A comparison of 99mTc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping

Colloby, Sean J.; Fenwick, John D.; Williams, David; Paling, S. M.; Lobotesis, Kyriakos; Ballard, Clive; McKeith, Ian G.; O’Brien, John T.

doi:10.1007/s00259-002-0778-5

Cited by 167 publications

(120 citation statements)

References 27 publications

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“…Even though we should be careful about drawing any major conclusions from data based on the present group of DLB patients, the results overall suggest that DLB in its early stages is more similar to Alzheimer disease with cortical dysfunction than to striatal dysfunction expressed as decreased DAT density (as in PD), and this possibility may explain the symptomatology (10). Most likely, however, the cortical dysfunction is more related to a cortical distribution of Lewy bodies than to Alzheimer disease pathology alone (21).…”

Section: Discussionmentioning

confidence: 84%

“…SPECT imaging of cerebral blood flow has demonstrated frontoparietooccipital hypoperfusion patterns in DLB patients (10). The frontal hypoperfusion is interesting, since the dorsolateral circuit involved in planning and attention connects the frontal cortex with the striatum and thus attentional fluctuations are also greatly influenced by the striatum and the dopamine system (11).…”

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confidence: 99%

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Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

et al. 2013

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Patients who have dementia with Lewy bodies (DLB) show both clinical and histopathologic overlap with Alzheimer disease patients and Parkinson disease patients. In this study, we correlated the core features of DLB (dementia, parkinsonism, hallucinations, and fluctuations) with striatal dopamine transporter (DAT) availability as assessed with SPECT and 123 I-N-(3-iodoprop-2E-enyl)-2-b-carbomethoxy-3b-(4-methylphenyl) nortropane ( 123 I-PE2I) in patients with newly diagnosed DLB. Methods: Two hundred eighty-eight patients were consecutively included in the study as they were referred for diagnostic SPECT scanning of DAT with 123 I-PE2I. Of those patients, 51 had, on the basis of clinical guideline criteria, a probable-DLB diagnosis at follow-up 16 6 11.6 mo later. Before or on the day of the SPECT scan, DLB patients had a routine neurologic examination including Hoehn and Yahr grading and were cognitively evaluated with the Mini Mental State Examination. The central feature in dementia with Lewy bodies (DLB) is progressive dementia, but compared with other forms of dementia it has several additional frequent core features, namely fluctuations, hallucinations, and parkinsonism. Parkinson disease (PD), DLB, and PD dementia are seen as a spectrum of the same condition, "Lewy body diseases" (1). In the clinic, DLB and PD dementia are nosologically differentiated only by the time span between the development of parkinsonism and dementia. In DLB, cognitive problems occur less than a year after the onset of parkinsonism (2). The dopamine system is deeply involved in all Lewy body diseases, and dopamine is reduced in the basal ganglia as a consequence of the aggregation of Lewy bodies in this area of the brain (3,4).Imaging of the dopamine transporter (DAT) with SPECT serves as a surrogate marker of the nerve connection between axons from the substantia nigra and neurons in the striatum (5,6). An in vitro study of brains from monkeys treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, meant as a model of human DLB, suggested that the loss of DAT and the loss of striatal dopamine content are linearly correlated (7).In PD, many studies have shown a clear correlation between DAT binding and core features of parkinsonism (8). We identified only one DAT SPECT imaging study including 15 DLB patients correlating DAT binding (in which 123 I-2-b-carbomethoxy-3b-(4-iodophenyl)-N-(3-fluoropropyl)nortropane [ 123 I-FP-CIT] was used as the radioligand) with parkinsonism. The authors suggested that there might be a difference in the predilection for DAT uptake in PD versus DLB, since the caudate-to-putamen ratio was less reduced in DLB than in PD and, further, no correlation between severity of parkinsonism and DAT binding was found in DLB patients (9).SPECT imaging of cerebral blood flow has demonstrated frontoparietooccipital hypoperfusion patterns in DLB patients (10). The frontal hypoperfusion is interesting, since the dorsolateral circuit involved in planning and attention connects the frontal cortex with the striatum and ...

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Section: Discussionmentioning

confidence: 84%

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confidence: 99%

Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

et al. 2013

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“…Therefore, one would have expected the presence of more extensive foci of cortical hypoactivity in our AD group relative to controls, involving the temporo-parietal cortex more largely and bilaterally, as well as affecting other regions, such as the medial temporal region, the precuneus, and the prefrontal cortex. 6,11,21 This suggests that, due to the lower sensitivity of single-detector SPECT systems, 22 the magnitude of rCBF deficits in a given sample may be underestimated when the SPM program is used to analyze data acquired with such a type of SPECT equipment. However, this possibility could not be directly ascertained in our study, as we did not obtain rCBF data from the same subjects using both our single-detector system and another, multiple-detector system affording greater sensitivity and spatial resolution.…”

Section: Discussionmentioning

confidence: 99%

“…9 SPECT studies of AD using the SPM approach have been invariably restricted to research centers that have access to sophisticated SPECT devices of two or more detectors, using imaging protocols of superior spatial resolution. 10,11 Conventional, single-detector SPECT systems provide rCBF data of lower spatial resolution and sensitivity compared to multiple-detector systems, but are cheaper and more largely available, particularly in routine clinical services. However, it is not known whether single-detector SPECT systems can detect statistically significant rCBF deficits with the SPM approach in studies comparing AD samples to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Voxel-Based Investigations of Regional Cerebral Blood Flow Abnormalities in Alzheimers Disease Using a Single-Detector Spect System

