Coexistence of cerebral hypometabolism and neuroinflammation in the thalamo-limbic-brainstem region in young women with functional somatic syndrome

• Published in: EJNMMI research Vol. 10; no. 1; pp. 29 - 11
• Main Authors: Matsudaira, Takashi, Terada, Tatsuhiro, Obi, Tomokazu, Yokokura, Masamichi, Takahashi, Yukitoshi, Ouchi, Yasuomi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 20.03.2020; Springer Nature B.V; SpringerOpen
• Subjects: [11C]DPA713; [18F]FDG; Amygdala; Cardiac Imaging; Correlation analysis; Fluorine isotopes; Functional somatic syndrome; Glucose metabolism; Human papillomavirus; Hypometabolism; Imaging; Immunization; Mapping; Medicine; Medicine & Public Health; Metabolism; Neuroinflammation; Nuclear Medicine; Oncology; Original Research; Orthopedics; Positron emission; Positron emission tomography; Radiology; Thalamus; Tomography; Glucose metabolism; Functional somatic syndrome; F]FDG; Neuroinflammation; [; Positron emission tomography; C]DPA713; [18F]FDG; [11C]DPA713
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-020-00617-1

Background Functional somatic syndrome (FSS) is a disorder characterized by clusters of medically unexplained symptoms. Some women suffer from persistent FSS after human papillomavirus (HPV) vaccination. However, a causal relationship has not been established, and the pathophysiology of FSS remains elusive. Here, we aimed to identify the brain regions showing altered cerebral metabolism and neuroinflammation in patients with FSS and to correlate the measures of positron emission tomography (PET) with clinical data. Twelve women diagnosed with FSS following HPV vaccination (FSS group) underwent both [ 18 F]FDG-PET to measure glucose metabolism and [ 11 C]DPA713-PET to measure neuroinflammation. [ 18 F]FDG standardized uptake value ratio (SUVR) and [ 11 C]DPA713 binding potential (BP ND ) values were compared voxel-wise between the FSS and control groups ( n = 12 for [ 18 F]FDG, n = 16 for [ 11 C]DPA713). A region-of-interest (ROI)-based analysis was performed to correlate PET parameters with clinical scores. Statistical significance was set at p < 0.05 corrected for multiple comparisons. Results Statistical parametric mapping revealed a concomitant significant decrease of [ 18 F]FDG SUVR and increase of [ 11 C]DPA713 BP ND in the regions covering the thalamus, mesial temporal area, and brainstem in the FSS group. Correlation analysis revealed that intelligence and memory scores were significantly positively correlated with [ 18 F]FDG SUVR and negatively so with [ 11 C]DPA713 BP ND in these regions. A direct comparison between [ 18 F]FDG SUVR and [ 11 C]DPA713 BP ND revealed a significant positive correlation in the right hippocampus and amygdala. Conclusions Cerebral hypometabolism with neuroinflammation occurring in the thalamo-limbic-brainstem region may reflect the pathophysiology of FSS.