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Glucose metabolism in nine patients with probable sporadic Creutzfeldt–Jakob disease: FDG-PET study using SPM and individual patient analysis

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Abstract

Only one large series using statistical parametric mapping (SPM) reports on FDG-PET in sporadic (Heidenhain and non-Heidenhain variant) Creutzfeldt–Jakob disease (sCJD), describing hypometabolism in bilateral parietal, frontal, and occipital cortices. Our aim was to study FDG-PET in non-Heidenhain probable sCJD patients in order to assess the most pertinent FDG-PET pattern, and to compare FDG-PET and MRI data. We used both SPM and NeuroGam® software analysis, compared with healthy controls, to describe the FDG-PET abnormalities. Individual FDG-PET and MRI–DWI data were compared. SPM group analysis showed lateralized hypometabolism in the medial parietal cortex, the lateral and medial frontal (sparing Brodmann’s area 4 and 6 and the anterior cingulate cortex), and lateral parietal cortex, in the absence of basal ganglia or cerebellar hypometabolism. The most severe hypometabolism was seen in Brodmann’s area 31, and to a lesser degree area 23 (both areas correspond to the posterior cingulate cortex) and the precuneus. On individual analysis using NeuroGam® software, additional variable temporal cortex and frequent basal ganglia (with caudate nucleus as the most frequently involved structure) hypometabolism was seen, in the absence of cerebellar hypometabolism. The cerebral lobe cortex was more frequently and more severely hypometabolic than basal ganglia structures. Concordance between FDG-PET and MRI abnormalities was most often present for both the cerebral lobe cortex and the basal ganglia. In the case of discordance, FDG-PET was more sensitive than MRI for the cortex, whereas MRI was more sensitive than FDG-PET for the basal ganglia. When pathological, both cortical lobe cortex and basal ganglia involvement were slightly more often lateralized on FDG-PET than on MRI. Despite the presence of overlapping features with other diseases presenting with rapidly progressive dementia, the FDG-PET pattern we found in our non-Heidenhain sCJD patients may help in the differential diagnosis of rapidly progressive dementia.

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Authors and Affiliations

  1. Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France

    Dimitri Renard

  2. Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Rik Vandenberghe

  3. Department of Nuclear Medicine, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France

    Laurent Collombier, Pierre-Olivier Kotzki & Vincent Boudousq

  4. Institut de Recherche en Cancérologie, INSERM U896, CRLC Val d’Aurelle, 34298, Montpellier Cedex 5, France

    Jean-Pierre Pouget

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  1. Dimitri Renard
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  2. Rik Vandenberghe
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  4. Pierre-Olivier Kotzki
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  6. Vincent Boudousq
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Correspondence to Dimitri Renard.

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Renard, D., Vandenberghe, R., Collombier, L. et al. Glucose metabolism in nine patients with probable sporadic Creutzfeldt–Jakob disease: FDG-PET study using SPM and individual patient analysis. J Neurol 260, 3055–3064 (2013). https://doi.org/10.1007/s00415-013-7117-6

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  • DOI: https://doi.org/10.1007/s00415-013-7117-6

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