{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:00:06Z","timestamp":1791928806365,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with Lewy body diseases have an increased risk of dementia, which is a significant predictor for survival. Posterior cortical hypometabolism on [<jats:sup>18<\/jats:sup>F]fluorodeoxyglucose positron emission tomography (PET) precedes the development of dementia by years. We therefore examined the prognostic value of cerebral glucose metabolism for survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled patients diagnosed with Parkinson's disease (PD), Parkinson's disease with dementia, or dementia with Lewy bodies who underwent [<jats:sup>18<\/jats:sup>F]fluorodeoxyglucose PET. Regional cerebral metabolism of each patient was analyzed by determining the expression of the PD\u2010related cognitive pattern (<jats:italic>Z<\/jats:italic>\u2010score) and by visual PET rating. We analyzed the predictive value of PET for overall survival using Cox regression analyses (age\u2010 and sex\u2010corrected) and calculated prognostic indices for the best model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Glucose metabolism was a significant predictor of survival in 259 included patients (n\u2009=\u2009118 events; hazard ratio: 1.4 [1.2\u20131.6] per <jats:italic>Z<\/jats:italic>\u2010score; hazard ratio: 1.8 [1.5\u20132.2] per visual PET rating score; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Risk stratification with visual PET rating scores yielded a median survival of 4.8, 6.8, and 12.9\u2009years for patients with severe, moderate, and mild posterior cortical hypometabolism (median survival not reached for normal cortical metabolism). Stratification into 5 groups based on the prognostic index revealed 10\u2010year survival rates of 94.1%, 78.3%, 34.7%, 0.0%, and 0.0%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Regional cerebral glucose metabolism is a significant predictor of survival in Lewy body diseases and may allow an earlier survival prediction than the clinical milestone \u201cdementia.\u201d Thus, [<jats:sup>18<\/jats:sup>F]fluorodeoxyglucose PET may improve the basis for therapy decisions, especially for invasive therapeutic procedures like deep brain stimulation in Parkinson's disease. 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