Both fluorine-18-labeled fluorodeoxyglucose ([(18)F]FDG) positron emission tomography, examining glucose metabolism, and resting-state functional magnetic resonance imaging (rs-fMRI), using covarying blood oxygen levels, can be used to explore neuronal dysfunction in Alzheimer's disease (AD). Both measures are reported to identify similar brain regions affected in AD patients. The spatial overlap and association of [(18)F]FDG with rs-fMRI in AD patients and controls were examined to investigate whether these two measures are associated, and if so, to what extent. For 24 AD patients and 18 controls, [(18)F]FDG and rs-fMRI data were available. [(18)F]FDG standardized uptake value ratios (SUVr), with cerebellar gray matter (GM) as reference tissue, were calculated. Eigenvector centrality (EC) mapping was used to spatially analyze the functional brain network. Group differences were calculated for [(18)F]FDG and eigenvector centrality mapping (ECM) values in four cortical regions (occipital, parietal, frontal, and temporal) and across voxels, with age, gender, and GM as covariates. Correlation of [(18)F]FDG with ECM was calculated within groups. Both lowered [(18)F]FDG SUVr and EC values were seen in the parietal and occipital cortex of AD patients. However, [(18)F]FDG yielded more robust and widespread brain areas affected in AD patients; hypometabolism was also observed in the temporal cortex and regions within frontal brain areas. Poor spatial overlap of both measures was observed. No associations were found between local [(18)F]FDG SUVr and ECM. In conclusion, agreement of [(18)F]FDG and ECM in AD patients seems moderate at best. [(18)F]FDG was most accurate in distinguishing AD patients from controls.
Keywords: Alzheimer's disease; brain metabolism; graph theory; positron emission tomography; resting-state functional connectivity fMRI.