{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:56:20Z","timestamp":1790614580111,"version":"4.1.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008678","name":"Universit\u00e4t Leipzig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008678","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["EJNMMI Rep."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Positron emission tomography (PET) of the brain using [\n                    <jats:sup>18<\/jats:sup>\n                    F]fluorodeoxyglucose (FDG) is becoming increasingly important for the diagnosis and differential diagnosis of atypical parkinsonian syndrome such as multiple system atrophy (MSA), which is characterized by hypometabolism of the putamen, pons, and cerebellum. We report on a patient with clinically established MSA based on a rapidly progressive, poorly levodopa-responsive parkinsonian syndrome, multidomain autonomic failure, and imaging findings where hereditary spastic paraplegia was discussed as a differential diagnosis. PET images revealed a well-preserved glucose metabolism in the striatum, specifically in the putamen, while metabolism in the cerebellum was significantly reduced. This pattern of glucose metabolism might indicate a distinct subtype of synucleinopathy as proven by seed-amplification assay and should be taken into account when diagnosing patients with MSA.\n                  <\/jats:p>","DOI":"10.1186\/s41824-026-00294-8","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T23:02:20Z","timestamp":1773961340000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An MSA-P patient presenting with preserved glucose metabolism in the putamen, cerebellar hypometabolism and pronounced loss of presynaptic dopamine transporter in the striatum"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-2764","authenticated-orcid":false,"given":"Swen","family":"Hesse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manja","family":"Schiefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solveig","family":"Tiepolt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorit","family":"Prochnow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"M\u00e4mecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Schniewind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Sabri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Falkenburger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Brock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"294_CR5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40478-024-01923-8","volume":"13","author":"S Br\u00e4uer","year":"2025","unstructured":"Br\u00e4uer S, Schniewind I, Dinter E, Falkenburger BH (2025) Recursive seed amplification detects distinct \u03b1-synuclein strains in cerebrospinal fluid of patients with Parkinson\u2019s disease. Acta Neuropathol Commun 13:13","journal-title":"Acta Neuropathol Commun"},{"key":"294_CR6","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/S1474-4422(15)00058-7","volume":"14","author":"PA Low","year":"2015","unstructured":"Low PA, Reich SG, Jankovic J, Shults CW, Stern MB, Novak P et al (2015) Natural history of multiple system atrophy in the USA: a prospective cohort study. Lancet Neurol 14:710\u2013719","journal-title":"Lancet Neurol"},{"key":"294_CR3","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/S1474-4422(24)00395-8","volume":"23","author":"Y Ma","year":"2024","unstructured":"Ma Y, Farris CM, Weber S, Schade S, Nguyen H, P\u00e9rez-Soriano A, Giraldo DM et al (2024) Sensitivity and specificity of a seed amplification assay for diagnosis of multiple system atrophy: a multicentre cohort study. Lancet Neurol 23:1225\u20131237","journal-title":"Lancet Neurol"},{"key":"294_CR9","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1111\/j.1468-1331.2004.00888.x","volume":"11","author":"JE Nielsen","year":"2004","unstructured":"Nielsen JE, Johnsen B, Koefoed P, Scheuer KH, Gr\u00f8nbech-Jensen M, Law I et al (2004) Hereditary spastic paraplegia with cerebellar ataxia: a complex phenotype associated with a new SPG4 gene mutation. Eur J Neurol 11:817\u2013824","journal-title":"Eur J Neurol"},{"key":"294_CR7","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1055\/s-0043-1777005","volume":"81","author":"JL Pedroso","year":"2023","unstructured":"Pedroso JL, Vale TC, Freitas JL, Ara\u00fajo FMM, Meira AT, Neto PB et al (2023) Movement disorders in hereditary spastic paraplegias. Arq Neuropsiquiatr 81:1000\u20131007","journal-title":"Arq Neuropsiquiatr"},{"key":"294_CR1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/s41572-022-00382-6","volume":"8","author":"W Poewe","year":"2022","unstructured":"Poewe W, Stankovic I, Halliday G, Meissner WG, Wenning GK, Pellechia MT et al (2022) Multiple system atrophy. Nat Rev Dis Primers 8:56","journal-title":"Nat Rev Dis Primers"},{"key":"294_CR4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s00401-020-02160-8","volume":"140","author":"M Rossi","year":"2020","unstructured":"Rossi M, Candelise N, Baiardi S, Capellari S, Giannini G, Orr\u00f9 CD et al (2020) Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies. Acta Neuropathol 140:49\u201362","journal-title":"Acta Neuropathol"},{"key":"294_CR8","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.parkreldis.2022.03.019","volume":"98","author":"P Varghaei","year":"2022","unstructured":"Varghaei P, Estiar MA, Ashtiani S, Veyron S, Mufti K, Leveille E et al (2022) Genetic, structural and clinical analysis of spastic paraplegia 4. Parkinsonism Relat Disord 98:62\u201369","journal-title":"Parkinsonism Relat Disord"},{"key":"294_CR2","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1002\/mds.29005","volume":"37","author":"GK Wenning","year":"2022","unstructured":"Wenning GK, Stankovic I, Vignatelli L, Fanciulli A, Calandra-Buonaura G, Seppi K et al (2022) The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy. Mov Disord 37:1131\u20131148","journal-title":"Mov Disord"}],"container-title":["EJNMMI Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41824-026-00294-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41824-026-00294-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41824-026-00294-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:55:34Z","timestamp":1781639734000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s41824-026-00294-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["294"],"URL":"https:\/\/doi.org\/10.1186\/s41824-026-00294-8","relation":{},"ISSN":["3005-074X"],"issn-type":[{"value":"3005-074X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]},"assertion":[{"value":"17 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2023","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"On page 3, citation [2] should be replaced by Wenning et al. 2022","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures were performed in line with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient prior investigation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics and consent to participate"}},{"value":"The authors affirm that his relative and legal guardian provided permission for publication of the patient\u2019s data and images in Fig.\u00a0\n                      \n                      a, b, c, and d.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Swen Hesse received travel grants and honoraria for presentations from GE Healthcare and Hermes Medical Solutions. The other authors declare no conflicts of interest or disclosures.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10"}}