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Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings.
Clin Nucl Med. 2016 May; 41(5):366-70.CN

Abstract

PURPOSE

The aim of this study was to describe brain metabolic changing patterns demonstrated by serial brain FDG PET/CT scans and their relationship with the clinical course in patients with anti-N-methyl-d-aspartate receptor encephalitis (ANMDARE).

PATIENTS AND METHODS

Eighteen serial PET scans of 8 patients with ANMDARE were reviewed. All the 18 PET scans were divided into 4 groups according to studies timing in different clinical course: group A, the acute and subacute phase; group B, early recovery phase; group C, recovery phase; and group D, relapsing phase. Antibody levels of ANMDARE of all these patients were tested at the same time. The PET images of each group were analyzed visually and also compared with 10 age- and sex-matched normal controls using voxel-wise statistical parametric mapping analysis (SPM5).

RESULTS

Variable brain metabolic patterns and its association with the clinical course and the levels of NMDA antibody were demonstrated by FDG PET images. First, severe hypometabolism in bilateral occipital lobes and relatively mild hypermetabolism in the partial frontal and basal ganglia in acute and subacute phase, the level of antibody was high. Second, in early recovery phase when the symptoms was partially improved, extensive cortical hypometabolism was observed, and the level of antibody was low. Third, the patients in the recovery phase have no obvious neurological and psychiatric symptoms; PET images were nearly normal, and the antibodies tests were all negative, correspondingly. Fourth, 3 scans of relapsing phase presented heterogeneous brain metabolic abnormalities.

CONCLUSIONS

There existed a specific serial brain metabolic changing pattern that correlated with the clinical course and antibody level in ANMDARE.

Authors+Show Affiliations

From the Departments of *Neurology, and †Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26914566

Citation

Yuan, Jing, et al. "Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings." Clinical Nuclear Medicine, vol. 41, no. 5, 2016, pp. 366-70.
Yuan J, Guan H, Zhou X, et al. Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings. Clin Nucl Med. 2016;41(5):366-70.
Yuan, J., Guan, H., Zhou, X., Niu, N., Li, F., Cui, L., & Cui, R. (2016). Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings. Clinical Nuclear Medicine, 41(5), 366-70. https://doi.org/10.1097/RLU.0000000000001164
Yuan J, et al. Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings. Clin Nucl Med. 2016;41(5):366-70. PubMed PMID: 26914566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings. AU - Yuan,Jing, AU - Guan,Hongzhi, AU - Zhou,Xiangqin, AU - Niu,Na, AU - Li,Fang, AU - Cui,Liying, AU - Cui,Ruixue, PY - 2016/2/26/entrez PY - 2016/2/26/pubmed PY - 2016/12/15/medline SP - 366 EP - 70 JF - Clinical nuclear medicine JO - Clin Nucl Med VL - 41 IS - 5 N2 - PURPOSE: The aim of this study was to describe brain metabolic changing patterns demonstrated by serial brain FDG PET/CT scans and their relationship with the clinical course in patients with anti-N-methyl-d-aspartate receptor encephalitis (ANMDARE). PATIENTS AND METHODS: Eighteen serial PET scans of 8 patients with ANMDARE were reviewed. All the 18 PET scans were divided into 4 groups according to studies timing in different clinical course: group A, the acute and subacute phase; group B, early recovery phase; group C, recovery phase; and group D, relapsing phase. Antibody levels of ANMDARE of all these patients were tested at the same time. The PET images of each group were analyzed visually and also compared with 10 age- and sex-matched normal controls using voxel-wise statistical parametric mapping analysis (SPM5). RESULTS: Variable brain metabolic patterns and its association with the clinical course and the levels of NMDA antibody were demonstrated by FDG PET images. First, severe hypometabolism in bilateral occipital lobes and relatively mild hypermetabolism in the partial frontal and basal ganglia in acute and subacute phase, the level of antibody was high. Second, in early recovery phase when the symptoms was partially improved, extensive cortical hypometabolism was observed, and the level of antibody was low. Third, the patients in the recovery phase have no obvious neurological and psychiatric symptoms; PET images were nearly normal, and the antibodies tests were all negative, correspondingly. Fourth, 3 scans of relapsing phase presented heterogeneous brain metabolic abnormalities. CONCLUSIONS: There existed a specific serial brain metabolic changing pattern that correlated with the clinical course and antibody level in ANMDARE. SN - 1536-0229 UR - https://www.unboundmedicine.com/medline/citation/26914566/Changing_Brain_Metabolism_Patterns_in_Patients_With_ANMDARE:_Serial_18F_FDG_PET/CT_Findings_ L2 - https://dx.doi.org/10.1097/RLU.0000000000001164 DB - PRIME DP - Unbound Medicine ER -