Abstract Details

Title Patterns of Hypometablism on FDG PET in Patients with Early-onset Parkinson’s Disease and Psychosis

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-018

Objective To investigate the pattern of hypometabolism observed on FDG-PET imaging in patients with early-onset Parkinson’s Disease (EOPD) and psychosis.

Background

Early-onset Parkinson’s disease (EOPD) is increasing recognized and is defined as the onset of Parkinson’s Disease (PD) occurring between ages of 21 and 50 years¹. However, the prevalence of psychosis in EOPD patients remains poorly understood. This study aims to investigate the relationship between hypometabolic patterns observed on FDG-PET imaging in EOPD patients with a history of psychosis.

Design/Methods We identified EOPD cases from 1990 to 2022 utilizing the Mayo Clinic Data Management tool. Medical records were reviewed by a movement disorder specialist (R.S.) to confirm the diagnosis of PD. The onset of PD was defined as the approximate date in which at least two of the four cardinal motor symptoms of PD (rest tremor, rigidity, bradykinesia, and impaired postural reflexes). Psychosis was defined as the presence of hallucinations, delusions or psychosis in the electronic medical records.

Results A total of 830 EOPD patients were identified in this cohort. Twenty-two of these patients had a documented FDG-PET scan. We identified 4 patients with a history of psychosis and 18 patients without psychosis. The median age at the time of EOPD diagnosis was 46.5 years. The median age at the onset of psychosis was 61 years. Among the four patients with psychosis, the predominant pattern of hypometabolism was asymmetric involvement of the frontal, parietal and temporal lobes, followed by basal ganglia involvement. In contrast, among the 18 paients without psychosis, the predominant pattern was asymmetric diffuse cerebral hypometablism, followed by asymmetric involvement of the frontal and parietal lobes.

Conclusions Asymmetric cortical hypometabolism is the most prevalent pattern observed in EOPD patients with psychosis. Among all EOPD patients who underwent an FDG-PET maging, asymmetric diffuse cerebral involvement was the predominant pattern of hypometabolism.

Authors/Disclosures
Bowen Song, MD PRESENTER	Dr. Song has nothing to disclose.
Capucine Piat, MD	Dr. Piat has nothing to disclose.
Pierpaolo Turcano, MD (Rush University Medical Center)	Dr. Turcano has nothing to disclose.
Emanuele Camerucci, MD (Kansas University Medical Center)	Dr. Camerucci has nothing to disclose.
Khaled Ghoniem, MD (Mayo Clinic)	Dr. Ghoniem has nothing to disclose.
James H. Bower, MD, MSc, FAAN (Mayo Clinic)	The institution of Dr. Bower has received research support from Abbvie.
Rodolfo Savica, MD, PhD, FAAN (Mayo Clinic)	The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.

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