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Abstract Details

Metabolic Changes in the Supplementary Motor Area in the Treatment of Parkinson's Disease
Movement Disorders
P06 - (-)
082
BACKGROUND: The SMA has been implicated in motor deficits in patients with PD. This region has been identified as a significant contributing node in the Parkinsons disease-related motor pattern (PDRP; Eidelberg and Niethammer, Ann. Neurol 2009). Treatment-mediated changes in PDRP expression correlate with clinical responses to either levodopa or STN stimulation. However, the role of SMA in these interventions is not well understood.
DESIGN/METHODS: 24 PD subjects underwent FDG PET imaging at The Feinstein Institute, NY. 11 subjects (age:59.6卤8.6 years, disease duration:7.1卤4.3 years, UPDRS:26.2卤8.6) were further scanned before (OFF) and after (ON) levodopa treatment. The remaining 13 subjects (age:60.8卤11.9 years, disease duration:10.9卤5.4 years, UPDRS:29.4卤11.0) were scanned before and after STN-DBS treatment. Images were preprocessed with SPM5. Volume-of-interest (VOI) analysis was performed to measure regional metabolism in the SMA before and during treatment. This was done by placing a sphere (radius=5mm) on the peak voxel of the corresponding PDRP region. UPDRS motor ratings were evaluated before and after treatments.
RESULTS: Metabolic activity in the SMA measured in the untreated state was abnormally elevated in both treatment groups (p<0.01). Levodopa reduced baseline SMA hypermetabolism to normal levels (p<0.005). In individual patuents, levodopa-mediated SMA changes correlated with the clinical improvement that was seen during treatment (r=0.62, p=0.057). By contrast, STN stimulation did not suppress SMA hypermetabolism (p=0.10). Metabolic changes in this region did not correlate (p=0.66) with clinical responses to this intervention.
CONCLUSIONS: In PD, baseline metabolic activity is increased at the SMA node of the PDRP network. This regional abnormality is normalized by levodopa treatment but not STN stimulation. It is likely that the two interventions modulate SMA activity through different network mechanisms.
Authors/Disclosures

PRESENTER 		No disclosure on file
Chris Tang, MD (The Feinstein Institute for Medical Research) No disclosure on file
Juanzhi Fang (EMD Serono) No disclosure on file
David Eidelberg, MD, FAAN (Feinstein Institute for Medical Research) Dr. Eidelberg has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for MeiraGTx. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TreeFrog Therapeutics. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Blue Rock Therapeutics, Inc.. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SANA Biotechnology, Inc. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bio Vie, Inc.. Dr. Eidelberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for KenaiTx, Inc.. Dr. Eidelberg has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aspen Neuroscience. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Oxford University Press. The institution of Dr. Eidelberg has received research support from The Michael J. Fox Foundation for Parkinson's Research. The institution of Dr. Eidelberg has received research support from Lupus Research Alliance. The institution of Dr. Eidelberg has received research support from National Institutes of Health. The institution of Dr. Eidelberg has received research support from Blue Rock Therapeutics. The institution of Dr. Eidelberg has received research support from National Institute of Neurological Disorders and Stroke. The institution of Dr. Eidelberg has received research support from The Michael J. Fox Foundation for Parkinson's Research. The institution of Dr. Eidelberg has received research support from National Institute of Allergy and Infectious Diseases. The institution of Dr. Eidelberg has received research support from Aspen Neurosciences, Inc. . The institution of Dr. Eidelberg has received research support from NIH. Dr. Eidelberg has received intellectual property interests from a discovery or technology relating to health care. Dr. Eidelberg has received intellectual property interests from a discovery or technology relating to health care.