Brain 18F-FDG distribution: which region is most affected by increased plasma glucose levels?

  • Kenji IshibashiEmail author
  • Masashi Kameyama
  • Kenji Ishii
  • J-ADNI Study Group
Letter to the Editor

Dear Sir,

Both similarities and differences can be found between the Alzheimer’s Disease Neuroimaging Initiative studies in North America (ADNI) and Japan (J-ADNI) as recently shown by Iwatsubo and colleagues [1]. Here, we present an example of the difference in 18F-FDG data between the two multicenter studies.

Our series of studies has shown that increased plasma glucose levels can alter the brain 18F-FDG distribution pattern from normal to Alzheimer’s disease (AD) like [2]. Apostolova and colleagues recently confirmed this phenomenon using 18F-FDG images of normal subjects (n = 87, 74.2 ± 5.3 years) from the ADNI study [3]. Additionally, they observed that the occipital cortex was one of the preferential areas where increased plasma glucose levels decreased 18F-FDG uptake. However, this occipital cortex change was not detected in our series of studies [2] or other relevant studies [4]. Therefore, we are concerned about the detection of the occipital cortex in the study by Apostolova...


18F-FDG Positron emission tomography Glucose 



The data used for this research were originally obtained by the Japanese Alzheimer’s Disease Neuroimaging Initiative (J-ADNI) led by Prof. Takeshi Iwatsubo and available at the website of the National Bioscience Database Center/the Japan Science and Technology Agency. J-ADNI Study Group provided data but did not participate in the analysis or writing of this research. A complete listing of J-ADNI investigators can be found at:

Author’s contribution

All authors designed the study. Ishibashi carried out the data processing. All authors interpreted the data. Ishibashi drafted the manuscript. All authors read and approved the final manuscript.


The authors received no funding for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

12149_2018_1327_MOESM1_ESM.pdf (100 kb)
Supplementary material 1 (PDF 99 KB)


  1. 1.
    Iwatsubo T, Iwata A, Suzuki K, Ihara R, Arai H, Ishii K, et al. Japanese and North American Alzheimer’s disease neuroimaging initiative studies: harmonization for international trials. Alzheimer’s Dementia. 2018;14(8):1077–87.CrossRefGoogle Scholar
  2. 2.
    Ishibashi K, Onishi A, Fujiwara Y, Ishiwata K, Ishii K. Effects of glucose, insulin, and insulin resistance on cerebral 18F-FDG distribution in cognitively normal older subjects. PLoS One. 2017;12(7):e0181400.CrossRefGoogle Scholar
  3. 3.
    Apostolova I, Lange C, Suppa P, Spies L, Klutmann S, Adam G, et al. Impact of plasma glucose level on the pattern of brain FDG uptake and the predictive power of FDG PET in mild cognitive impairment. Eur J Nucl Med Mol Imaging. 2018;45(8):1417–22.CrossRefGoogle Scholar
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    Burns CM, Chen K, Kaszniak AW, Lee W, Alexander GE, Bandy D, et al. Higher serum glucose levels are associated with cerebral hypometabolism in Alzheimer regions. Neurology. 2013;80(17):1557–64.CrossRefGoogle Scholar
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    Ishibashi K, Sakurai K, Shimoji K, Tokumaru AM, Ishii K. Altered functional connectivity of the default mode network by glucose loading in young, healthy participants. BMC Neurosci. 2018;19(1):33.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2019

Authors and Affiliations

  1. 1.Research Team for NeuroimagingTokyo Metropolitan Institute of GerontologyTokyoJapan
  2. 2.Department of Diagnostic RadiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan

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