Cortical Metabolic and Nigrostriatal Abnormalities Associated With Clinical Stage-Specific Dementia With Lewy Bodies

Abstract

The networks yielded from FDG PET and TRODAT-1 revealed good correlation with clinical data and that nigrostriatal pathway abnormalities are preceded by typical occipital hypometabolism in mild stage of DLB. Dopamine transporter levels may serve as early diagnostic tool and FDG PET as staging indicator for DLB pathology.

Early microglial activation and peripheral inflammation in dementia with Lewy bodies

“…Early inflammation of the caudate, which declines with cognitive impairment, implicates a key component of the basal ganglia in the cognitive impairment seen in DLB. Indeed, hypometabolism in the caudate of DLB patients has previously been detected in early disease ( Huang et al , 2015 ). In addition, in a comparison with Parkinson’s disease patients, DLB patients are reported to have a more severe reduction in dopamine uptake within the caudate ( Walker et al , 2004 ; Gomperts et al , 2016 ).…”

Clinical utility of (99mTc)‐TRODAT‐1 scans to differentiate Parkinsonian syndromes: case studies and commentary

“…One study of ( 99m Tc)-TRODAT-1 showed significantly lower uptake in DLB compared to healthy controls, which is in line with evidence from other presynaptic SPECT ligands. 2,18 In Case 3, clinically diagnosed DLB, there was also markedly reduced uptake bilaterally (Fig. 1C).…”

Novel clinicopathological characteristics differentiate dementia with Lewy bodies from Parkinson’s disease dementia

“…Relative preservation of FDG-PET uptake in posterior or mid-cingulate metabolism, is known as the 'cingulate island sign', a useful marker when differentiating DLB from AD [48]. It has also been found that nigrostriatal abnormalities appear to be preceded by occipital hypometabolism in mild DLB [49]. Functional imaging in PDD shows reduced metabolism in the frontal, parietal and occipital regions [1,50].…”