1
|
Kang S, Jeon S, Lee YG, Ye BS. Alteration of medial temporal lobe metabolism related to Alzheimer's disease and dementia with lewy bodies. Alzheimers Res Ther 2024; 16:89. [PMID: 38654300 PMCID: PMC11036684 DOI: 10.1186/s13195-024-01429-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/11/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Association of medial temporal lobe (MTL) metabolism with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) has not been evaluated considering their mixed disease (MD). METHODS 131 patients with AD, 133 with DLB, 122 with MD, and 28 normal controls (NCs) underwent neuropsychological tests, assessments for parkinsonism, cognitive fluctuation (CF), and visual hallucinations (VH), and 18F-fluorodeoxyglucose PET to quantify MTL metabolism in the amygdala, hippocampus, and entorhinal cortex. The effects of AD and DLB on MTL metabolism were evaluated using general linear models (GLMs). Associations between MTL metabolism, cognition, and clinical features were evaluated using GLMs or logistic regression models separately performed for the AD spectrum (NC + AD + MD), DLB spectrum (NC + DLB + MD), and disease groups (AD + DLB + MD). Covariates included age, sex, and education. RESULTS AD was associated with hippocampal/entorhinal hypometabolism, whereas DLB was associated with relative amygdalar/hippocampal hypermetabolism. Relative MTL hypermetabolism was associated with lower attention/visuospatial/executive scores and severe parkinsonism in both the AD and DLB spectra and disease groups. Left hippocampal/entorhinal hypometabolism was associated with lower verbal memory scores, whereas right hippocampal hypometabolism was associated with lower visual memory scores in both the AD spectrum and disease groups. Relative MTL hypermetabolism was associated with an increased risk of CF and VH in the disease group, and relative amygdalar hypermetabolism was associated with an increased risk of VH in the DLB spectrum. CONCLUSIONS Entorhinal-hippocampal hypometabolism and relative amygdala-hippocampal hypermetabolism could be characteristics of AD- and DLB-related neurodegeneration, respectively.
Collapse
Affiliation(s)
- Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Seun Jeon
- Metabolism-Dementia Research Institute , Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Gun Lee
- Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| |
Collapse
|
2
|
Tisserand A, Blanc F, Mondino M, Muller C, Durand H, Demuynck C, Loureiro de Sousa P, Ravier A, Sanna L, Botzung A, Philippi N. Who am I with my Lewy bodies? The insula as a core region of the self-concept networks. Alzheimers Res Ther 2024; 16:85. [PMID: 38641653 PMCID: PMC11027417 DOI: 10.1186/s13195-024-01447-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 04/01/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) is characterized by insular atrophy, which occurs at the early stage of the disease. Damage to the insula has been associated with disorders reflecting impairments of the most fundamental components of the self, such as anosognosia, which is a frequently reported symptom in patients with Lewy bodies (LB). The purpose of this study was to investigate modifications of the self-concept (SC), another component of the self, and to identify neuroanatomical correlates, in prodromal to mild DLB. METHODS Twenty patients with prodromal to mild DLB were selected to participate in this exploratory study along with 20 healthy control subjects matched in terms of age, gender, and level of education. The Twenty Statements Test (TST) was used to assess the SC. Behavioral performances were compared between LB patients and control subjects. Three-dimensional magnetic resonance images (MRI) were acquired for all participants and correlational analyses were performed using voxel-based morphometry (VBM) in whole brain and using a mask for the insula. RESULTS The behavioral results on the TST showed significantly impaired performances in LB patients in comparison with control subjects (p < .0001). Correlational analyses using VBM revealed positive correlations between the TST and grey matter volume within insular cortex, right supplementary motor area, bilateral inferior temporal gyri, right inferior frontal gyrus, and left lingual gyrus, using a threshold of p = .001 uncorrected, including total intracranial volume (TIV), age, and MMSE as nuisance covariates. Additionally, correlational analysis using a mask for the insula revealed positive correlation with grey matter volume within bilateral insular cortex, using a threshold of p = .005. CONCLUSIONS The behavioral results confirm the existence of SC impairments in LB patients from the prodromal stage of the disease, compared to matched healthy controls. As we expected, VBM analyses revealed involvement of the insula, among that of other brain regions, already known to be involved in other self-components. While this study is exploratory, our findings provide important insights regarding the involvement of the insula within the self, confirming the insula as a core region of the self-networks, including for high-order self-representations such as the SC.
Collapse
Affiliation(s)
- Alice Tisserand
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), IMIS team and IRIS platform, Strasbourg, France.
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France.
| | - Frédéric Blanc
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), IMIS team and IRIS platform, Strasbourg, France
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Mary Mondino
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), IMIS team and IRIS platform, Strasbourg, France
| | - Candice Muller
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Hélène Durand
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Catherine Demuynck
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Paulo Loureiro de Sousa
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), IMIS team and IRIS platform, Strasbourg, France
| | - Alix Ravier
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Léa Sanna
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Anne Botzung
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| | - Nathalie Philippi
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), IMIS team and IRIS platform, Strasbourg, France
- University Hospitals of Strasbourg,CM2R (Research and Resources Memory Centre), Geriatric Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Strasbourg, France
| |
Collapse
|
3
|
Singh NA, Goodrich AW, Graff-Radford J, Machulda MM, Sintini I, Carlos AF, Robinson CG, Reid RI, Lowe VJ, Jack CR, Petersen RC, Boeve BF, Josephs KA, Kantarci K, Whitwell JL. Altered structural and functional connectivity in Posterior Cortical Atrophy and Dementia with Lewy bodies. Neuroimage 2024; 290:120564. [PMID: 38442778 PMCID: PMC11019668 DOI: 10.1016/j.neuroimage.2024.120564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/03/2024] [Indexed: 03/07/2024] Open
Abstract
Posterior cortical atrophy (PCA) and dementia with Lewy bodies (DLB) show distinct atrophy and overlapping hypometabolism profiles, but it is unknown how disruptions in structural and functional connectivity compare between these disorders and whether breakdowns in connectivity relate to either atrophy or hypometabolism. Thirty amyloid-positive PCA patients, 24 amyloid-negative DLB patients and 30 amyloid-negative cognitively unimpaired (CU) healthy individuals were recruited at Mayo Clinic, Rochester, MN, and underwent a 3T head MRI, including structural MRI, resting state functional MRI (rsfMRI) and diffusion tensor imaging (DTI) sequences, as well as [18F] fluorodeoxyglucose (FDG) PET. We assessed functional connectivity within and between 12 brain networks using rsfMRI and the CONN functional connectivity toolbox and calculated regional DTI metrics using the Johns Hopkins atlas. Multivariate linear-regression models corrected for multiple comparisons and adjusted for age and sex compared DTI metrics and within-network and between-network functional connectivity across groups. Regional gray-matter volumes and FDG-PET standard uptake value ratios (SUVRs) were calculated and analyzed at the voxel-level using SPM12. We used univariate linear-regression models to investigate the relationship between connectivity measures, gray-matter volume, and FDG-PET SUVR. On DTI, PCA showed degeneration in occipito-parietal white matter, posterior thalamic radiations, splenium of the corpus collosum and sagittal stratum compared to DLB and CU, with greater degeneration in the temporal white matter and the fornix compared to CU. We observed no white-matter degeneration in DLB compared to CU. On rsfMRI, reduced within-network connectivity was present in dorsal and ventral default mode networks (DMN) and the dorsal-attention network in PCA compared to DLB and CU, with reduced within-network connectivity in the visual and sensorimotor networks compared to CU. DLB showed reduced connectivity in the cerebellar network compared to CU. Between-network analysis showed increased connectivity in both cerebellar-to-sensorimotor and cerebellar-to-dorsal attention network connectivity in PCA and DLB. PCA showed reduced anterior DMN-to-cerebellar and dorsal attention-to-sensorimotor connectivity, while DLB showed reduced posterior DMN-to-sensorimotor connectivity compared to CU. PCA showed reduced dorsal DMN-to-visual connectivity compared to DLB. The multimodal analysis revealed weak associations between functional connectivity and volume in PCA, and between functional connectivity and metabolism in DLB. These findings suggest that PCA and DLB have unique connectivity alterations, with PCA showing more widespread disruptions in both structural and functional connectivity; yet some overlap was observed with both disorders showing increased connectivity from the cerebellum.
Collapse
Affiliation(s)
| | - Austin W Goodrich
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | | | - Mary M Machulda
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Irene Sintini
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Arenn F Carlos
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | | | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, United States; Department of Information Technology, Mayo Clinic, Rochester, MN, United States
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | | | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | | |
Collapse
|
4
|
Li Q, Wang J, Cui R, Yuan J. Identifying Mixed Dementia With Lewy Bodies and Alzheimer Disease Using Multitracer PET Imaging: A Case Study. Clin Nucl Med 2024; 49:364-365. [PMID: 38350092 DOI: 10.1097/rlu.0000000000005081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
ABSTRACT We reported imaging findings with complex signs that were corresponded with both dementia with Lewy bodies (DLB) and Alzheimer disease (AD) in the case of a 78-year-old woman. Initially suspected as DLB due to cognitive and movement issues, diagnostic support included the cingulate island sign on 18 F-FDG PET, positive 131 I-MIBG cardiac scintigraphy, and DAT PET. However, MRI indicated hippocampal atrophy, and 18 F-FDG PET showed hypometabolism in the medial temporal lobe, suggesting the possibility of concomitant AD. Subsequent detection of β-amyloid pathology and tau accumulation in the brain further supported the concurrent presence of AD pathology.
