Glucose Hypometabolism and Neuropathological Correlates in Brains of Dementia with Lewy Bodies

Higuchi, Makoto; Tashiro, Masato; Arai, Hiroyuki; Okamura, Nobuyuki; Hara, Sachiko; Higuchi, Susumu; Itoh, Masatoshi; Shin, Ryong-Woon; Trojanowski, John Q.; Sasaki, Hidetada

doi:10.1006/exnr.2000.7342

Cited by 186 publications

(136 citation statements)

References 28 publications

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“…However, 29% of DLB patients and 35% of FTD patients showed a pattern of cortical deficits similar to that of AD patients. Therefore, the presence of cortical abnormalities discriminated AD from DLB and FTD, with a high sensitivity (.90%) though a lower specificity (71% and 65%, respectively), which is consistent with previous studies (9,37,38). It remains to be determined whether the AD PET patterns observed in a subset of clinical DLB and FTD patientswhich were considered as a misclassification-reflect, instead, the existence of AD pathology in these patients.…”

Section: Discussionsupporting

confidence: 91%

Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

et al. 2008

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This multicenter study examined 18 F-FDG PET measures in the differential diagnosis of Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB) from normal aging and from each other and the relation of disease-specific patterns to mild cognitive impairment (MCI). Methods: We examined the 18 F-FDG PET scans of 548 subjects, including 110 healthy elderly individuals (''normals'' or NLs), 114 MCI, 199 AD, 98 FTD, and 27 DLB patients, collected at 7 participating centers. Individual PET scans were Z scored using automated voxelbased comparison with generation of disease-specific patterns of cortical and hippocampal 18 F-FDG uptake that were then applied to characterize MCI. Results: Standardized diseasespecific PET patterns were developed that correctly classified 95% AD, 92% DLB, 94% FTD, and 94% NL. MCI patients showed primarily posterior cingulate cortex and hippocampal hypometabolism (81%), whereas neocortical abnormalities varied according to neuropsychological profiles. An AD PET pattern was observed in 79% MCI with deficits in multiple cognitive domains and 31% amnesic MCI. 18 F-FDG PET heterogeneity in MCI with nonmemory deficits ranged from absent hypometabolism to FTD and DLB PET patterns. Conclusion: Standardized automated analysis of 18 F-FDG PET scans may provide an objective and sensitive support to the clinical diagnosis in early dementia.

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Section: Discussionsupporting

confidence: 91%

Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

et al. 2008

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“…The lack of postmortem evidence of wallerian degeneration in the DLB brain 44 and the presence of widespread spongiform changes and gliosis affecting long projection fibers are a part of DLB pathophysiology. 45 Zaja-Milatovic et al 46,47 reported evidence of spinodendritic degeneration of gamma-aminobutyric acidsergic medium spiny neurons in specific regions of the caudate nucleus. This may be a structural correlate of the impairments in executive function in patients with DLB, and such pathologic changes may explain the reduction of striatal volume in these patients.…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

Goto¹,

Ishii²,

Uemura³

et al. 2010

AJNR Am J Neuroradiol

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“…Numerous studies have reported occipital hypoperfusion and hypometabolism in DLB patients, and parietotemporal reduction is common to both AD and DLB (12)(13)(14)(15)(16)(17)(18)(19)(20). The cingulate cortex in DLB, compared with in AD, appears to be relatively spared, but the clinical value of this finding has not been previously investigated (21).…”

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confidence: 99%

The ¹⁸F-FDG PET Cingulate Island Sign and Comparison to ¹²³I-β-CIT SPECT for Diagnosis of Dementia with Lewy Bodies

Lim¹,

Katsifis²,

Villemagne³

et al. 2009

J Nucl Med

264

189

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Neuroimaging is increasingly used to supplement the clinical diagnosis of dementia with Lewy bodies (DLB) by showing reduced occipital metabolism and perfusion and reduced striatal dopaminergic innervation. We aimed to optimize the interpretation of 18 F-FDG PET images for differentiating DLB from Alzheimer disease (AD) and to compare the results with dopamine transporter imaging using 123 I-b-carbomethoxy-3ß-(4-iodophenyl)-tropane ( 123 I-b-CIT) SPECT. Methods: Fourteen subjects with a clinical diagnosis of DLB and 10 with AD underwent both 18 F-FDG PET and 123 I-b-CIT SPECT. Four DLB and 1 AD diagnoses were subsequently confirmed at autopsy. Diagnostic accuracy was calculated for visual interpretation by 3 readers of standard 3-plane and stereotactic surface projection 18 F-FDG PET images, receiver-operating-characteristic analysis of regional 18 F-FDG uptake, and a cutoff value for the striatal-to-occipital binding ratio of b-CIT defined by receiver-operating-characteristic analysis. Results: Visual interpretation of 3-plane 18 F-FDG PET images had a sensitivity of 83% and specificity of 93% for DLB, slightly higher than the results with the stereotactic surface projection images. Regionally, hypometabolism in the lateral occipital cortex had the highest sensitivity (88%), but relative preservation of the mid or posterior cingulate gyrus (cingulate island sign) had the highest specificity (100%). Region-of-interest analysis revealed that occipital hypometabolism and relative preservation of the posterior cingulate both had a sensitivity of 77% and specificity of 80%. b-CIT achieved 100% accuracy and greater effect size than did 18 F-FDG PET (Cohen d 5 4.1 vs. 1.9). Conclusion: Both 18 F-FDG PET and 123 I-b-CIT SPECT appear useful for the diagnosis of DLB, although the latter provides more robust results. The cingulate island sign may enhance the specificity of 18 F-FDG PET.

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Glucose Hypometabolism and Neuropathological Correlates in Brains of Dementia with Lewy Bodies

Cited by 186 publications

References 28 publications

Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

The ¹⁸F-FDG PET Cingulate Island Sign and Comparison to ¹²³I-β-CIT SPECT for Diagnosis of Dementia with Lewy Bodies

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Glucose Hypometabolism and Neuropathological Correlates in Brains of Dementia with Lewy Bodies

Cited by 186 publications

References 28 publications

Multicenter Standardized 18F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

Multicenter Standardized 18F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

The 18F-FDG PET Cingulate Island Sign and Comparison to 123I-β-CIT SPECT for Diagnosis of Dementia with Lewy Bodies

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Product

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Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

Multicenter Standardized ¹⁸F-FDG PET Diagnosis of Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias

The ¹⁸F-FDG PET Cingulate Island Sign and Comparison to ¹²³I-β-CIT SPECT for Diagnosis of Dementia with Lewy Bodies