Single-dose rapamycin increases brain glucose metabolism but reduces synaptic density in Long-Evans rats

Rapamycin, an inhibitor of the mechanistic target of rapamycin (mTOR), has shown promise as a neuroprotective compound in preclinical studies. Reduced brain glucose metabolism and loss of synaptic density are key features of Alzheimer's disease that can be measured in vivo using positron emission tomography (PET) imaging, allowing for assessment of treatment effects on brain function. Here, we used PET to investigate the acute effects of a single-dose of rapamycin on glucose metabolism and synaptic density in Long-Evans rats. In a repeated measures design, we quantified changes in brain glucose metabolism using [18F]FDG PET (n=13) at baseline, one day, and one week after intraperitoneal administration of rapamycin (8 mg/kg). In a separate cohort (n=6), we measured synaptic density using [18F]SynVesT-1 PET at baseline and one day after rapamycin administration. Regional standardized uptake values (SUV) were calculated for [18F]FDG while total distribution volumes were estimated for [18F]SynVesT-1 using image-derived input functions of the heart. Rapamycin induced significant increases in [18F]FDG SUV across multiple brain regions one day after administration, an effect that persisted at one-week follow-up. In contrast, [18F]SynVesT-1 binding showed significant decreases throughout the brain at 24 hours post-administration, indicating reduced synaptic density. These opposing effects on glucose metabolism and synaptic density point to multifaceted actions of rapamycin in the brain, possibly reflecting improved metabolic function occurring simultaneously with acute synaptic loss. These results show that [18F]FDG and synaptic density PET imaging could serve as useful biomarkers in human clinical trials evaluating rapamycin's mechanistic and therapeutic effects in neurodegenerative disorders.