Collapse
Affiliation(s)
| | - Junshan Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
5
|
Fernando R, Thomas AJ, Hamilton CA, Durcan R, Barker S, Ciafone J, Barnett N, Olsen K, Firbank M, Roberts G, Lloyd J, Petrides G, Colloby S, Allan LM, McKeith IG, O'Brien JT, Taylor JP, Donaghy PC. Identifying parkinsonism in mild cognitive impairment. J Neurol Sci 2024; 458:122941. [PMID: 38422782 DOI: 10.1016/j.jns.2024.122941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Clinical parkinsonism is a core diagnostic feature for mild cognitive impairment with Lewy bodies (MCI-LB) but can be challenging to identify. A five-item scale derived from the Unified Parkinson's Disease Rating Scale (UPDRS) has been recommended for the assessment of parkinsonism in dementia. This study aimed to determine whether the five-item scale is effective to identify parkinsonism in MCI. METHODS Participants with MCI from two cohorts (n = 146) had a physical examination including the UPDRS and [123I]-FP-CIT SPECT striatal dopaminergic imaging. Participants were classified as having clinical parkinsonism (P+) or no parkinsonism (P-), and with abnormal striatal dopaminergic imaging (D+) or normal imaging (D-). The five-item scale was the sum of UPDRS tremor at rest, bradykinesia, action tremor, facial expression, and rigidity scores. The ability of the scale to differentiate P+D+ and P-D- participants was examined. RESULTS The five-item scale had an AUROC of 0.92 in Cohort 1, but the 7/8 cut-off defined for dementia had low sensitivity to identify P+D+ participants (sensitivity 25%, specificity 100%). Optimal sensitivity and specificity was obtained at a 3/4 cut-off (sensitivity 83%, specificity 88%). In Cohort 2, the five-item scale had an AUROC of 0.97, and the 3/4 cut-off derived from Cohort 1 showed sensitivity of 100% and a specificity of 82% to differentiate P+D+ from P-D- participants. The five-item scale was not effective in differentiating D+ from D- participants. CONCLUSIONS The five-item scale is effective to identify parkinsonism in MCI, but a lower threshold must be used in MCI compared with dementia.
Collapse
Affiliation(s)
- Rishira Fernando
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Alan J Thomas
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Rory Durcan
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Sally Barker
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Joanna Ciafone
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Nicola Barnett
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Kirsty Olsen
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Michael Firbank
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Gemma Roberts
- Translational and Clinical Research Institute, Newcastle University, UK; Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - Jim Lloyd
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - George Petrides
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - Sean Colloby
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Louise M Allan
- Centre for Research in Ageing and Cognitive Health, University of Exeter, UK
| | - Ian G McKeith
- Translational and Clinical Research Institute, Newcastle University, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, UK.
| |
Collapse
|
6
|
Nakata T, Shimada K, Iba A, Oda H, Terashima A, Koide Y, Kawasaki R, Yamada T, Ishii K. Differential diagnosis of MCI with Lewy bodies and MCI due to Alzheimer's disease by visual assessment of occipital hypoperfusion on SPECT images. Jpn J Radiol 2024; 42:308-318. [PMID: 37861956 DOI: 10.1007/s11604-023-01501-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Predicting progression of mild cognitive impairment (MCI) to Alzheimer's disease (AD) or dementia with Lewy bodies (DLB) is important. We evaluated morphological and functional differences between MCI with Lewy bodies (MCI-LB) and MCI due to AD (MCI-AD), and a method for differentiating between these conditions using brain MRI and brain perfusion SPECT. METHODS A continuous series of 101 subjects, who had visited our memory clinic and met the definition of MCI, were enrolled retrospectively. They were consisted of 60 MCI-LB and 41 MCI-AD subjects. Relative cerebral blood flow (rCBF) on SPECT images and relative brain atrophy on MRI images were evaluated. We performed voxel-based analysis and visually inspected brain perfusion SPECT images for regional brain atrophy, occipital hypoperfusion and the cingulate island sign (CIS), for differential diagnosis of MCI-LB and MCI-AD. RESULTS MRI showed no significant differences in regional atrophy between the MCI-LB and MCI-AD groups. In MCI-LB subjects, occipital rCBF was significantly decreased compared with MCI-AD subjects (p < 0.01, family wise error [FWE]-corrected). Visual inspection of occipital hypoperfusion had sensitivity, specificity, and accuracy values of 100%, 73.2% and 89.1%, respectively, for differentiating MCI-LB and MCI-AD. Occipital hypoperfusion was offered higher diagnostic utility than the CIS. CONCLUSIONS The occipital lobe was the region with significantly decreased rCBF in MCI-LB compared with MCI-AD subjects. Occipital hypoperfusion on brain perfusion SPECT may be a more useful imaging biomarker than the CIS for visually differentiating MCI-LB and MCI-AD.
Collapse
Affiliation(s)
- Takashi Nakata
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan.
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan.
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan.
| | - Kenichi Shimada
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
| | - Akiko Iba
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
- Department of Psychiatry, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Hyogo Mental Health Center, 3 Noborio, Kamitanigami, Yamadacho, Kita-Ku, Kobe, Hyogo, Japan
| | - Haruhiko Oda
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
- Hyogo Mental Health Center, 3 Noborio, Kamitanigami, Yamadacho, Kita-Ku, Kobe, Hyogo, Japan
| | - Akira Terashima
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
| | - Yutaka Koide
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| | - Ryota Kawasaki
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| | - Takahiro Yamada
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan
| | - Kazunari Ishii
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| |
Collapse
|
7
|
Oltra J, Habich A, Schwarz CG, Nedelska Z, Przybelski SA, Inguanzo A, Diaz‐Galvan P, Lowe VJ, Oppedal K, Gonzalez MC, Philippi N, Blanc F, Barkhof F, Lemstra AW, Hort J, Padovani A, Rektorova I, Bonanni L, Massa F, Kramberger MG, Taylor J, Snædal JG, Walker Z, Antonini A, Dierks T, Segura B, Junque C, Westman E, Boeve BF, Aarsland D, Kantarci K, Ferreira D. Sex differences in brain atrophy in dementia with Lewy bodies. Alzheimers Dement 2024; 20:1815-1826. [PMID: 38131463 PMCID: PMC10947875 DOI: 10.1002/alz.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/13/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Sex influences neurodegeneration, but it has been poorly investigated in dementia with Lewy bodies (DLB). We investigated sex differences in brain atrophy in DLB using magnetic resonance imaging (MRI). METHODS We included 436 patients from the European-DLB consortium and the Mayo Clinic. Sex differences and sex-by-age interactions were assessed through visual atrophy rating scales (n = 327; 73 ± 8 years, 62% males) and automated estimations of regional gray matter volume and cortical thickness (n = 165; 69 ± 9 years, 72% males). RESULTS We found a higher likelihood of frontal atrophy and smaller volumes in six cortical regions in males and thinner olfactory cortices in females. There were significant sex-by-age interactions in volume (six regions) and cortical thickness (seven regions) across the entire cortex. DISCUSSION We demonstrate that males have more widespread cortical atrophy at younger ages, but differences tend to disappear with increasing age, with males and females converging around the age of 75. HIGHLIGHTS Male DLB patients had higher odds for frontal atrophy on radiological visual rating scales. Male DLB patients displayed a widespread pattern of cortical gray matter alterations on automated methods. Sex differences in gray matter measures in DLB tended to disappear with increasing age.
