Positron emission tomography with FDG and newly developed tracers for the assessment of brain metabolism and synaptic function in neurological disorders

: Positron emission tomography has enabled us to measure various fundamental parameters of human brain physiology and chemistry, such as cerebral blood flow, metabolism and synaptic functions. Blood flow and oxygen metabolism is important for the understanding of cerebro-vascular disease. Glucose metabolism is tightly coupled with brain function and FDG-PET is useful for the determination of epileptic foci and for the evaluation of tumor malignancy. Imaging analysis of functional neuroanatomy of these parameters is very promising for the early diagnosis of dementia, such as Alzheimer's disease. Measurement of pre- and post-synaptic function is applicable to the differential diagnosis of parkinsonism. In early stage of Parkinson's disease, only presynaptic dopaminergic function is impaired, while in multiple system atrophy with striato-nigral degeneration type, both pre-and post dopaminergic function is reduced. Development of new radiotracers is expected for detection of early specific pathological changes and more previous changes underlying the deterioration of neurochemistry, such as genetic abnormalities.