Background: Both movement (MD) and cognitive (CD) disorders can occur associated in some neurodegenerative diseases, such as Parkinson’s disease (PD) and Alzheimer’s disease (AD).

Objective: We further investigated the usefulness of 123I-Ioflupane SPECT and 18F-FDG PET combined use in patients with these disorders in the early stage.

Methods: We retrospectively enrolled twenty-five consecutive patients with MD and CD clinical symptoms of recent appearance. All patients had undergone neurologic examination, neuropsychological tests, and magnetic resonance imaging. 123I-Ioflupane SPECT was performed in all cases, followed by 18F-FDG PET two weeks later. In the two procedures, both qualitative (QL) and quantitative (QN) image analyses were determined.

Results: In patients with both 123I-Ioflupane SPECT and 18F-FDG PET pathologic data, associated dopaminergic and cognitive impairments were confirmed in 56% of cases. Pathologic SPECT with normal PET in 16% of cases could diagnose MD and exclude an associated CD, despite clinical symptoms. On the contrary, normal SPECT with pathologic PET in 28% of cases could exclude basal ganglia damage while confirming CD. QN 123I-Ioflupane SPECT analysis showed better performance than QL since QN correctly characterized two cases of MD with normal QL. Moreover, correct classification of normal metabolism was made only by QN analysis of 18F-FDG PET in four cases, despite suspect areas of hypometabolism at QL.

Conclusion: The combined use of these imaging procedures proved a reliable diagnostic tool to accurately identify and characterize MD and CD in early stage. QN analysis was effective in supporting QL evaluation, and its routine use is suggested, especially with inconclusive QL.

背景：运动 (MD) 和认知 (CD) 障碍均可发生在一些神经退行性疾病中，例如帕金森病 (PD) 和阿尔茨海默病 (AD)。

目的：我们进一步研究了 123I-碘氟烷 SPECT 和 18F-FDG PET 联合使用在早期这些疾病患者中的有用性。

方法：我们回顾性招募了 25 名近期出现 MD 和 CD 临床症状的连续患者。所有患者均接受了神经系统检查、神经心理测试和磁共振成像检查。在所有病例中均进行了 123I-碘氟烷 SPECT，两周后进行了 18F-FDG PET。在这两个过程中，确定了定性 (QL) 和定量 (QN) 图像分析。

结果：在具有 123I-碘氟烷 SPECT 和 18F-FDG PET 病理数据的患者中，56% 的病例证实存在相关的多巴胺能和认知障碍。尽管有临床症状，但仍有 16% 的病例 PET 正常的病理 SPECT 可以诊断 MD 并排除相关的 CD。相反，28% 病例的病理 PET 正常 SPECT 可以在确认 CD 的同时排除基底神经节损伤。QN 123I-Ioflupane SPECT 分析显示出比 QL 更好的性能，因为 QN 正确地表征了两例具有正常 QL 的 MD。此外，尽管 QL 怀疑存在低代谢区域，但仅通过对 4 例 18F-FDG PET 的 QN 分析对正常代谢进行了正确分类。

结论：这些成像程序的结合使用证明是一种可靠的诊断工具，可以在早期准确识别和表征 MD 和 CD。QN 分析可有效支持 QL 评估，建议常规使用，尤其是对于不确定的 QL。