Collapse
Affiliation(s)
- Javier Oltra
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Annegret Habich
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | | | - Zuzana Nedelska
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | | | - Anna Inguanzo
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Ketil Oppedal
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
| | - Maria C. Gonzalez
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
- Department of Quality and Health TechnologyFaculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Nathalie Philippi
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederic Blanc
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine (AMC)Amsterdam UMC, Vrije UniversiteitAmsterdamthe Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | - Afina W. Lemstra
- Alzheimer Center AmsterdamNeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegeneration, Vrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
| | - Jakub Hort
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Alessandro Padovani
- Neurology UnitDepartment of Clinical and Experimental Sciences (DSCS)University of BresciaBresciaItaly
| | - Irena Rektorova
- Brain and Mind ResearchCentral European Institute of Technology (CEITET)Masaryk UniversityBrnoCzech Republic
| | - Laura Bonanni
- Department of Medicine and Aging Sciences University G. d'Annunzio of Chieti‐Pescara ChietiChietiItaly
| | - Federico Massa
- Department of NeuroscienceRehabilitationOphthalmology, Genetics, Maternal and Child HealthUniversity of GenovaGenovaItaly
| | | | - John‐Paul Taylor
- Translational and Clinical Research InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | | | - Zuzana Walker
- Division of PsychiatryUniversity College LondonLondonUK
- St Margaret's HospitalEssex Partnership University NHS Foundation TrustEssexUK
| | - Angelo Antonini
- Parkinson and Movement Disorders UnitStudy Center on Neurodegeneration (CESNE)PadovaItaly
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | - Barbara Segura
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Carme Junque
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Eric Westman
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Dag Aarsland
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Department of Old Age PsychiatryInstitute of PsychiatryPsychology & Neuroscience (IoPPN)King's College LondonLondonUK
| | | | - Daniel Ferreira
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
- Facultad de Ciencias de la SaludUniversidad Fernando Pessoa CanariasLas PalmasEspaña
| |
Collapse
|
8
|
Stockbauer A, Beyer L, Huber M, Kreuzer A, Palleis C, Katzdobler S, Rauchmann BS, Morbelli S, Chincarini A, Bruffaerts R, Vandenberghe R, Kramberger MG, Trost M, Garibotto V, Nicastro N, Lathuilière A, Lemstra AW, van Berckel BNM, Pilotto A, Padovani A, Ochoa-Figueroa MA, Davidsson A, Camacho V, Peira E, Bauckneht M, Pardini M, Sambuceti G, Aarsland D, Nobili F, Gross M, Vöglein J, Perneczky R, Pogarell O, Buerger K, Franzmeier N, Danek A, Levin J, Höglinger GU, Bartenstein P, Cumming P, Rominger A, Brendel M. Metabolic network alterations as a supportive biomarker in dementia with Lewy bodies with preserved dopamine transmission. Eur J Nucl Med Mol Imaging 2024; 51:1023-1034. [PMID: 37971501 PMCID: PMC10881642 DOI: 10.1007/s00259-023-06493-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Metabolic network analysis of FDG-PET utilizes an index of inter-regional correlation of resting state glucose metabolism and has been proven to provide complementary information regarding the disease process in parkinsonian syndromes. The goals of this study were (i) to evaluate pattern similarities of glucose metabolism and network connectivity in dementia with Lewy bodies (DLB) subjects with subthreshold dopaminergic loss compared to advanced disease stages and to (ii) investigate metabolic network alterations of FDG-PET for discrimination of patients with early DLB from other neurodegenerative disorders (Alzheimer's disease, Parkinson's disease, multiple system atrophy) at individual patient level via principal component analysis (PCA). METHODS FDG-PETs of subjects with probable or possible DLB (n = 22) without significant dopamine deficiency (z-score < 2 in putamen binding loss on DaT-SPECT compared to healthy controls (HC)) were scaled by global-mean, prior to volume-of-interest-based analyses of relative glucose metabolism. Single region metabolic changes and network connectivity changes were compared against HC (n = 23) and against DLB subjects with significant dopamine deficiency (n = 86). PCA was applied to test discrimination of patients with DLB from disease controls (n = 101) at individual patient level. RESULTS Similar patterns of hypo- (parietal- and occipital cortex) and hypermetabolism (basal ganglia, limbic system, motor cortices) were observed in DLB patients with and without significant dopamine deficiency when compared to HC. Metabolic connectivity alterations correlated between DLB patients with and without significant dopamine deficiency (R2 = 0.597, p < 0.01). A PCA trained by DLB patients with dopamine deficiency and HC discriminated DLB patients without significant dopaminergic loss from other neurodegenerative parkinsonian disorders at individual patient level (area-under-the-curve (AUC): 0.912). CONCLUSION Disease-specific patterns of altered glucose metabolism and altered metabolic networks are present in DLB subjects without significant dopaminergic loss. Metabolic network alterations in FDG-PET can act as a supporting biomarker in the subgroup of DLB patients without significant dopaminergic loss at symptoms onset.
Collapse
Affiliation(s)
- Anna Stockbauer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Maria Huber
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Annika Kreuzer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Silvia Morbelli
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Rose Bruffaerts
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Neurology Department, University Hospitals Leuven, Louvain, Belgium
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Neurology Department, University Hospitals Leuven, Louvain, Belgium
| | - Milica G Kramberger
- Department of Neurology and Department for Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia
| | - Maja Trost
- Department of Neurology and Department for Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals and NIMTLab, Geneva University, Geneva, Switzerland
| | - Nicolas Nicastro
- Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Aurélien Lathuilière
- LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario, BG, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Miguel A Ochoa-Figueroa
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Diagnostic Radiology, Linköping University Hospital, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anette Davidsson
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Valle Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrico Peira
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Dag Aarsland
- Centre of Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mattes Gross
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jonathan Vöglein
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, S10 2HQ, UK
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institut for Stroke and Dementia Research, University of Munich, Munich, Germany
| | | | - Adrian Danek
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, University of Bern, Inselspital Bern, Bern, Switzerland
- School of Psychology and Counselling and IHBI, Queensland University of Technology, Brisbane, Australia
| | - Axel Rominger
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, University of Bern, Inselspital Bern, Bern, Switzerland
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
| |
Collapse
|
9
|
Kang S, Jeon S, Lee YG, Ye BS. Dopamine transporter positron emission tomography in patients with Alzheimer's disease with Lewy body disease features. Neurobiol Aging 2024; 134:57-65. [PMID: 37992545 DOI: 10.1016/j.neurobiolaging.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/24/2023]
Abstract
In 36 normal controls (NC), 37 patients with Alzheimer's disease (AD) without parkinsonism (ADP-), 31 AD with parkinsonism (ADP+), and 40 AD with dementia with Lewy bodies (ADDLB), dual-phase dopamine transporter (DAT) positron emission tomography (PET) were performed to evaluate the diagnostic performance of DAT and early-to-delayed uptake ratios (E/Ds) in the anterior caudate (AC), posterior caudate (PC), anterior putamen (AP), posterior putamen (PP), and substantia nigra (SN) to differentiate ADP+/ADDLB from NC, and their effects on parkinsonism and cognition. DAT-SN and E/D-PP showed higher accuracies to differentiate ADP+/ADDLB from NC than DAT-PP. Among AD patients, lower DAT in the putamen and PC and higher E/Ds in the striatum were associated with severe parkinsonism, while higher E/Ds in the putamen, PC, and SN were associated with executive dysfunction. Our results suggest that decreased DAT-SN and increased E/D-PP could be biomarkers differentiating ADP+/ADDLB from pure AD and controls. Meanwhile, increased E/Ds in the putamen could reflect the severity of DLB presenting with parkinsonism and executive dysfunction among AD patients.
Collapse
Affiliation(s)
- Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seun Jeon
- Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
10
|
Chin KS, Churilov L, Doré V, Villemagne VL, Rowe CC, Yassi N, Watson R. Tau in dementia with Lewy bodies. Aust N Z J Psychiatry 2024; 58:175-182. [PMID: 37264610 DOI: 10.1177/00048674231177219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Neurofibrillary tangles are present in a proportion of people with dementia with Lewy bodies and may be associated with worse cognition. Recent advances in biomarkers for Alzheimer's disease include second-generation tau positron emission tomography as well as the detection of phosphorylated tau at threonine 181 (p-tau181) in plasma. This study aimed to investigate tau in people with dementia with Lewy bodies using a second-generation tau positron emission tomography tracer as well as plasma p-tau181. METHODS Twenty-seven participants (mean age 74.7 ± 5.5) with clinically diagnosed probable dementia with Lewy bodies underwent comprehensive clinical assessment and positron emission tomography imaging (18F-MK6240 and 18F-NAV4694). Plasma p-tau181 levels were measured using Simoa technology. RESULTS Five dementia with Lewy bodies participants (18.5%) had an abnormal tau positron emission tomography (increased tau uptake in the temporal meta-region-of-interest). Higher plasma p-tau181 concentrations correlated with higher tau deposition in the temporal region (ρ = 0.46, 95% confidence interval = [0.10, 0.72]) and classified abnormal tau positron emission tomography in dementia with Lewy bodies with an area under the curve of 0.95 (95% confidence interval = [0.86, 0.99]). Plasma p-tau181 also correlated positively with cortical amyloid-beta binding (ρ = 0.68, 95% confidence interval = [0.40, 0.84]) and classified abnormal amyloid-beta positron emission tomography in dementia with Lewy bodies with an area under the curve of 0.91 (95% confidence interval = [0.79, 0.99]). There was no association found between tau deposition and any of the clinical variables. CONCLUSIONS Tau is a common co-pathology in dementia with Lewy bodies. Plasma p-tau181 correlated with abnormal tau and amyloid-beta positron emission tomography and may potentially be used as a marker to identify co-morbid Alzheimer's disease-related pathology in dementia with Lewy bodies. The clinical implications of tau in dementia with Lewy bodies need to be further evaluated in larger longitudinal studies.
Collapse
Affiliation(s)
- Kai Sin Chin
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Leonid Churilov
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC, Australia
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, CSIRO, Clayton South, VIC, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC, Australia
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC, Australia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC, Australia
| | - Nawaf Yassi
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Rosie Watson
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| |
Collapse
|
11
|
Subotic A, Gee M, Nelles K, Ba F, Dadar M, Duchesne S, Sharma B, Masellis M, Black SE, Almeida QJ, Smith EE, Pieruccini-Faria F, Montero-Odasso M, Camicioli R. Gray matter loss relates to dual task gait in Lewy body disorders and aging. J Neurol 2024; 271:962-975. [PMID: 37902878 DOI: 10.1007/s00415-023-12052-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/08/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Within the spectrum of Lewy body disorders (LBD), both Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are characterized by gait and balance disturbances, which become more prominent under dual-task (DT) conditions. The brain substrates underlying DT gait variations, however, remain poorly understood in LBD. OBJECTIVE To investigate the relationship between gray matter volume loss and DT gait variations in LBD. METHODS Seventy-nine participants including cognitively unimpaired PD, PD with mild cognitive impairment, PD with dementia (PDD), or DLB and 20 cognitively unimpaired controls were examined across a multi-site study. PDD and DLB were grouped together for analyses. Differences in gait speed between single and DT conditions were quantified by dual task cost (DTC). Cortical, subcortical, ventricle, and cerebellum brain volumes were obtained using FreeSurfer. Linear regression models were used to examine the relationship between gray matter volumes and DTC. RESULTS Smaller amygdala and total cortical volumes, and larger ventricle volumes were associated with a higher DTC across LBD and cognitively unimpaired controls. No statistically significant interaction between group and brain volumes were found. Adding cognitive and motor covariates or white matter hyperintensity volumes separately to the models did not affect brain volume and DTC associations. CONCLUSION Gray matter volume loss is associated with worse DT gait performance compared to single task gait, across cognitively unimpaired controls through and the LBD spectrum. Impairment in DT gait performance may be driven by age-related cortical neurodegeneration.
