Occipital lobe and posterior cingulate perfusion in the prediction of dementia with Lewy body pathology in a clinical sample

Prosser, Angus; Tossici-Bolt, Livia; Kipps, Christopher

doi:10.1097/mnm.0000000000000750

Cited by 5 publications

(6 citation statements)

References 36 publications

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“…Interestingly, there was no significant global PVS volume fraction difference between IPD and FPD; however, there was a significantly higher regional PVS volume fraction in the white matter of the lateral occipital and cuneus regions in IPD compared to FPD. Both brain regions have been implicated in PD‐related cognitive impairment through changes in perfusion and volume in the lateral occipital and cuneus regions, respectively 64,72 . Despite these observed differences, the clinical distinction between IPD and FPD remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Both brain regions have been implicated in PD-related cognitive impairment through changes in perfusion and volume in the lateral occipital and cuneus regions, respectively. 64,72 Despite these observed differences, the clinical distinction between IPD and FPD remains unclear. Some reports indicate greater cognitive deficits and/or progression in familial forms such as SNCA and GBA, 73,74 whereas others show the opposite [75][76][77] or no clinical differences.…”

Section: Discussionmentioning

confidence: 99%

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Global and Regional Changes in Perivascular Space in Idiopathic and Familial Parkinson's Disease

et al. 2021

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Background The glymphatic system, including the perivascular space (PVS), plays a critical role in brain homeostasis. Although mounting evidence from Alzheimer's disease has supported the potential role of PVS in neurodegenerative disorders, its contribution in Parkinson's disease (PD) has not been fully elucidated. Although idiopathic (IPD) and familial PD (FPD) share similar pathophysiology in terms of protein aggregation, the differential impact of PVS on PD subtypes remains unknown. Our objective was to examine the differences in PVS volume fraction in IPD and FPD compared to healthy controls (HCs) and nonmanifest carriers (NMCs). Methods A total of 470 individuals were analyzed from the Parkinson's Progression Markers Initiative database, including (1) IPD (n = 179), (2) FPD (LRRK2 [leucine‐rich repeat kinase 2], glucocerebrosidase, or α‐synuclein) (n = 67), (3) NMC (n = 101), and (4) HCs (n = 84). Total PVS volume fraction (%) was compared using parcellation and quantitation within greater white matter volume at global and regional levels in all cortical and subcortical white matter. Results There was a significant increase in global and regional PVS volume fraction in PD versus non‐PD, particularly in FPD versus NMC and LRRK2 FPD versus NMC. Regionally, FPD and NMC differed in the medial orbitofrontal region, as did LRRK2 FPD versus NMC. Non‐PD and PD differed in the medial orbitofrontal region and the banks of the superior temporal regions. IPD and FPD differed in the cuneus and lateral occipital regions. Conclusions Our findings support the role of PVS in PD and highlight a potentially significant contribution of PVS to the pathophysiology of FPD, particularly LRRK2. © 2021 International Parkinson and Movement Disorder Society

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Global and Regional Changes in Perivascular Space in Idiopathic and Familial Parkinson's Disease

et al. 2021

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“…The occipital lobe is important for visuospatial processing. Hypoperfusion and atrophy in the occipital lobe has been associated with dementia with Lewy bodies ( Hanyu et al, 2006 ; Prosser et al, 2017 ), visual hallucinations in Alzheimer’s disease ( Holroyd et al, 2000 ), and poor cognitive scores ( Smith et al, 2001 ).…”

Section: Discussionmentioning

confidence: 99%

Deep learning identifies brain structures that predict cognition and explain heterogeneity in cognitive aging

Saboo

Varatharajah

et al. 2022

NeuroImage

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“…Interestingly, cingulate hypometabolism was also found to be missed frequently in patients meeting clinical criteria for DLB, and significant disagreement existed between radiological reports and independent reads. Classically, the cingulate island sign, identified as sparing of metabolism in the posterior cingulate region as compared to the precuneus and cuneus, was identified as a specific marker when taken alongside occipital hypometabolism [ 11 , 12 ]. Other studies found that the degree of cingulate hypometabolism in the presence of occipital hypometabolism may correlate to coexisting AD pathology as well [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other regions of interest have been identified in DLB, such as preservation of posterior cingulate island perfusion, which can enhance specificity for DLB on FDG-PET studies up to 100% when taken alongside occipital hypometabolism concurrently [ 10 ]. Prosser et al [ 11 ] found that preserved cingulate island perfusion and reduced occipital hypometabolism on Tc-HMPAO SPECT increase specificity but not sensitivity for DLB. Conversely, another study by Graff-Radford et al [ 12 ] found that the degree of cingulate island metabolism was inversely correlated with Braak Neurofibrilary Tangle (NFT) staging, suggesting coexistence of Alzheimer Disease pathology in patients carrying a diagnosis of probable DLB and exhibiting cingulate hypoperfusion.…”

Section: Introductionmentioning

confidence: 99%

Occipital and Cingulate Hypometabolism are Significantly Under-Reported on 18-Fluorodeoxyglucose Positron Emission Tomography Scans of Patients with Lewy Body Dementia

Hamed

Schraml

Wilson

et al. 2018

J Alzheimers Dis Parkinsonism

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ObjectiveTo determine whether occipital and cingulate hypometabolism is being under-reported or missed on 18-fluorodeoxyglucose positron emission tomography (FDG-PET) CT scans in patients with Dementia with Lewy Bodies (DLB).BackgroundRecent studies have reported higher sensitivity and specificity for occipital and cingulate hypometabolism on FDG-PET of DLB patients.MethodsThis retrospective chart review looked at regions of interest (ROI’s) in FDG-PET CT scan reports in 35 consecutive patients with a clinical diagnosis of probable, possible, or definite DLB as defined by the latest DLB Consortium Report. ROI’s consisting of glucose hypometabolism in frontal, parietal, temporal, occipital, and cingulate areas were tabulated and charted separately by the authors from the reports. A blinded Nuclear medicine physician read the images independently and marked ROI’s separately. A Cohen’s Kappa coefficient statistic was calculated to determine agreement between the reports and the blinded reads.ResultsOn the radiology reports, 25.71% and 17.14% of patients reported occipital and cingulate hypometabolism respectively. Independent reads demonstrated significant disagreement with the proportion of occipital and cingulate hypometabolism being reported on initial reads: 91.43% and 85.71% respectively. Cohen’s Kappa statistic determinations demonstrated significant agreement only with parietal hypometabolism (p<0.05).ConclusionOccipital and cingulate hypometabolism is under-reported and missed frequently on clinical interpretations of FDG-PET scans of patients with DLB, but the frequency of hypometabolism is even higher than previously reported. Further studies with more statistical power and receiver operating characteristic analyses are needed to delineate the sensitivity and specificity of these in vivo biomarkers.

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Occipital lobe and posterior cingulate perfusion in the prediction of dementia with Lewy body pathology in a clinical sample

Cited by 5 publications

References 36 publications

Global and Regional Changes in Perivascular Space in Idiopathic and Familial Parkinson's Disease

Global and Regional Changes in Perivascular Space in Idiopathic and Familial Parkinson's Disease

Deep learning identifies brain structures that predict cognition and explain heterogeneity in cognitive aging

Occipital and Cingulate Hypometabolism are Significantly Under-Reported on 18-Fluorodeoxyglucose Positron Emission Tomography Scans of Patients with Lewy Body Dementia

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