High‐Resolution Fluorodeoxyglucose Positron Emission Tomography Shows Both Global and Regional Cerebral Hypometabolism in Multiple Sclerosis

The authors study brain regional glucose metabolism prospectively in multiple sclerosis (MS) using high‐resolution 2‐[18‐F]fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG PET) in 25 MS patients of the Dent Neurologic Institute compared with 6 healthy subjects. Glucose metabolism is measur...

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Bibliographic Details
Published in:	Journal of neuroimaging Vol. 8; no. 4; pp. 228 - 234
Main Authors:	Bakshi, Rohit, Miletich, Robert S., Kinkel, Peter R., Emmet, Marja L., Kinkel, William R.
Format:	Journal Article
Language:	English
Published:	United States 01-10-1998
Subjects:	Adult Brain - diagnostic imaging Brain - metabolism Contrast Media Female Fluorodeoxyglucose F18 Glucose - metabolism Humans Male Middle Aged Multiple Sclerosis - diagnostic imaging Multiple Sclerosis - metabolism Tomography, Emission-Computed
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Summary:	The authors study brain regional glucose metabolism prospectively in multiple sclerosis (MS) using high‐resolution 2‐[18‐F]fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG PET) in 25 MS patients of the Dent Neurologic Institute compared with 6 healthy subjects. Glucose metabolism is measured in 20 regions of interest using a line‐profile technique. Compared with control subjects, a 9% reduction in total brain glucose metabolism is noted in MS patients (p < 0.05). Hypometabolism is widespread, including the cerebral cortex, subcortical nuclei, supratentorial white matter, and infratentorial structures. This reduction represents absolute regional decreases ranging from 3% to 18%. The most dramatic absolute reductions occur in the superior mesial frontal cortex, superior dorsolateral frontal cortex, mesial occipital cortex, lateral occipital cortex, deep inferior parietal white matter, and pons. The regional hypometabolism in the superior mesial frontal cortex and superior dorsolateral frontal cortex is statistically significant (p < 0.05), whereas the changes in the mesial occipital cortex (p = 0.07) and the lateral occipital cortex (p = 0.09) approach significance. The authors' findings suggest that widespread cerebral dysfunction occurs in MS, and that diaschisis or neuronal system disconnection resulting from white matter disease plays a major role. Cortical gray matter hypometabolism may also reflect direct MS involvement. The quantitative cerebral abnormalities detected by FDG PET may serve as a marker of disease activity in understanding the pathophysiological expression and therapeutic response of MS.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1051-2284 1552-6569
DOI:	10.1111/jon199884228