Collapse
Affiliation(s)
- Arsenije Subotic
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Myrlene Gee
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Krista Nelles
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Fang Ba
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada
| | - Mahsa Dadar
- Department of Psychiatry, Douglas Mental Health University Health Centre, McGill University, Montreal, QC, Canada
| | - Simon Duchesne
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- CERVO Brain Research Center, Quebec City, QC, Canada
| | - Breni Sharma
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mario Masellis
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Quincy J Almeida
- Movement Disorders Research and Rehabilitation Centre, Carespace Health and Wellness, Waterloo, ON, Canada
| | - Eric E Smith
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Parkwood Institute Lawson Health Research Institute, London, ON, Canada
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute Lawson Health Research Institute, London, ON, Canada
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
- Schulich School of Medicine and Dentistry, Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada.
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
12
|
Firbank MJ, Collerton D, Morgan KD, Schumacher J, Donaghy PC, O'Brien JT, Thomas A, Taylor JP. Functional connectivity in Lewy body disease with visual hallucinations. Eur J Neurol 2024; 31:e16115. [PMID: 37909801 DOI: 10.1111/ene.16115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND PURPOSE Visual hallucinations are a common, potentially distressing experience of people with Lewy body disease (LBD). The underlying brain changes giving rise to visual hallucinations are not fully understood, although previous models have posited that alterations in the connectivity between brain regions involved in attention and visual processing are critical. METHODS Data from 41 people with LBD and visual hallucinations, 48 with LBD without visual hallucinations and 60 similarly aged healthy comparator participants were used. Connections were investigated between regions in the visual cortex and ventral attention, dorsal attention and default mode networks. RESULTS Participants with visual hallucinations had worse cognition and motor function than those without visual hallucinations. In those with visual hallucinations, reduced functional connectivity within the ventral attention network and from the visual to default mode network was found. Connectivity strength between the visual and default mode network correlated with the number of correct responses on a pareidolia task, and connectivity within the ventral attention network with visuospatial performance. CONCLUSIONS Our results add to evidence of dysfunctional connectivity in the visual and attentional networks in those with LBD and visual hallucinations.
Collapse
Affiliation(s)
- Michael J Firbank
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel Collerton
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katrina daSilva Morgan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Julia Schumacher
- Deutsches Zentrum für Neurodegenerative Erkrankungen Standort Rostock/Greifswald, Rostock, Mecklenburg-Vorpommern, Germany
- Department of Neurology, University Medical Center Rostock, Rostock, Germany
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Alan Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
13
|
Okkels N, Horsager J, Fedorova TD, Knudsen K, Skjærbæk C, Andersen KB, Labrador-Espinosa M, Vestergaard K, Mortensen JK, Klit H, Møller M, Danielsen EH, Johnsen EL, Bekan G, Hansen KV, Munk OL, Damholdt MF, Kjeldsen PL, Hansen AK, Gottrup H, Grothe MJ, Borghammer P. Impaired cholinergic integrity of the colon and pancreas in dementia with Lewy bodies. Brain 2024; 147:255-266. [PMID: 37975822 DOI: 10.1093/brain/awad391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/20/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
Dementia with Lewy bodies is characterized by a high burden of autonomic dysfunction and Lewy pathology in peripheral organs and components of the sympathetic and parasympathetic nervous system. Parasympathetic terminals may be quantified with 18F-fluoroetoxybenzovesamicol, a PET tracer that binds to the vesicular acetylcholine transporter in cholinergic presynaptic terminals. Parasympathetic imaging may be useful for diagnostics, improving our understanding of autonomic dysfunction and for clarifying the spatiotemporal relationship of neuronal degeneration in prodromal disease. Therefore, we aimed to investigate the cholinergic parasympathetic integrity in peripheral organs and central autonomic regions of subjects with dementia with Lewy bodies and its association with subjective and objective measures of autonomic dysfunction. We hypothesized that organs with known parasympathetic innervation, especially the pancreas and colon, would have impaired cholinergic integrity. To achieve these aims, we conducted a cross-sectional comparison study including 23 newly diagnosed non-diabetic subjects with dementia with Lewy bodies (74 ± 6 years, 83% male) and 21 elderly control subjects (74 ± 6 years, 67% male). We obtained whole-body images to quantify PET uptake in peripheral organs and brain images to quantify PET uptake in regions of the brainstem and hypothalamus. Autonomic dysfunction was assessed with questionnaires and measurements of orthostatic blood pressure. Subjects with dementia with Lewy bodies displayed reduced cholinergic tracer uptake in the pancreas (32% reduction, P = 0.0003) and colon (19% reduction, P = 0.0048), but not in organs with little or no parasympathetic innervation. Tracer uptake in a region of the medulla oblongata overlapping the dorsal motor nucleus of the vagus correlated with autonomic symptoms (rs = -0.54, P = 0.0077) and changes in orthostatic blood pressure (rs = 0.76, P < 0.0001). Tracer uptake in the pedunculopontine region correlated with autonomic symptoms (rs = -0.52, P = 0.0104) and a measure of non-motor symptoms (rs = -0.47, P = 0.0230). In conclusion, our findings provide the first imaging-based evidence of impaired cholinergic integrity of the pancreas and colon in dementia with Lewy bodies. The observed changes may reflect parasympathetic denervation, implying that this process is initiated well before the point of diagnosis. The findings also support that cholinergic denervation in the brainstem contributes to dysautonomia.
Collapse
Affiliation(s)
- Niels Okkels
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Tatyana D Fedorova
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Casper Skjærbæk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Katrine B Andersen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Miguel Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Janne K Mortensen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Henriette Klit
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Mette Møller
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Erik H Danielsen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Erik L Johnsen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Goran Bekan
- Department of Neurology, Regionshospitalet Gødstrup, 7400 Herning, Denmark
| | - Kim V Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Ole L Munk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Malene F Damholdt
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Pernille L Kjeldsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| |
Collapse
|
14
|
Goodheart AE, Blackstone C. Getting to the heart of Lewy body disease. J Clin Invest 2024; 134:e175798. [PMID: 38165040 PMCID: PMC10760943 DOI: 10.1172/jci175798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Early identification of neurodegenerative diseases before extensive neuronal loss or disabling symptoms have occurred is imperative for effective use of disease-modifying therapies. Emerging data indicate that central Lewy body diseases - Parkinson disease and dementia with Lewy bodies - can begin in the peripheral nervous system, opening up a therapeutic window before central involvement. In this issue of the JCI, Goldstein et al. report that cardiac 18F-dopamine positron emission tomography reveals lower activity selectively in individuals with several self-reported Parkinson disease risk factors who later develop Parkinson disease or dementia with Lewy bodies. Accurately identifying which at-risk individuals will develop central Lewy body disease will optimize early patient selection for disease-modifying therapies.
Collapse
|
15
|
Monvoisin-Joly T, Furcieri E, Chabran E, Mondino M, Loureiro de Sousa P, Botzung A, Frédéric B. Neural basis of writing in prodromal to mild dementia with lewy bodies. Int J Geriatr Psychiatry 2024; 39:e6056. [PMID: 38229210 DOI: 10.1002/gps.6056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVES We have previously demonstrated difficulties in written production in dementia with Lewy bodies (DLB) patients. We now aim to determine the neural correlates of writing production in DLB, combining clinical data and structural MRI measures. METHOD Sixteen prodromal to mild DLB patients were selected to participate in the study. The GREMOTS test was used to assess writing production. Using three-dimensional T1 brain MRI images, correlations between the GREMOTS test and grey matter (GM) volume were performed using voxel-based morphometry (VBM; SPM12, XjView and Matlab R2021b softwares). RESULTS VBM analysis (p < 0.001, uncorrected) revealed a positive and significant correlation between both left anterior insula and left supramarginal gyrus GM volumes and DLB patients' ability to write logatoms using the phonological route. The handwriting deficit was negatively and significantly correlated to the supplementary motor area. The parkinsonism-like characteristics of agraphia were negatively and significantly correlated with both right anterior and right posterior cerebellum GM volumes. Our study also revealed a negative and significant correlation between grammatical spelling impairments and an area of the orbitofrontal gyrus, and a negative and significant correlation between supramarginal gyrus and general slowness in dictation tasks. CONCLUSION Writing disorders in early DLB patients appears to be GM decreases in several brain regions, such as the left anterior insula, the left supramaginal gyrus, as well as two areas of the right cerebellum.
