F-FDG PET 揭示前驱期和临床期帕金森病的颅葡萄糖代谢模式。

Cranial glucose metabolic patterns across prodromal and clinical parkinson's disease revealed by F-FDG PET.

作者信息

Lu Weizhao, Song Tianbin, Zhou Ying, Zeng Qiaoling, Li Jing, Cui Bixiao, Lu Jie

机构信息

Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.

Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Xuanwu Hospital, Beijing, 100053, China.

出版信息

Eur J Nucl Med Mol Imaging. 2025 Sep 3. doi: 10.1007/s00259-025-07533-3.

DOI:10.1007/s00259-025-07533-3

PMID:40900316

Abstract

PURPOSE

Bone plays pivotal roles in glucose homeostasis of the human body. Parkinson's disease (PD) is accompanied by metabolic dysfunction and increased risks of bone diseases. Nevertheless, whether PD affects bone glucose metabolism remains unknown. This study aimed to assess cranial glucose metabolism in different stages of PD using brain F-fludeoxyglucose positron emission tomography (F-FDG PET).

METHODS

This prospective cross-sectional study included 190 participants, including 34 controls, 32 prodromal PD (pPD), 50 de novo PD (dnPD) and 74 medicated PD (mPD) patients. mPD patients were further separated into 3 stages: early-, middle- and late-stage PD patients. Comparisons of glucose uptake in the cranium was assessed using general linear model among controls, pPD, dnPD and mPD patients, as well as among mPD patients with different stages. Furthermore, effects of motor function, disease duration and dopaminergic medication on cranial glucose uptake were assessed using multiple linear regression.

RESULTS

The results demonstrated cranial hypermetabolism in clinically confirmed PD patients (dnPD and mPD patients) compared to HCs in the cranium, frontal, sphenoid and parietal bones (p < 0.05). In addition, mPD patients also demonstrated hypermetabolism in temporal and occipital bones compared to HCs (p < 0.05). However, this metabolic pattern was not observed in the prodromal individuals. Moreover, multiple linear regression identified fasting blood glucose as a positive modulator (β = 0.020 ~ 0.043, p < 0.05) and dopaminergic medication as a negative regulator (β=-1.207 × 10~-9.482 × 10, p < 0.005) of cranial glucose metabolic activity.

CONCLUSION

The current study uncovered cranial metabolic abnormalities in PD, offering new perspectives and pathophysiological insights underlying bone-related comorbidities in PD.

摘要

目的

骨骼在人体葡萄糖稳态中发挥着关键作用。帕金森病（PD）伴有代谢功能障碍和骨骼疾病风险增加。然而，PD是否影响骨骼葡萄糖代谢仍不清楚。本研究旨在使用脑氟脱氧葡萄糖正电子发射断层扫描（F-FDG PET）评估PD不同阶段的颅骨葡萄糖代谢。

方法

这项前瞻性横断面研究纳入了190名参与者，包括34名对照者、32名前驱期PD（pPD）患者、50名新发PD（dnPD）患者和74名药物治疗期PD（mPD）患者。mPD患者进一步分为3个阶段：早期、中期和晚期PD患者。使用一般线性模型评估对照者、pPD、dnPD和mPD患者以及不同阶段mPD患者颅骨葡萄糖摄取的差异。此外，使用多元线性回归评估运动功能、疾病持续时间和多巴胺能药物对颅骨葡萄糖摄取的影响。

结果

结果显示，与健康对照者相比，临床确诊的PD患者（dnPD和mPD患者）在颅骨、额骨、蝶骨和顶骨存在颅骨代谢亢进（p<0.05）。此外，与健康对照者相比，mPD患者在颞骨和枕骨也表现出代谢亢进（p<0.05）。然而，在前驱期个体中未观察到这种代谢模式。此外，多元线性回归确定空腹血糖是颅骨葡萄糖代谢活性的正调节因子（β=0.020~~0.043，p<0.05），多巴胺能药物是负调节因子（β=-1.207×10~~-9.482×10，p<0.005）。