Duran

Zampieri

Bottino

et al. 2007

Clinics

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. Voxel-based investigations of regional cerebral blood flow abnormalities in Alzheimer's disease using a single-detector SPECT system. Clinics. 2007;62(4):377-84. PURPOSE:To evaluate the feasibility of using the Statistical Parametric Mapping (SPM) program for an automated, voxel-byvoxel assessment of regional cerebral blood flow (rCBF) deficits in Alzheimer's disease (AD) subjects relative to age-matched controls studied with a conventional, single-detector SPECT system. METHODS: We used a databank of 99mTc-HMPAO images of 19 patients with a diagnosis of probable AD and 15 elderly healthy volunteers; data were acquired using an Orbiter-Siemens single-detector SPECT system. Using SPM, images were transformed spatially, smoothed (12mm), and the data were compared on a voxel-by-voxel basis with t-tests. RESULTS: There were significant rCBF reductions in AD patients relative to controls involving regions predicted a priori to be affected in AD, namely the left temporal and parietal neocortices, and the right posterior cingulate gyrus (p<0.05, corrected for multiple comparisons). DISCUSSION: The location of rCBF reductions in AD subjects in our study is consistent with the deficits detected in previous functional imaging studies of AD using higher-resolution devices. This suggests the potential usefulness of using SPM for the analysis of data acquired with single-detector SPECT systems, despite the limited sensitivity and spatial resolution of such equipment.

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“…In particular, the use of advanced statistical brain imaging analysis, such as 3-dimensional stereotactic surface projections (3D-SSP) and statistical parametric mapping (SPM), has detected occipital hypometabolism or hypoperfusion in DLB (9)(10)(11)(12)(13). Statistical mapping methods are excellent in terms of objectivity and reproducibility but do not provide clear anatomic information or the range and extent of an abnormal site in visual assessment of 3D images.…”

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confidence: 99%

Evaluation of Probable or Possible Dementia with Lewy Bodies Using 123I-IMP Brain Perfusion SPECT, 123I-MIBG, and 99mTc-MIBI Myocardial SPECT

Inui¹,

Toyama²,

Manabe³

et al. 2007

Journal of Nuclear Medicine

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We evaluated the diagnostic usefulness of combination studies with a statistical mapping method in N-isopropyl-p-123 Iiodoamphetamine ( 123 I-IMP) brain perfusion SPECT, cardiac sympathetic nerve function by 123 I-metaiodobenzylguanidine ( 123 I-MIBG), and myocardial function by electrocardiographically gated 99m Tc-sestamibi ( 99m Tc-MIBI) SPECT for patients with probable or possible dementia with Lewy bodies (DLB). Methods: Twelve patients with probable DLB (7 male, 5 female; mean age 6 SD, 72.3 6 5.63 y; range, 65-82 y) and 9 patients with possible DLB (3 male, 6 female; mean age 6 SD, 73.1 6 9.23 y; range, 59-88 y) were enrolled in this study. 123 I-IMP SPECT images were analyzed with 3-dimensional stereotactic surface projections (3D-SSP) and the severity of ischemia was classified objectively using quantitatively analytic and display software; stereotactic extraction estimation (SEE) methods were compared with a normal database. In addition, we evaluated 123 I-MIBG heart-to-mediastinum (H/M) uptake ratios. Moreover, we performed 99m Tc-MIBI SPECT to evaluate myocardial perfusion and the left ventricular ejection fraction (LVEF) compared with a normal database. Results: 3D-SSP images of group comparison with healthy control subjects showed significantly decreased perfusion in the parietotemporal, occipital cortex, posterior cingulated, and precuneus regions in the probable DLB group but no significant reduction in the possible DLB group. Mean H/M ratios in the probable DLB group were significantly lower than those of the possible DLB group and the control group, respectively. Ten of 12 patients (83.3%) with probable DLB and 1 of 9 patients (11.1%) with possible DLB showed severe reduction in the bilateral occipital lobe and also a low 123 I-MIBG uptake. One patient (8.3%) with probable DLB and 2 patients (22.2%) with possible DLB showed no bilateral occipital hypoperfusion but showed low 123 I-MIBG uptake. One patient (8.3%) with probable DLB and 6 patients (66.7%) with possible DLB showed no occipital hypoperfusion and normal 123 I-MIBG uptake. 99m Tc-MIBI gated SPECT did not indicate any wall motion abnormality in any subjects. Conclusion: These results suggest that combined examination of cerebral blood flow with 3D-SSP and SEE analysis, and cardiac sympathetic nerve function with 123 I-MIBG, would be a useful supporting diagnostic method in patients with DLB-particularly, in possible DLB and when cerebral blood flow does not indicate occipital hypoperfusion.

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A comparison of 99mTc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping

Cited by 167 publications

References 27 publications

Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

Voxel-Based Investigations of Regional Cerebral Blood Flow Abnormalities in Alzheimers Disease Using a Single-Detector Spect System

Evaluation of Probable or Possible Dementia with Lewy Bodies Using 123I-IMP Brain Perfusion SPECT, 123I-MIBG, and 99mTc-MIBI Myocardial SPECT

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