Collapse
Affiliation(s)
- Tiphaine Monvoisin-Joly
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
- Research and Resources Memory Centre (CM2R), Geriatrics Department, Geriatric Day Hospital and Neuropsychology Unit, University Hospitals of Strasbourg, Illkirch, France
- University Training Centre for Speech and Language Therapy (CFUO), Faculty of Medicine, University of Strasbourg, Illkirch, France
| | - Emmanuelle Furcieri
- Research and Resources Memory Centre (CM2R), Geriatrics Department, Geriatric Day Hospital and Neuropsychology Unit, University Hospitals of Strasbourg, Illkirch, France
| | - Elena Chabran
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
- University Training Centre for Speech and Language Therapy (CFUO), Faculty of Medicine, University of Strasbourg, Illkirch, France
| | - Mary Mondino
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
| | - Paulo Loureiro de Sousa
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
| | - Anne Botzung
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
- Research and Resources Memory Centre (CM2R), Geriatrics Department, Geriatric Day Hospital and Neuropsychology Unit, University Hospitals of Strasbourg, Illkirch, France
| | - Blanc Frédéric
- ICube Laboratory UMR 7357 (IMIS Team) and Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg and CNRS, Illkirch, France
- Research and Resources Memory Centre (CM2R), Geriatrics Department, Geriatric Day Hospital and Neuropsychology Unit, University Hospitals of Strasbourg, Illkirch, France
| |
Collapse
|
16
|
Kucikova L, Kalabizadeh H, Motsi KG, Rashid S, O'Brien JT, Taylor JP, Su L. A systematic literature review of fMRI and EEG resting-state functional connectivity in Dementia with Lewy Bodies: Underlying mechanisms, clinical manifestation, and methodological considerations. Ageing Res Rev 2024; 93:102159. [PMID: 38056505 DOI: 10.1016/j.arr.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/14/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Previous studies suggest that there may be important links between functional connectivity, disease mechanisms underpinning the Dementia with Lewy Body (DLB) and the key clinical symptoms, but the exact relationship remains unclear. We performed a systematic literature review to address this gap by summarising the research findings while critically considering the impact of methodological differences on findings. The main methodological choices of fMRI articles included data-driven, seed-based or regions of interest approaches, or their combinations. Most studies focused on examining large-scale resting-state networks, which revealed a consistent decrease in connectivity and some associations with non-cognitive symptoms. Although the inter-network connectivity showed mixed results, the main finding is consistent with theories positing disconnection between visual and attentional areas of the brain implicated in the aetiology of psychotic symptoms in the DLB. The primary methodological choice of EEG studies was implementing the phase lag index and using graph theory. The EEG studies revealed a consistent decrease in connectivity on alpha and beta frequency bands. While the overall trend of findings showed decreased connectivity, more subtle changes in the directionality of connectivity were observed when using a hypothesis-driven approach. Problems with cognition were also linked with greater functional connectivity disturbances. In summary, connectivity measures can capture brain disturbances in the DLB and remain crucial in uncovering the causal relationship between the networks' disorganisation and underlying mechanisms resulting in psychotic, motor, and cognitive symptoms of the DLB.
Collapse
Affiliation(s)
- Ludmila Kucikova
- Neuroscience Institute, University of Sheffield, Sheffield, United Kingdom; Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Hoda Kalabizadeh
- Oxford Machine Learning in NeuroImaging Lab, OMNI, Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | | | - Sidrah Rashid
- Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Li Su
- Neuroscience Institute, University of Sheffield, Sheffield, United Kingdom; Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
| |
Collapse
|
17
|
Asahara Y, Kameyama M, Ishii K, Ishibashi K. Diagnostic performance of the cingulate island sign ratio for differentiating dementia with Lewy bodies from Alzheimer's disease changes depending on the mini-mental state examination score. J Neurol Sci 2023; 455:122782. [PMID: 37976791 DOI: 10.1016/j.jns.2023.122782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The cingulate island sign (CIS) ratio is a diagnostic adjunct for differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). A recent study showed that the CIS ratio in DLB changed depending on the Mini-Mental State Examination (MMSE) score. We aimed to evaluate whether the diagnostic performance (sensitivity and specificity) of the CIS ratio for differentiating DLB from AD changes depending on the MMSE score. METHODS Twenty-two patients with DLB and 26 amyloid-positive patients with AD, who underwent 18F-FDG PET and completed an MMSE examination, were classified into three groups according to MMSE scores: Group A (MMSE >24), Group B (20 ≤ MMSE ≤24), and Group C (MMSE <20). In each group, we compared the CIS ratio between patients with DLB and AD and conducted receiver operating characteristic (ROC) curve analysis to calculate the sensitivity and specificity. RESULTS Within Group B, the CIS ratio in DLB was significantly higher than that in AD (p = 0.0005), but not within Groups A (p = 0.5117) and C (p = 0.8671). ROC curve analyses showed that the sensitivities and specificities of the CIS ratio for differentiating DLB from AD were 66.7% and 77.8% in Group A, 91.7% and 100.0% in Group B, and 75.0% and 66.7% in Group C, respectively. CONCLUSIONS The present study suggests that the diagnostic performance of the CIS ratio for differentiating DLB from AD changes depending on the MMSE score, with higher sensitivity and specificity at MMSE scores of 20-24.
Collapse
Affiliation(s)
- Yuki Asahara
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Department of Neurology, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masashi Kameyama
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kenji Ishibashi
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| |
Collapse
|
18
|
Lenka A, Isonaka R, Holmes C, Goldstein DS. Cardiac 18F-dopamine positron emission tomography predicts the type of phenoconversion of pure autonomic failure. Clin Auton Res 2023; 33:737-747. [PMID: 37843677 DOI: 10.1007/s10286-023-00987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE Pure autonomic failure (PAF) is a rare disease characterized by neurogenic orthostatic hypotension (nOH), no known secondary cause, and lack of a neurodegenerative movement or cognitive disorder. Clinically diagnosed PAF can evolve ("phenoconvert") to a central Lewy body disease [LBD, e.g., Parkinson's disease (PD) or dementia with Lewy bodies (DLB)] or to the non-LBD synucleinopathy multiple system atrophy (MSA). Since cardiac 18F-dopamine-derived radioactivity usually is low in LBDs and usually is normal in MSA, we hypothesized that patients with PAF with low cardiac 18F-dopamine-derived radioactivity would be more likely to phenoconvert to a central LBD than to MSA. METHODS We reviewed data from all the patients seen at the National Institutes of Health Clinical Center from 1994 to 2023 with a clinical diagnosis of PAF and data about 18F-dopamine positron emission tomography (PET). RESULTS Nineteen patients (15 with low 18F-dopamine-derived radioactivity, 4 with normal radioactivity) met the above criteria and had follow-up data. Nine (47%) phenoconverted to a central synucleinopathy over a mean of 6.6 years (range 1.5-18.8 years). All 6 patients with low cardiac 18F-dopamine-derived radioactivity who phenoconverted during follow-up developed a central LBD, whereas none of 4 patients with consistently normal 18F-dopamine PET phenoconverted to a central LBD (p = 0.0048), 3 evolving to probable MSA and 1 upon autopsy having neither a LBD nor MSA. CONCLUSION Cardiac 18F-dopamine PET can predict the type of phenoconversion of PAF. This capability could refine eligibility criteria for entry into disease-modification trials aimed at preventing evolution of PAF to symptomatic central LBDs.
Collapse
Affiliation(s)
- Abhishek Lenka
- Autonomic Medicine Section, National Institute of Neurological, Disorders and Stroke (NINDS), National Institutes of Health (NIH), CNP/DIR/NINDS/NIH, 9000 Rockville Pike MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892, USA
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Risa Isonaka
- Autonomic Medicine Section, National Institute of Neurological, Disorders and Stroke (NINDS), National Institutes of Health (NIH), CNP/DIR/NINDS/NIH, 9000 Rockville Pike MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892, USA
| | - Courtney Holmes
- Autonomic Medicine Section, National Institute of Neurological, Disorders and Stroke (NINDS), National Institutes of Health (NIH), CNP/DIR/NINDS/NIH, 9000 Rockville Pike MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892, USA
| | - David S Goldstein
- Autonomic Medicine Section, National Institute of Neurological, Disorders and Stroke (NINDS), National Institutes of Health (NIH), CNP/DIR/NINDS/NIH, 9000 Rockville Pike MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892, USA.
| |
Collapse
|
19
|
Gan J, Shi Z, Liu S, Li X, Liu Y, Zhu H, Shen L, Zhang G, Lu H, Gang B, Chen Z, Ji Y. White matter hyperintensities in cognitive impairment with Lewy body disease: a multicentre study. Eur J Neurol 2023; 30:3711-3721. [PMID: 37500565 DOI: 10.1111/ene.16002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND PURPOSE White matter hyperintensities (WMHs) are associated with cognitive deficits and worse clinical outcomes in dementia, but rare studies have been carried out of cognitive impairment in Lewy body disease (CI-LB) patients. The objective was to investigate the associations between WMHs and clinical manifestations in patients with CI-LB. METHODS In this retrospective multicentre cohort study, 929 patients (486 with dementia with Lewy bodies [DLB], 262 with Parkinson's disease dementia [PDD], 74 with mild cognitive impairment [MCI] with Lewy bodies [MCI-LB] and 107 with Parkinson's disease with MCI [PD-MCI]) were analysed from 22 memory clinics between January 2018 and June 2022. Demographic and clinical data were collected by reviewing medical records. WMHs were semi-quantified according to the Fazekas method. Associations between WMHs and clinical manifestations were investigated by multivariate linear or logistic regression models. RESULTS Dementia with Lewy bodies patients had the highest Fazekas scores compared with PDD, MCI-LB and PD-MCI. Multivariable regressions showed the Fazekas score was positively associated with the scores of Unified Parkinson's Disease Rating Scale Part III (p = 0.001), Hoehn-Yahn stage (p = 0.004) and total Neuropsychiatric Inventory (p = 0.001) in MCI-LB and PD-MCI patients. In patients with DLB and PDD, Fazekas scores were associated with the absence of rapid eye movement sleep behaviour disorder (p = 0.041) and scores of Unified Parkinson's Disease Rating Scale Part III (p < 0.001), Hoehn-Yahn stage (p < 0.001) and the Montreal Cognitive Assessment (p = 0.014). CONCLUSION White matter hyperintensity burden of DLB was higher than for PDD, MCI-LB and PD-MCI. The greater WMH burden was significantly associated with poorer cognitive performance, worse motor function and more severe neuropsychiatric symptoms in CI-LB.
