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

Goto, Hideyuki; Ishii, Kazunari; Uemura, Takafumi; Miyamoto, Naokazu; Yoshikawa, Toshiki; Shimada, Kenji; Ohkawa, Shinichi

doi:10.3174/ajnr.a1926

Cited by 34 publications

(26 citation statements)

References 55 publications

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“…Previous work has reported hemodynamic adaptation for group results based on averaged time series (5); however, in the present study results were obtained with all analysis steps and parameter extraction performed at the single-subject level. This may be useful for the study of individual brain physiology in normal versus abnormal aging (29); to measure pharmacological responses to specific drugs; or in conditions of cortical hyperexcitability such as epilepsy (30,31) and primary neurovascular headaches (32), metabolic disorders such as MELAS (33), and vascular disorders such as hypertension and vascular dementia (10,34). To achieve a setup that can eventually be used in individual patients, several issues must be addressed: the brain region to study, acquisition time, compliance of the participants, quality assurance of the data, and the fitting algorithm.…”

Section: Discussionmentioning

confidence: 99%

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Quantifying hemodynamic refractory bold effects in normal subjects at the single‐subject level using an inverse logit fitting procedure

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Vandemaele

Reyngoudt

et al. 2011

Magnetic Resonance Imaging

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Purpose: To evaluate whether hemodynamic refractory effects provoked by repeated visual stimulation can be detected and quantified at the single-subject level using a recently described hemodynamic response function (HRF) fitting algorithm. Materials and Methods:Hemodynamic refractory effects were induced with an easily applicable functional MRI (fMRI) paradigm. A fitting method with inverse logit (IL) functions was applied to quantify net HRFs at the singlesubject level with three interstimulus intervals (ISI; 1, 2, and 6 s). The model yielded amplitude, latencies, and width for each HRF.Results: HRF fitting was possible in 44 of 51 healthy volunteers, with excellent goodness-of-fit (R 2 ¼ 0.9745 6 0.0241). Refractory effects were most pronounced for the 1-s ISI (P < 0.001) and had nearly disappeared for the 6-s ISI.Conclusion: Quantifying refractory effects in individuals was possible in 86.3% of normal subjects using the IL fitting algorithm. This setup may be suitable to explore such effects in individual patients.

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Section: Discussionmentioning

confidence: 99%

“…Studying neural adaptation through refractory effects may also be of interest in certain disease states of the brain including epilepsy (8), headache disorders (9), and vascular dementia (10). To be useful in investigating these diseases, fMRI must provide insight into individual patient data (i.e., at the single-subject level).…”

mentioning

confidence: 99%

Quantifying hemodynamic refractory bold effects in normal subjects at the single‐subject level using an inverse logit fitting procedure

Descamps

Vandemaele

Reyngoudt

et al. 2011

Magnetic Resonance Imaging

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“…Similar approaches have recently been applied also to the differentiation of DLB from other conditions. Goto and colleagues [67] integrated MRI striatal volumetric data with occipital perfusion SPECT to distinguish patients with mild DLB from patients with mild AD with high sensitivity and specificity. Kantarci and colleagues [68] achieved increased accuracy (98%) for distinguishing DLB from AD by combining information from occipital FDG uptake, global Pittsburgh compound B retention, and hippocampal volume.…”

Section: Data Analysesmentioning

confidence: 99%

Neuroimaging characteristics of dementia with Lewy bodies

Mak

Williams³

et al. 2014

Alzheimers Res Ther

101

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This review summarises the findings and applications from neuroimaging studies in dementia with Lewy bodies (DLB), highlighting key differences between DLB and other subtypes of dementia. We also discuss the increasingly important role of imaging biomarkers in differential diagnosis and outline promising areas for future research in DLB. DLB shares common clinical, neuropsychological and pathological features with Parkinson’s disease dementia and other dementia subtypes, such as Alzheimer’s disease. Despite the development of consensus diagnostic criteria, the sensitivity for differential diagnosis of DLB in clinical practice remains low and many DLB patients will be misdiagnosed. The importance of developing accurate imaging markers in dementia is highlighted by the potential for treatments targeting specific molecular abnormalities as well as the responsiveness to cholinesterase inhibitors and marked neuroleptic sensitivity of DLB. We review various brain imaging techniques that have been applied to investigate DLB, including the characteristic nigrostriatal degeneration in DLB using positron emission tomography (PET) and single-photon emission computed tomography (SPECT) tracers. Dopamine transporter loss has proven to reliably differentiate DLB from other dementias and has been incorporated into the revised clinical diagnostic criteria for DLB. To date, this remains the 'gold standard' for diagnostic imaging of DLB. Regional cerebral blood flow, 18 F-fluorodeoxygluclose-PET and SPECT have also identified marked deficits in the occipital regions with relative sparing of the medial temporal lobe when compared to Alzheimer’s disease. In addition, structural, diffusion, and functional magnetic resonance imaging techniques have shown alterations in structure, white matter integrity, and functional activity in DLB. We argue that the multimodal identification of DLB-specific biomarkers has the potential to improve ante-mortem diagnosis and contribute to our understanding of the pathological background of DLB and its progression.

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“…However, other studies also suggested the presence of hypoperfusion in the frontal, parietal, and temporal cortex and in the thalamus (Chang et al, 2008). The differentiation between AD and DLB patients was often investigated by means of this second perfusionbased SPECT approach, in order to identify characteristic features allowing to distinguish between the two most common types of dementias (Colloby et al, 2010a;Colloby et al, 2010b;Goto et al, 2010;Kasama et al, 2005;Kemp et al, 2005;Mito et al, 2005;Shimizu et al, 2008;Tateno et al, 2008a). When compared with AD, DLB patients presented a preserved perfusion in the medial temporal lobe structures and a hypoperfusion in the occipital lobes, besides an increased perfusion in the striatum and thalamus bilaterally.…”

Section: Single Photon Emission Computed Tomography (Spect)mentioning

confidence: 99%

“…Several studies (Hanyu et al, 2006b;Inui et al, 2007;Novellino et al, 2010;Tateno et al, 2008b) which combined SPECT and (1,2,3)I-metaiodobenzylguanidine myocardial (MIBG) scintigraphy reported that the accuracy power in the diagnostic process of DLB resulted increased. Furthermore, Goto and colleagues (Goto et al, 2010) proposed to combine the computation of ratios on perfusion SPECT with MRI volumetric data (hippocampal, occipital, and striatal structures) to discriminate between DLB and AD. They found that the striatal volume and the occipital SPECT ratio in the DLB group was lower than that in the AD group and concluded that the combination of SPECT and MRI might contribute to a successful differential diagnosis of DLB.…”

Section: Single Photon Emission Computed Tomography (Spect)mentioning

confidence: 99%