Glucose metabolism in small subcortical structures in Parkinson's disease

Per Borghammer, Søren B. Hansen, Carsten Eggers, Mallar Chakravarty, Kim Vang, Joel Aanerud, Rüdiger Hilker, Wolf Dieter Heiss, Anders Rodell, Ole L. Munk, David Keator, Albert Gjedde

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Objectives- Evidence from experimental animal models of Parkinson's disease (PD) suggests a characteristic pattern of metabolic perturbation in discrete, very small basal ganglia structures. These structures are generally too small to allow valid investigation by conventional positron emission tomography (PET) cameras. However, the high-resolution research tomograph (HRRT) PET system has a resolution of 2mm, sufficient for the investigation of important structures such as the pallidum and thalamic subnuclei. Materials and methods- Using the HRRT, we performed [18F]-fluorodeoxyglucose (FDG) scans on 21 patients with PD and 11 age-matched controls. We employed three types of normalization: white matter, global mean, and data-driven normalization. We performed volume-of-interest analyses of small subcortical gray matter structures. Voxel-based comparisons were performed to investigate the extent of cortical hypometabolism. Results- The most significant level of relative subcortical hypermetabolism was detected in the external pallidum (GPe), irrespective of normalization strategy. Hypermetabolism was suggested also in the internal pallidum, thalamic subnuclei, and the putamen. Widespread cortical hypometabolism was seen in a pattern very similar to previously reported patterns in patients with PD. Conclusion- The presence and extent of subcortical hypermetabolism in PD is dependent on type of normalization. However, the present findings suggest that PD, in addition to widespread cortical hypometabolism, is probably characterized by true hypermetabolism in the GPe. This finding was predicted by the animal 2-deoxyglucose autoradiography literature, in which high-magnitude hypermetabolism was also most robustly detected in the GPe.

Original languageEnglish (US)
Pages (from-to)303-310
Number of pages8
JournalActa Neurologica Scandinavica
Issue number5
StatePublished - May 2012
Externally publishedYes


  • Glucose
  • Metabolism
  • Normalization
  • Parkinson's disease
  • Positron emission tomography

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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