Clinical imaging in dementia with Lewy bodies

Surendranathan, Ajenthan; O’Brien, John

doi:10.1136/eb-2017-102848

Cited by 25 publications

(16 citation statements)

References 52 publications

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“…Furthermore, as pointed out in a recent review [39], the most significant subcortical changes reported in DLB patients in the literature relate to functional rather than structural imaging data. Finally, the comparison between the AD and DLB groups revealed a relative bilateral preservation of the medial temporal lobe structures in the latter, in line with a number of existing data reviewed by Surendranathan [40].…”

Section: Discussionsupporting

confidence: 87%

Changes in gray matter volume and functional connectivity in dementia with Lewy bodies compared to Alzheimer’s disease and normal aging: implications for fluctuations

et al. 2020

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Background: Fluctuations are one of the core clinical features characterizing dementia with Lewy bodies (DLB). They represent a determining factor for its diagnosis and strongly impact the quality of life of patients and their caregivers. However, the neural correlates of this complex symptom remain poorly understood. This study aimed to investigate the structural and functional changes in DLB patients, compared to Alzheimer's disease (AD) patients and healthy elderly subjects, and their potential links with fluctuations. Methods: Structural and resting-state functional MRI data were collected from 92 DLB patients, 70 AD patients, and 22 control subjects, who also underwent a detailed clinical examination including the Mayo Clinic Fluctuation Scale. Gray matter volume changes were analyzed using whole-brain voxel-based morphometry, and resting-state functional connectivity was investigated using a seed-based analysis, with regions of interest corresponding to the main nodes of the salience network (SN), frontoparietal network (FPN), dorsal attention network (DAN), and default mode network (DMN). Results: At the structural level, fluctuation scores in DLB patients did not relate to the atrophy of insular, temporal, and frontal regions typically found in this pathology, but instead showed a weak correlation with more subtle volume reductions in different regions of the cholinergic system. At the functional level, the DLB group was characterized by a decreased connectivity within the SN and attentional networks, while the AD group showed decreases within the SN and DMN. In addition, higher fluctuation scores in DLB patients were correlated to a greater connectivity of the SN with the DAN and left thalamus, along with a decreased connectivity between the SN and DMN, and between the right thalamus and both the FPN and DMN.

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Section: Discussionsupporting

confidence: 87%

Changes in gray matter volume and functional connectivity in dementia with Lewy bodies compared to Alzheimer’s disease and normal aging: implications for fluctuations

et al. 2020

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“…DLB is often misdiagnosed and there is need for reliable neuroimaging markers which can distinguish DLB from other types of dementia . DAT scans remain the best neuroimaging technique to differentiate DLB from AD . An abnormal 123 I‐FP‐CIT SPECT strongly supports the diagnosis of DLB, although around 20% of DLB patients (mixed DLB+AD and pure DLB) can have a normal 123 I‐FP‐CIT SPECT .…”

Section: Methodsmentioning

confidence: 99%

Review: Clinical, neuropathological and genetic features of Lewy body dementias

Hansen

Ling

Lashley

et al. 2019

Neuropathology Appl Neurobio

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2019) Neuropathology and Applied Neurobiology 45, 635-654 Clinical, neuropathological and genetic features of Lewy body dementias Lewy body dementias are the second most common neurodegenerative dementias after Alzheimer's disease and include dementia with Lewy bodies and Parkinson's disease dementia. They share similar clinical and neuropathological features but differ in the time of dementia and parkinsonism onset. Although Lewy bodies are their main pathological hallmark, several studies have shown the emerging importance of Alzheimer's disease pathology. Clinical amyloid-b imaging using Pittsburgh Compound B (PiB) supports neuropathological studies which found that amyloid-b pathology is more common in dementia with Lewy bodies than in Parkinson's disease dementia. Nevertheless, other co-occurring pathologies, such as cerebral amyloid angiopathy, TDP-43 pathology and synaptic pathology may also influence the development of neurodegeneration and dementia. Recent genetic studies demonstrated an important role of APOE genotype and other genes such as GBA and SNCA which seem to be involved in the pathophysiology of Lewy body dementias. The aim of this article is to review the main clinical, neuropathological and genetic aspects of dementia with Lewy bodies and Parkinson's disease dementia. This is particularly relevant as future management for these two conditions may differ.

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“…Occipital hypometabolism on FDG-PET is associated with DLB, 38 and together with relative preservation of posterior cingulate metabolism (the cingulate island sign) e26 is a supportive biomarker of DLB. 2 How frequently the cingulate island sign is seen in prodromal DLB remains to be established; significantly reduced posterior cingulate metabolism may be a useful indication of the concurrence of additional neurofibrillary tangle pathology.…”

Section: Low Occipital Uptake On Perfusion/metabolism Scanmentioning

confidence: 99%

Research criteria for the diagnosis of prodromal dementia with Lewy bodies

et al. 2020

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The prodromal phase of dementia with Lewy bodies (DLB) includes (1) mild cognitive impairment (MCI), (2) delirium-onset, and (3) psychiatric-onset presentations. The purpose of our review is to determine whether there is sufficient information yet available to justify development of diagnostic criteria for each of these. Our goal is to achieve evidence-based recommendations for the recognition of DLB at a predementia, symptomatic stage. We propose operationalized diagnostic criteria for probable and possible mild cognitive impairment with Lewy bodies, which are intended for use in research settings pending validation for use in clinical practice. They are compatible with current criteria for other prodromal neurodegenerative disorders including Alzheimer and Parkinson disease. Although there is still insufficient evidence to propose formal criteria for delirium-onset and psychiatric-onset presentations of DLB, we feel that it is important to characterize them, raising the index of diagnostic suspicion and prioritizing them for further investigation.

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Clinical imaging in dementia with Lewy bodies

Cited by 25 publications

References 52 publications

Changes in gray matter volume and functional connectivity in dementia with Lewy bodies compared to Alzheimer’s disease and normal aging: implications for fluctuations

Changes in gray matter volume and functional connectivity in dementia with Lewy bodies compared to Alzheimer’s disease and normal aging: implications for fluctuations

Review: Clinical, neuropathological and genetic features of Lewy body dementias

Research criteria for the diagnosis of prodromal dementia with Lewy bodies

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