Collapse
Affiliation(s)
- Jinghuan Gan
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Shuai Liu
- Department of Neurology, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Xudong Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Yiming Liu
- Department of Neurology, Qilu Hospital, Shandong University, Shandong, China
| | - Hongcan Zhu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Hunan, China
| | - Guili Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Hao Lu
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, China
| | - Baozhi Gang
- Department of Neurology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhichao Chen
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yong Ji
- Department of Neurology, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| |
Collapse
|
20
|
Arai K, Sakimoto H, Urata Y, Kariya M, Nakamura T, Ikehata T, Shimojima R, Furue N, Ishizuka T, Sano A, Nakamura M. Aging-Related Catatonia with Reversible Dopamine Transporter Dysfunction in Females with Depressive Symptoms: A Case Series. Am J Geriatr Psychiatry 2023; 31:1200-1205. [PMID: 37328402 DOI: 10.1016/j.jagp.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The authors describe five depressive patients with initially decreased striatal accumulation of dopamine transporter (DAT) single-photon emission computed tomography (SPECT), which improved in parallel with clinical symptoms. METHODS Patients who exhibited decreased striatal accumulation and recovery of DATSPECT were identified among patients with the symptoms of depression. Their clinical and neuroimaging data were reviewed. RESULTS Five patients were identified. All patients were presenile or senile women who presented with catatonia subsequent to symptoms of depression that remitted with treatment. DAT-SPECT showed a decreased striatal accumulation in all patients, which increased after treatment. Two patients had met the diagnostic criteria of probable dementia with Lewy bodies (DLB), but no longer did so after their symptoms improved. CONCLUSIONS Reversible DAT dysfunction observed in this study suggests that reversible impairment of dopaminergic transmission in the striatum partly underlies catatonia. Careful consideration should be given to diagnosing DLB in patients with decreased DAT-SPECT accumulation, especially when catatonia is present.
Collapse
Affiliation(s)
- Kaoru Arai
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hitoshi Sakimoto
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuka Urata
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mai Kariya
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takeshi Nakamura
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Department of Psychiatry (TN, RS, NF), Kagoshima Prefectural Aira Hospital, Kagoshima, Japan
| | - Tatsuki Ikehata
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Department of Psychiatry (TI), Imamura general hospital, Kagoshima, Japan
| | - Rion Shimojima
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Department of Psychiatry (TN, RS, NF), Kagoshima Prefectural Aira Hospital, Kagoshima, Japan
| | - Naomi Furue
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Department of Psychiatry (TN, RS, NF), Kagoshima Prefectural Aira Hospital, Kagoshima, Japan
| | - Takanori Ishizuka
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akira Sano
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Kagoshima University (AS), Kagoshima, Japan
| | - Masayuki Nakamura
- Department of Psychiatry (KA, HS, YU, MK, TN, TI, RS, NF, TI, AS, MN), Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
| |
Collapse
|
21
|
Jellinger KA. Mild cognitive impairment in dementia with Lewy bodies: an update and outlook. J Neural Transm (Vienna) 2023; 130:1491-1508. [PMID: 37418039 DOI: 10.1007/s00702-023-02670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
Dementia with Lewy bodies (DLB), the second most common degenerative neurocognitive disorder after Alzheimer disease (AD), is frequently preceded by a period of mild cognitive impairment (MCI), in which cognitive decline is associated with impairment of executive functions/attention, visuospatial deficits, or other cognitive domains and a variety of noncognitive and neuropsychiatric symptoms, many of which are similar but less severe than in prodromal AD. While 36-38% remain in the MCI state, at least the same will convert to dementia. Biomarkers are slowing of the EEG rhythms, atrophy of hippocampus and nucleus basalis of Meynert, temporoparietal hypoperfusion, signs of degeneration of the nigrostriatal dopaminergic, cholinergic and other neurotransmitter systems, and inflammation. Functional neuroimaging studies revealed disturbed connectivity of frontal and limbic networks associated with attention and cognitive controls, dopaminergic and cholinergic circuits manifested prior to overt brain atrophy. Sparse neuropathological data showed varying Lewy body and AD-related stages associated with atrophy of entorhinal, hippocampal, and mediotemporal cortices. Putative pathomechanisms of MCI are degeneration of limbic, dopaminergic, and cholinergic systems with Lewy pathology affecting specific neuroanatomical pathways associated with progressing AD-related lesions, but many pathobiological mechanisms involved in the development of MCI in LBD remain to be elucidated as a basis for early diagnosis and future adequate treatment modalities to prevent progression of this debilitating disorder.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
| |
Collapse
|
22
|
Woo KA, Kim H, Yoon EJ, Shin JH, Nam H, Jeon B, Kim YK, Lee J. Brain olfactory-related atrophy in isolated rapid eye movement sleep behavior disorder. Ann Clin Transl Neurol 2023; 10:2192-2207. [PMID: 37743764 PMCID: PMC10723229 DOI: 10.1002/acn3.51905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/10/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE To investigate structural and functional connectivity changes in brain olfactory-related structures in a longitudinal prospective cohort of isolated REM sleep behavior disorder (iRBD) and their clinical correlations, longitudinal evolution, and predictive values for phenoconversion to overt synucleinopathies, especially Lewy body diseases. METHODS The cohort included polysomnography-confirmed iRBD patients and controls. Participants underwent baseline assessments including olfactory tests, neuropsychological evaluations, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, 3T brain MRI, and 18 F-FP-CIT PET scans. Voxel-based morphometry (VBM) was performed to identify regions of atrophy in iRBD, and volumes of relevant olfactory-related regions of interest (ROI) were estimated. Subgroups of patients underwent repeated volumetric MRI and resting-state functional MRI (fMRI) scans after four years. RESULTS A total of 51 iRBD patients were included, with 20 of them converting to synucleinopathy (mean time to conversion 3.08 years). Baseline VBM analysis revealed atrophy in the right olfactory cortex and gyrus rectus in iRBD. Subsequent ROI comparisons with controls showed atrophy in the amygdala. These olfactory-related atrophies tended to be associated with worse depression, anxiety, and urinary problems in iRBD. Amygdala 18 F-FP-CIT uptake tended to be reduced in iRBD patients with hyposmia (nonsignificant after multiple comparison correction) and correlated with urinary problems. Resting-state fMRI of 23 patients and 32 controls revealed multiple clusters with aberrant olfactory-related functional connectivity. Hypoconnectivity between the putamen and olfactory cortex was associated with mild parkinsonian signs in iRBD. Longitudinal analysis of volumetric volumetric MRI in 22 iRBD patients demonstrated four-year progression of olfactory-related atrophy. Cox regression analysis revealed that this atrophy significantly predicted phenoconversion. INTERPRETATION Progressive atrophy of central olfactory structures may be a potential indicator of Lewy body disease progression in iRBD.
Collapse
Affiliation(s)
- Kyung Ah Woo
- Department of NeurologySeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
| | - Heejung Kim
- Department of Nuclear MedicineSeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
- Institute of Radiation Medicine, Medical Research CenterSeoul National UniversitySeoulRepublic of Korea
| | - Eun Jin Yoon
- Department of Nuclear MedicineSeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
- Memory Network Medical Research CenterSeoul National UniversitySeoulRepublic of Korea
| | - Jung Hwan Shin
- Department of NeurologySeoul National University Hospital, Seoul National University College of MedicineSeoulRepublic of Korea
| | - Hyunwoo Nam
- Department of NeurologySeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
| | - Beomseok Jeon
- Department of NeurologySeoul National University Hospital, Seoul National University College of MedicineSeoulRepublic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear MedicineSeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
| | - Jee‐Young Lee
- Department of NeurologySeoul Metropolitan Government–Seoul National University Boramae Medical Center, Seoul National University College of MedicineSeoulRepublic of Korea
| |
Collapse
|
23
|
Sako W, Suda A, Taniguchi D, Kamagata K, Shindo A, Ogawa T, Oji Y, Nishikawa N, Hatano T, Aoki S, Hattori N. Midbrain atrophy in pathologically diagnosed Lewy body disease and clinically diagnosed Parkinson's disease. J Neurol Sci 2023; 454:120821. [PMID: 37832378 DOI: 10.1016/j.jns.2023.120821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE Midbrain atrophy is considered specific to progressive supranuclear palsy (PSP) compared with Parkinson's disease (PD). We aimed to determine how often midbrain atrophy is observed in pathologically diagnosed Lewy body disease (LBD) and clinically diagnosed PD and the robustness of midbrain atrophy assessed by the One-Line Method previously developed for the diagnosis of PSP. METHODS We studied two separate cohorts with MRI: the first pathologically diagnosed cohort consisted of patients with LBD (n = 13), PSP (n = 6), multiple system atrophy (MSA, n = 7), and corticobasal degeneration (CBD, n = 2); the second cohort consisted of patients with PD (n = 122). Midbrain length was measured using the One-Line Method and FreeSurfer estimated volumes of the subcortical nuclei. RESULTS The area under the curve of midbrain length differentiating PSP from LBD, MSA, and CBD in a pathologically diagnosed cohort was 0.91. Midbrain length with cut-off values of 10.5 mm and 9.5 mm had a sensitivity of 100% and 67% and a specificity of 68% and 96%, respectively. In the first cohort, 7.7% and 23.0% of patients with LBD showed midbrain lengths <9.5 mm and 10.5 mm, respectively, and in the second cohort, 4.9% and 19.7% showed midbrain lengths <9.5 mm and 10.5 mm, respectively. INTERPRETATION Midbrain length measured using the One-Line Method is helpful in the diagnosis of PSP. Some cases of pathologically diagnosed LBD and clinically diagnosed PD present with midbrain atrophy.
