The relationship between hallucinations and FDG-PET in dementia with Lewy bodies

Firbank, Michael; Lloyd, Jim; O’Brien, John

doi:10.1007/s11682-015-9434-0

Cited by 28 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One could hypothesize that dysfunction in this network of structures may contribute to the overlapping features observed across PCA and DLB. Occipital hypometabolism has been associated with the presence of DLB clinical features (27)(28)(29), and visual hallucinations, parkinsonism, and RBD were observed in some of our PCA patients, as has previously been reported (13). Atrophy of the primary visual cortex and thalamus has indeed been associated with the presence of visual hallucinations in PCA (13), and parietal and thalamic atrophy has been associated with parkinsonism in PCA (30).…”

Section: Discussionsupporting

confidence: 71%

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

et al. 2016

View full text Add to dashboard Cite

Posterior cortical atrophy (PCA) and dementia with Lewy bodies (DLB) have both been associated with occipital lobe hypometabolism on 18 F-FDG PET, whereas relative sparing of posterior cingulate metabolism compared with precuneus/cuneus (i.e., cingulate island sign) is a feature of DLB. We aimed to determine whether patterns of hypometabolism or the cingulate island sign differed between PCA and DLB. Methods: Sixteen clinically diagnosed PCA and 13 probable DLB subjects underwent 18 F-FDG PET. All PCA subjects showed b-amyloid deposition on PET scanning. Regional hypometabolism was assessed compared with a control cohort (n 5 29) using voxel-and region-level analyses in statistical parametric mapping. A ratio of metabolism in the posterior cingulate to precuneus plus cuneus was calculated to assess the cingulate island sign. In addition, the 18 F-FDG PET scans were visually assessed to determine whether the cingulate island sign was present in each subject. Results: PCA and DLB showed overlapping patterns of hypometabolism involving the lateral occipital lobe, lingual gyrus, cuneus, precuneus, posterior cingulate, inferior parietal lobe, supramarginal gyrus, striatum, and thalamus. However, DLB showed greater hypometabolism in the medial occipital lobe, orbitofrontal cortex, anterior temporal lobe, and caudate nucleus than PCA, and PCA showed more asymmetric patterns of hypometabolism than DLB. The cingulate island sign was present in both DLB and PCA, although it was more asymmetric in PCA. Conclusion: Regional hypometabolism overlaps to a large degree between PCA and DLB, although the degree of involvement of the frontal and anterior temporal lobes and the presence of asymmetry could be useful in differential diagnosis.

show abstract

Section: Discussionsupporting

confidence: 71%

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Cell loss in the nucleus basalis of Meynert (Ch4 intermediate part) affects the cholinergic innervation to occipital–parietal cortical regions in DLB (Liu, Chang, Pearce, & Gentleman, ). At group level, occipital hypometabolism was also associated with DLB core clinical symptoms (e.g., (Albin et al, ; Caminiti, Alongi, et al, ; Chiba et al, ; Firbank, Lloyd, & O'Brien, ; Graff‐Radford et al, ; Iaccarino et al, ; Ishii et al, ; Kantarci et al, ; Klein et al, ; Minoshima et al, ; Perani et al, ; Perneczky et al, ; Perneczky et al, ; Satoh et al, ; Teune et al, )). A recent study, clustering DLB patients based on their individual brain hypometabolism maps, found that patients with more severe occipital involvement present a higher prevalence of VH, visuospatial, and visuoperceptive deficits (Caminiti et al, ).…”

Section: Discussionmentioning

confidence: 99%

Vulnerability of multiple large‐scale brain networks in dementia with Lewy bodies

Sala

Caminiti

Iaccarino

et al. 2019

Human Brain Mapping

View full text Add to dashboard Cite

Aberrations of large‐scale brain networks are found in the majority of neurodegenerative disorders. The brain connectivity alterations underlying dementia with Lewy bodies (DLB) remain, however, still elusive, with contrasting results possibly due to the pathological and clinical heterogeneity characterizing this disorder. Here, we provide a molecular assessment of brain network alterations, based on cerebral metabolic measurements as proxies of synaptic activity and density, in a large cohort of DLB patients (N = 72). We applied a seed‐based interregional correlation analysis approach (p < .01, false discovery rate corrected) to evaluate large‐scale resting‐state networks' integrity and their interactions. We found both local and long‐distance metabolic connectivity alterations, affecting the posterior cortical networks, that is, primary visual and the posterior default mode network, as well as the limbic and attention networks, suggesting a widespread derangement of the brain connectome. Notably, patients with the lowest visual and attention cognitive scores showed the most severe connectivity derangement in regions of the primary visual network. In addition, network‐level alterations were differentially associated with the core clinical manifestations, namely, hallucinations with more severe metabolic dysfunction of the attention and visual networks, and rapid eye movement sleep behavior disorder with alterations of connectivity of attention and subcortical networks. These multiple network‐level vulnerabilities may modulate the core clinical and cognitive features of DLB and suggest that DLB should be considered as a complex multinetwork disorder.

show abstract

“…Occipital hypometabolism and reduced regional cerebral blood flow (rCBF) are characteristics of DLB 114,115 , and have been linked to visual hallucination severity 116 . Whether the same regions exhibit reduced metabolism and rCBF in PD psychosis is less clear.…”

Section: Imaging and Electrophysiologymentioning

confidence: 99%

The psychosis spectrum in Parkinson disease

et al. 2017

View full text Add to dashboard Cite

In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication. We discuss recent developments, including recognition of an increase in the prevalence of psychosis with disease duration, addition of new visual symptoms to the psychosis continuum, and identification of frontal executive, visual perceptual and memory dysfunction at different disease stages. In addition, we highlight novel risk factors — for example, autonomic dysfunction — that have emerged from prospective studies, structural MRI evidence of frontal, parietal, occipital and hippocampal involvement, and approval of pimavanserin for the treatment of PD psychosis. The accumulating evidence raises novel questions and directions for future research to explore the clinical management and biomarker potential of PD psychosis.

show abstract

The relationship between hallucinations and FDG-PET in dementia with Lewy bodies

Cited by 28 publications

References 16 publications

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

Vulnerability of multiple large‐scale brain networks in dementia with Lewy bodies

The psychosis spectrum in Parkinson disease

Contact Info

Product

Resources

About

The relationship between hallucinations and FDG-PET in dementia with Lewy bodies

Cited by 28 publications

References 16 publications

18F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

18F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

Vulnerability of multiple large‐scale brain networks in dementia with Lewy bodies

The psychosis spectrum in Parkinson disease

Contact Info

Product

Resources

About

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies

¹⁸F-FDG PET in Posterior Cortical Atrophy and Dementia with Lewy Bodies