123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies

Kasanuki, Koji; Iseki, Eizo; Ota, Kazumi; Kondo, Daizo; Ichimiya, Yosuke; Satô, Kiyoshi; Arai, Heii

doi:10.1007/s00259-016-3466-6

Cited by 25 publications

(27 citation statements)

References 32 publications

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“…In addition, the level of binding in both groups was again negatively correlated with the level of parkinsonism 24. This suggests that DAT imaging may even be able to distinguish early DLB in those presenting with mild symptoms.…”

Section: Methodsmentioning

confidence: 81%

Clinical imaging in dementia with Lewy bodies

Surendranathan

O’Brien

2018

Evid Based Mental Health

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Dementia with Lewy bodies (DLB) is a common neurodegenerative dementia in older people; however, the clinical features, particularly cognitive fluctuations and rapid eye movement sleep disorder, are often hard to elicit, leading to difficulty in making the diagnosis clinically. Here we examine the literature for the evidence behind imaging modalities that could assist in making the diagnosis. Dopamine transporter (DAT) imaging remains the best modality for differentiation from dementia of Alzheimer's type with high sensitivity and specificity reported based on pathological diagnoses. Iodine-metaiodobenzylguanidine myocardial scintigraphy (MIBG) however is rapidly becoming an alternative imaging modality for the diagnosis of DLB, though studies assessing its accuracy with postmortem verification are still awaited. However, there are suggestions that MIBG may be better in the differentiation of vascular parkinsonism from DLB than DAT scans but may have lower sensitivity for detecting DLB compared with the 80% sensitivity seen in DAT imaging. Structural MRI scans have long been used for the diagnosis of dementia; however, their utility in DLB is limited to revealing the presence of coexisting Alzheimer's disease. Fluorodeoxyglucose (FDG) PET is an alternative biomarker that can also differentiate Alzheimer's disease and DLB but lacks the evidence base of both DAT and MIBG scans.

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Section: Methodsmentioning

confidence: 81%

Clinical imaging in dementia with Lewy bodies

Surendranathan

O’Brien

2018

Evid Based Mental Health

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“…Cognitive dysfunction in iRBD patients was related to abnormal surface contraction in the left putamen and thalamus [10]. Reduced dopaminergic availability is also associated with hyposmia and RBD in the prodromal DLB population [11]. Intriguingly, a correlation was found between olfactory score and reduced dopamine transporter densities in the amygdala but not in the caudate or anterior putamen.…”

Section: Discussionmentioning

confidence: 97%

Cognitive decline in association with hyposmia in idiopathic rapid eye movement sleep behavior disorder: a prospective 2‐year follow‐up study

Shin

Lee

Kim

et al. 2019

Euro J of Neurology

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Background and purpose The aim was to analyze the characteristics and progression of cognitive dysfunction in non‐demented idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with baseline olfactory function. Methods From a prospective polysomnography‐confirmed iRBD cohort, 25 patients (16 patients in 2‐year follow‐up) and 13 normal controls were included. Initial and 2‐year follow‐up cognitive functions were analyzed with olfactory function and 18F‐fluorinated‐N‐3‐fluoropropyl‐2β‐carboxymethoxy‐3β‐(4‐iodophenyl)‐nortropane (18F‐FP‐CIT) uptake in deep nuclei initially. Results Idiopathic RBD patients had impaired attention, memory and executive function compared to controls. Baseline cognitive tests were comparable between the iRBD subgroups with and without hyposmia. 18F‐FP‐CIT uptake tended to be lower in the hyposmic group than in the normosmic group. The olfactory test score was positively correlated with amygdala uptake in iRBD patients (P = 0.027). After 2 years, visuospatial and verbal memory dysfunction worsened more in hyposmics than in normosmics. Lower initial olfactory test score was associated with more severe declines in verbal memory function. Conclusions Hyposmia may be a predictive sign of cognitive decline in iRBD patients.

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“…Imaging assessing the integrity of the dopaminergic system suggests that decreased binding of 123 I-FP-CIT occurs in a substantial proportion of MCI-LB. 10,30 Moreover, the dopaminergic deficit can precede the onset of clinical parkinsonism. 10 that in a substantial proportion of cases, cardiac sympathetic involvement occurs before dementia.…”

Section: Discussionmentioning

confidence: 99%

Imaging in prodromal dementia with Lewy bodies: Where do we stand?

Durcan

Donaghy

Osborne

et al. 2019

Int J Geriat Psychiatry

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Objectives The aim of this review was to provide an overview of the literature on imaging in prodromal dementia with Lewy bodies (DLB). Design Systematic PubMed search and literature review. Results Diagnostic classification of the prodromal DLB stage remains to be established but is likely to require imaging biomarkers to improve diagnostic accuracy. In subjects with mild cognitive impairment with Lewy body disease (MCI‐LB) (here synonymous with prodromal DLB) and REM sleep behaviour disorder, a high risk condition for future conversion to a synucleinopathy, imaging modalities have assessed early structural brain changes, striatal dopaminergic integrity, metabolic brain, and cerebral perfusion alterations. It remains uncertain whether structural brain imaging can differentiate MCI‐LB from mild cognitive impairment with Alzheimer disease (MCI‐AD), but early right anterior insula thinning has been reported to occur in MCI‐LB compared with MCI‐AD. Dopaminergic deficits have been observed in a substantial proportion of MCI‐LB subjects and have a high specificity for Lewy body disease at the pre‐dementia stage. Cardiac sympathetic denervation, occipital hypometabolism, or hypoperfusion is less studied as this pre‐dementia stage and it remains to be determined whether any imaging abnormalities antedate DLB. Conclusion Imaging studies in prodromal DLB are still in their infancy but offer great potential to study early in vivo structural and functional biological alterations. Future work should focus on longitudinal multimodal imaging studies with postmortem validation of diagnosis in order to develop and then validate criteria for prodromal DLB.

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123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies

Abstract: I-FP-CIT SPECT may play a role for detecting DLB among the subjects in prodromal stage. During this stage, long-term olfactory dysfunction and/or RBD may indicate more severe degeneration of the nigro-striatal dopaminergic pathway.

Cited by 25 publications

References 32 publications

Clinical imaging in dementia with Lewy bodies

Clinical imaging in dementia with Lewy bodies

Cognitive decline in association with hyposmia in idiopathic rapid eye movement sleep behavior disorder: a prospective 2‐year follow‐up study

Imaging in prodromal dementia with Lewy bodies: Where do we stand?

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