest Reproducibility

• Published in: Journal of cerebral blood flow and metabolism Vol. 27; no. 3; pp. 597 - 605
• Main Authors: Ma, Yilong, Tang, Chengke, Spetsieris, Phoebe G, Dhawan, Vijay, Eidelberg, David
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2007; Lippincott Williams & Wilkins; Sage Publications Ltd
• Subjects: Aged; Algorithms; Antiparkinson Agents - therapeutic use; Biological and medical sciences; Biomarkers; Brain - blood supply; Brain - diagnostic imaging; Brain - metabolism; Cardiovascular system; Cerebrovascular Circulation; Deep Brain Stimulation; Errors of metabolism; Female; Glucose - metabolism; Humans; Image Processing, Computer-Assisted - methods; Investigative techniques, diagnostic techniques (general aspects); Levodopa - therapeutic use; Lipids (lysosomal enzyme disorders, storage diseases); Male; Medical sciences; Metabolic diseases; Metabolic Networks and Pathways; Middle Aged; Neurology; Parkinson Disease - diagnostic imaging; Parkinson Disease - metabolism; Parkinson Disease - therapy; Parkinson's disease; Positron-Emission Tomography; Sensitivity and Specificity; Software; Ultrasonic investigative techniques; Vascular diseases and vascular malformations of the nervous system; cerebral blood flow; PD; glucose metabolism; test—retest reliability; PCA; Nervous system diseases; Parkinson disease; Glucose; test-retest reliability; Test reliability; Metabolism; Cerebral disorder; Blood flow; Reproducibility; Central nervous system disease; Degenerative disease; Cerebrovascular disease; Extrapyramidal syndrome
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1038/sj.jcbfm.9600358

Parkinson's disease (PD) is associated with an abnormal pattern of regional brain function. The expression of this PD-related covariance pattern (PDRP) has been used to assess disease progression and the response to treatment. In this study, we validated the PDRP network as a measure of parkinsonism by prospectively computing its expression (PDRP scores) in 15O-water (H215O) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scans from PD patients and healthy volunteers. The reliability of this measure was also assessed within subjects using a test—retest design in mildly affected and advanced PD patients scanned at baseline and during treatment with levodopa or deep brain stimulation (DBS). We found that PDRP expression was significantly elevated in PD patients (P<0.001) relative to controls in a prospective analysis of brain scans obtained with either H215O or FDG PET. A significant correlation (R2=0.61; P<0.001) was evident between PDRP scores computed from H215O and FDG images in PD subjects scanned with both tracers. Test—retest reproducibility was very high (intraclass correlation coefficient (ICC)>0.92) for PDRP scores measured both within PET session and between sessions separated by up to 2 months. This high reproducibility was observed in both early stage and advanced PD patients scanned at baseline and during treatment. The within-subject variability of this measure was less than 10% for both unmedicated and treated conditions. These findings suggest that the PDRP network is a reproducible and stable descriptor of regional functional abnormalities in parkinsonism. The quantification of PDRP expression in PD patients can serve as a potential biomarker in PET intervention studies for this disorder.