Neuroimaging in Dementia With Lewy Bodies

Abstract

Dementia with Lewy bodies (DLB) is one of the most common forms of dementia. It can present as neurocognitive decline, visual hallucinations, and concomitant symptoms of rapid eye movement (REM) sleep behavior disorder. Early diagnosis remains one of the cornerstones of managing this form of neurocognitive disorder but, often, making an early and accurate diagnosis can prove to be challenging. For this article, our goal was to review the utility of various neuroimaging modalities in making a swift and accurate diagnosis of DLB. We used PubMed to look for helpful, informative, and peer-reviewed articles. We discussed the role of a plethora of different imaging techniques, ranging from structural imaging like computed tomography (CT) and magnetic resonance imaging (MRI) to molecular imaging (single-photon emission computed tomography, positron emission to-tomography) as a diagnostic tool for DLB. We arrived at the conclusion that these novel neuroimaging modalities have already proven to be very helpful in ruling out differentials and making an early diagnosis of DLB. However, ongoing research is required to increase the diagnostic accuracy, leading to the early identification and treatment of DLB.

The Role of 18F-Flortaucipir (AV-1451) in the Diagnosis of Neurodegenerative Disorders

“…Although the tau burden was much lower than AD, the topographical distribution of high tracer retention mimicked that of the AD [23]. The extent of 18F-AV-1451 uptake was also found to correlate well with the clinical severity of cognitive dysfunction as measured by mini-mental state examination (MMSE) [23,24]. Increased parietal 18F-AV-1451 retention has also been recorded in DLB patients and this was linked to the abnormality of executive functions in these patients [25].…”

“Occipital Pole” Sign on 18F-FDG PET for Dementia With Lewy Bodies and Posterior Cortical Atrophy

“…Axial ( A ) and sagittal ( B ) 18 F-FDG PET images of brain of a patient with dementia with Lewy body 7–11 . The picture shows hypometabolism in the lateral occipital cortex (yellow arrowheads).…”

“…Axial (A) and sagittal (B) 18 F-FDG PET images of brain of a patient with dementia with Lewy body. [7][8][9][10][11] The picture shows hypometabolism in the lateral occipital cortex (yellow arrowheads). The preserved uptake in the medial occipital cortex (gold arrowheads) correlates to the primary visual cortex (PVC) and forms the "occipital tunnel" sign 12 on the medial sagittal projection (B) and the "occipital pole" sign on the posterior cortex projection (C).…”