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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 7/2007

01-07-2007 | Original article

Identification by [99mTc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson’s disease

Authors: Andrea Varrone, Marco Pagani, Elena Salvatore, Dario Salmaso, Valeria Sansone, Marianna Amboni, Flavio Nobili, Giuseppe De Michele, Alessandro Filla, Paolo Barone, Sabina Pappatà, Marco Salvatore

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2007

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Abstract

Purpose

Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome that can be difficult to differentiate from Parkinson’s disease (PD), particularly at an early stage. [99mTc]ethyl cysteinate dimer (ECD) SPECT could represent a widely available tool to assist in the differential diagnosis. In this study we used voxel-based analysis and Computerised Brain Atlas (CBA)-based principal component analysis (PCA) of [99mTc]ECD SPECT data to test whether: (1) specific patterns of rCBF abnormalities can differentiate PSP from controls and PD; (2) networks of dysfunctional brain regions can be found in PSP vs controls and PD.

Methods

Nine PD patients, 16 PSP patients and ten controls were studied with [99mTc]ECD SPECT using a brain-dedicated device (Ceraspect). Voxel-based analysis was performed with statistical parametric mapping. PCA was applied to volume of interest data after spatial normalisation to CBA.

Results

The voxel-based analysis showed hypoperfusion of the anterior cingulate and medial frontal cortex in PSP compared with controls and PD. In PSP patients the rCBF impairment extended to the pre-supplementary motor area and prefrontal cortex, areas involved in executive function and motor networks. Compared with PSP patients, PD patients showed a mild rCBF decrease in associative visual areas which could be related to the known impairment of visuospatial function. The PCA identified three principal components differentiating PSP patients from controls and/or PD patients that included groups of cortical and subcortical brain regions with relatively decreased (cingulate cortex, prefrontal cortex and caudate) or increased (parietal cortex) rCBF, representing distinct functional networks in PSP.

Conclusion

Anterior cingulate hypoperfusion seems to be an early, distinct brain abnormality in PSP as compared with PD.
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Metadata
Title
Identification by [99mTc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson’s disease
Authors
Andrea Varrone
Marco Pagani
Elena Salvatore
Dario Salmaso
Valeria Sansone
Marianna Amboni
Flavio Nobili
Giuseppe De Michele
Alessandro Filla
Paolo Barone
Sabina Pappatà
Marco Salvatore
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2007
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-006-0344-7

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