Collapse
Affiliation(s)
- Wataru Sako
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
| | - Akimitsu Suda
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Daisuke Taniguchi
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Atsuhiko Shindo
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Takashi Ogawa
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yutaka Oji
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Noriko Nishikawa
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan; Neurodegenerative Disorders Collaborative laboratory, RIKEN Center for Brain Science, Saitama, Japan.
| |
Collapse
|
24
|
Silva-Rodríguez J, Labrador-Espinosa MA, Moscoso A, Schöll M, Mir P, Grothe MJ. Characteristics of amnestic patients with hypometabolism patterns suggestive of Lewy body pathology. Brain 2023; 146:4520-4531. [PMID: 37284793 PMCID: PMC10629761 DOI: 10.1093/brain/awad194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/27/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
A clinical diagnosis of Alzheimer's disease dementia (ADD) encompasses considerable pathological and clinical heterogeneity. While Alzheimer's disease patients typically show a characteristic temporo-parietal pattern of glucose hypometabolism on 18F-fluorodeoxyglucose (FDG)-PET imaging, previous studies have identified a subset of patients showing a distinct posterior-occipital hypometabolism pattern associated with Lewy body pathology. Here, we aimed to improve the understanding of the clinical relevance of these posterior-occipital FDG-PET patterns in patients with Alzheimer's disease-like amnestic presentations. Our study included 1214 patients with clinical diagnoses of ADD (n = 305) or amnestic mild cognitive impairment (aMCI, n = 909) from the Alzheimer's Disease Neuroimaging Initiative, who had FDG-PET scans available. Individual FDG-PET scans were classified as being suggestive of Alzheimer's (AD-like) or Lewy body (LB-like) pathology by using a logistic regression classifier trained on a separate set of patients with autopsy-confirmed Alzheimer's disease or Lewy body pathology. AD- and LB-like subgroups were compared on amyloid-β and tau-PET, domain-specific cognitive profiles (memory versus executive function performance), as well as the presence of hallucinations and their evolution over follow-up (≈6 years for aMCI, ≈3 years for ADD). Around 12% of the aMCI and ADD patients were classified as LB-like. For both aMCI and ADD patients, the LB-like group showed significantly lower regional tau-PET burden than the AD-like subgroup, but amyloid-β load was only significantly lower in the aMCI LB-like subgroup. LB- and AD-like subgroups did not significantly differ in global cognition (aMCI: d = 0.15, P = 0.16; ADD: d = 0.02, P = 0.90), but LB-like patients exhibited a more dysexecutive cognitive profile relative to the memory deficit (aMCI: d = 0.35, P = 0.01; ADD: d = 0.85 P < 0.001), and had a significantly higher risk of developing hallucinations over follow-up [aMCI: hazard ratio = 1.8, 95% confidence interval = (1.29, 3.04), P = 0.02; ADD: hazard ratio = 2.2, 95% confidence interval = (1.53, 4.06) P = 0.01]. In summary, a sizeable group of clinically diagnosed ADD and aMCI patients exhibit posterior-occipital FDG-PET patterns typically associated with Lewy body pathology, and these also show less abnormal Alzheimer's disease biomarkers as well as specific clinical features typically associated with dementia with Lewy bodies.
Collapse
Affiliation(s)
- Jesús Silva-Rodríguez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Miguel A Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28029 Madrid, Spain
| | - Alexis Moscoso
- Wallenberg Center for Molecular and Translational Medicine and Department of Psychiatry and Neurochemistry, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Michael Schöll
- Wallenberg Center for Molecular and Translational Medicine and Department of Psychiatry and Neurochemistry, University of Gothenburg, 41345 Gothenburg, Sweden
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, WC1ELondon, UK
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28029 Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28029 Madrid, Spain
- Wallenberg Center for Molecular and Translational Medicine and Department of Psychiatry and Neurochemistry, University of Gothenburg, 41345 Gothenburg, Sweden
| | | |
Collapse
|
25
|
Lichter DG, Hershey LA. Proposal to Add FDG-PET as an Outcome Measure for Clinical Trials in Patients With Prodromal Lewy Body Dementia. Neurology 2023; 101:666-667. [PMID: 37400241 PMCID: PMC10585694 DOI: 10.1212/wnl.0000000000207498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/21/2023] [Indexed: 07/05/2023] Open
Affiliation(s)
- David G Lichter
- From the Department of Neurology (D.G.L.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY; and University of Oklahoma Health Sciences Center (retired) (L.A.H.), Oklahoma City.
| | - Linda A Hershey
- From the Department of Neurology (D.G.L.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY; and University of Oklahoma Health Sciences Center (retired) (L.A.H.), Oklahoma City
| |
Collapse
|
26
|
Schumacher J, Ray NJ, Hamilton CA, Bergamino M, Donaghy PC, Firbank M, Watson R, Roberts G, Allan L, Barnett N, O'Brien JT, Thomas AJ, Taylor JP. Free water imaging of the cholinergic system in dementia with Lewy bodies and Alzheimer's disease. Alzheimers Dement 2023; 19:4549-4563. [PMID: 36919460 DOI: 10.1002/alz.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Degeneration of cortical cholinergic projections from the nucleus basalis of Meynert (NBM) is characteristic of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), whereas involvement of cholinergic projections from the pedunculopontine nucleus (PPN) to the thalamus is less clear. METHODS We studied both cholinergic projection systems using a free water-corrected diffusion tensor imaging (DTI) model in the following cases: 46 AD, 48 DLB, 35 mild cognitive impairment (MCI) with AD, 38 MCI with Lewy bodies, and 71 controls. RESULTS Free water in the NBM-cortical pathway was increased in both dementia and MCI groups compared to controls and associated with cognition. Free water along the PPN-thalamus tract was increased only in DLB and related to visual hallucinations. Results were largely replicated in an independent cohort. DISCUSSION While NBM-cortical projections degenerate early in AD and DLB, the thalamic cholinergic input from the PPN appears to be more selectively affected in DLB and might associate with visual hallucinations. HIGHLIGHTS Free water in the NBM-cortical cholinergic pathways is increased in AD and DLB. NBM-cortical pathway integrity is related to overall cognitive performance. Free water in the PPN-thalamus cholinergic pathway is only increased in DLB, not AD. PPN-thalamus pathway integrity might be related to visual hallucinations in DLB.
Collapse
Affiliation(s)
- Julia Schumacher
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
- Department of Neurology, University Medical Center Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
| | - Nicola J Ray
- Health, Psychology and Communities Research Centre, Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Maurizio Bergamino
- Barrow Neurological Institute, Neuroimaging Research, Phoenix, Arizona, USA
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Michael Firbank
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Rosie Watson
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Gemma Roberts
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Louise Allan
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
- University of Exeter Medical School, Exeter, UK
| | - Nicola Barnett
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, UK
| | - Alan J Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| |
Collapse
|
27
|
Chouliaras L, O'Brien JT. The use of neuroimaging techniques in the early and differential diagnosis of dementia. Mol Psychiatry 2023; 28:4084-4097. [PMID: 37608222 PMCID: PMC10827668 DOI: 10.1038/s41380-023-02215-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
Dementia is a leading cause of disability and death worldwide. At present there is no disease modifying treatment for any of the most common types of dementia such as Alzheimer's disease (AD), Vascular dementia, Lewy Body Dementia (LBD) and Frontotemporal dementia (FTD). Early and accurate diagnosis of dementia subtype is critical to improving clinical care and developing better treatments. Structural and molecular imaging has contributed to a better understanding of the pathophysiology of neurodegenerative dementias and is increasingly being adopted into clinical practice for early and accurate diagnosis. In this review we summarise the contribution imaging has made with particular focus on multimodal magnetic resonance imaging (MRI) and positron emission tomography imaging (PET). Structural MRI is widely used in clinical practice and can help exclude reversible causes of memory problems but has relatively low sensitivity for the early and differential diagnosis of dementia subtypes. 18F-fluorodeoxyglucose PET has high sensitivity and specificity for AD and FTD, while PET with ligands for amyloid and tau can improve the differential diagnosis of AD and non-AD dementias, including recognition at prodromal stages. Dopaminergic imaging can assist with the diagnosis of LBD. The lack of a validated tracer for α-synuclein or TAR DNA-binding protein 43 (TDP-43) imaging remain notable gaps, though work is ongoing. Emerging PET tracers such as 11C-UCB-J for synaptic imaging may be sensitive early markers but overall larger longitudinal multi-centre cross diagnostic imaging studies are needed.
Collapse
Affiliation(s)
- Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| |
Collapse
|
28
|
Hansen N, Müller SJ, Khadhraoui E, Ernst M, Riedel CH, Wiltfang J, Lange C, Bouter C. Psychiatric onset of prodromal dementia with Lewy bodies: Current insights into neuroimaging tools. World J Biol Psychiatry 2023; 24:558-563. [PMID: 36919624 DOI: 10.1080/15622975.2023.2191008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Our article is dedicated to describing the state-of-the-art in imaging techniques for assessing prodromal dementia with Lewy bodies (pro-DLB) with a psychiatric-onset. MATERIALS AND METHODS Imaging biomarker techniques are discussed. RESULTS (123)-I-2-ß-carbomethoxy-3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography (123I-FP-CIT SPECT) seems to be a promising method as it reveals abnormalities in pro-DLB with a psychiatric-onset. New potential biomarkers can be revealed via novel techniques, such as manual segmentation in magnetic resonance imaging (MRI), which helps detect atrophy of the substantia innominata in pro-DLB with a psychiatric-onset as opposed to an onset with mild cognitive impairment (MCI). FDG-PET can also help us distinguish patients with mixed pro-DLB from those pro-DLB patients with a psychiatric-onset or MCI-onset. Changes in large-scale networks in the posterior standard mode and in attentional networks could be early signs in resting-state functional MRI to characterise pro-DLB. CONCLUSIONS In conclusion, there is a wide range of techniques that need to be explored in large-scale studies and are of promising value in understanding pro-DLB with a psychiatric-onset.
Collapse
Affiliation(s)
- Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sebastian Johannes Müller
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Eya Khadhraoui
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Marielle Ernst
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Heiner Riedel
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Claudia Lange
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Carolin Bouter
- Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
29
|
Park DG, Kim JY, Kim MS, Kim MH, An YS, Chang J, Yoon JH. Neurofilament light chain and cardiac MIBG uptake as predictors for phenoconversion in isolated REM sleep behavior disorder. J Neurol 2023; 270:4393-4402. [PMID: 37233802 DOI: 10.1007/s00415-023-11785-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Isolated rapid-eye-movement (REM) sleep behavior disorder (iRBD) is considered as a prodromal stage of either multiple system atrophy (MSA) or Lewy body disease (LBD; Parkinson's disease and dementia with Lewy bodies). However, current knowledge is limited in predicting and differentiating the type of future phenoconversion in iRBD patients. We investigated the role of plasma neurofilament light chain (NfL) and cardiac metaiodobenzylguanidine (MIBG) uptake as predictors for phenoconversion. METHODS Forty patients with iRBD were enrolled between April 2018 and October 2019 and prospectively followed every 3 months to determine phenoconversion to either MSA or LBD. Plasma NfL levels were measured at enrollment. Cardiac MIBG uptake and striatal dopamine transporter uptake were assessed at baseline. RESULTS Patients were followed for a median of 2.92 years. Four patients converted to MSA and 7 to LBD. Plasma NfL level at baseline was significantly higher in future MSA-converters (median 23.2 pg/mL) when compared with the rest of the samples (median 14.1 pg/mL, p = 0.003). NfL level above 21.3 pg/mL predicted phenoconversion to MSA with the sensitivity of 100% and specificity of 94.3%. Baseline MIBG heart-to-mediastinum ratio of LBD-converters (median 1.10) was significantly lower when compared with the rest (median 2.00, p < 0.001). Heart-to-mediastinum ratio below 1.545 predicted phenoconversion to LBD with the sensitivity of 100% and specificity of 92.9%. CONCLUSIONS Plasma NfL and cardiac MIBG uptake may be useful biomarkers in predicting phenoconversion of iRBD. Elevated plasma NfL levels may suggest imminent phenoconversion to MSA, whereas low cardiac MIBG uptake suggests phenoconversion to LBD.
Collapse
Affiliation(s)
- Don Gueu Park
- Department of Neurology, Ajou University School of Medicine, 164, Worldcup-Ro, Songjae Hall, Suwon-Si, Gyeonggi-Do, 16499, South Korea
| | - Ju Yeong Kim
- Department of Biomedical Sciences, Ajou University School of Medicine, Suwon-Si, Republic of Korea
| | - Min Seung Kim
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Mi Hee Kim
- Department of Neurology, Ajou University School of Medicine, 164, Worldcup-Ro, Songjae Hall, Suwon-Si, Gyeonggi-Do, 16499, South Korea
| | - Young-Sil An
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon-Si, Republic of Korea
| | - Jaerak Chang
- Department of Biomedical Sciences, Ajou University School of Medicine, Suwon-Si, Republic of Korea.
- Department of Brain Science, Ajou University School of Medicine, 164, Worldcup-Ro, Songjae Hall, Suwon-Si, Gyeonggi-Do, 16499, South Korea.
| | - Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, 164, Worldcup-Ro, Songjae Hall, Suwon-Si, Gyeonggi-Do, 16499, South Korea.
| |
Collapse
|
30
|
Shir D, Pham NTT, Botha H, Koga S, Kouri N, Ali F, Knopman DS, Petersen RC, Boeve BF, Kremers WK, Nguyen AT, Murray ME, Reichard RR, Dickson DW, Graff-Radford N, Josephs KA, Whitwell J, Graff-Radford J. Clinicoradiologic and Neuropathologic Evaluation of Corticobasal Syndrome. Neurology 2023; 101:e289-e299. [PMID: 37268436 PMCID: PMC10382268 DOI: 10.1212/wnl.0000000000207397] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/23/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Corticobasal syndrome (CBS) is a clinical phenotype characterized by asymmetric parkinsonism, rigidity, myoclonus, and apraxia. Originally believed secondary to corticobasal degeneration (CBD), mounting clinicopathologic studies have revealed heterogenous neuropathologies. The objectives of this study were to determine the pathologic heterogeneity of CBS, the clinicoradiologic findings associated with different underlying pathologies causing CBS, and the positive predictive value (PPV) of current diagnostic criteria for CBD among patients with a CBS. METHODS Clinical data, brain MRI, and neuropathologic data of patients followed at Mayo Clinic and diagnosed with CBS antemortem were reviewed according to neuropathology category at autopsy. RESULTS The cohort consisted of 113 patients with CBS, 61 (54%) female patients. Mean ± SD disease duration was 7 ± 3.7 years; mean ± SD age at death was 70.5 ± 9.1 years. The primary neuropathologic diagnoses were 43 (38%) CBD, 27 (24%) progressive supranuclear palsy (PSP), 17 (15%) Alzheimer disease (AD), 10 (9%) frontotemporal lobar degeneration (FTLD) with TAR DNA-binding protein 43 (TDP) inclusions, 7 (6%) diffuse Lewy body disease (DLBD)/AD, and 9 (8%) with other diagnoses. Patients with CBS-AD or CBS-DLBD/AD were youngest at death (median [interquartile range]: 64 [13], 64 [11] years) while CBS-PSP were oldest (77 [12.5] years, p = 0.024). Patients with CBS-DLBD/AD had the longest disease duration (9 [6] years), while CBS-other had the shortest (3 [4.25] years, p = 0.04). Posterior cortical signs and myoclonus were more characteristic of patients with CBS-AD and patients with CBS-DLBD/AD. Patients with CBS-DLBD/AD displayed more features of Lewy body dementia. Voxel-based morphometry revealed widespread cortical gray matter loss characteristic of CBS-AD, while CBS-CBD and CBS-PSP predominantly involved premotor regions with greater amount of white matter loss. Patients with CBS-DLBD/AD showed atrophy in a focal parieto-occipital region, and patients with CBS-FTLD-TDP had predominant prefrontal cortical loss. Patients with CBS-PSP had the lowest midbrain/pons ratio (p = 0.012). Of 67 cases meeting clinical criteria for possible CBD at presentation, 27 were pathology-proven CBD, yielding a PPV of 40%. DISCUSSION A variety of neurodegenerative disorders can be identified in patients with CBS, but clinical and regional imaging differences aid in predicting underlying neuropathology. PPV analysis of the current CBD diagnostic criteria revealed suboptimal performance. Biomarkers adequately sensitive and specific for CBD are needed.
Collapse
Affiliation(s)
- Dror Shir
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Nha Trang Thu Pham
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Hugo Botha
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Shunsuke Koga
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Naomi Kouri
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Farwa Ali
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Brad F Boeve
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Walter K Kremers
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Aivi T Nguyen
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Melissa E Murray
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - R Ross Reichard
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Neill Graff-Radford
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL.
| | - Keith Anthony Josephs
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jennifer Whitwell
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Department of Neurology (D.S., H.B., F.A., D.S.K., R.C.P., B.F.B., K.A.J., J.G.-R.), and Department of Radiology (N.T.T.P., J.W.), Mayo Clinic, Rochester, MN; Department of Neuroscience (S.K., N.K., M.E.M., D.W.D.), Mayo Clinic, Jacksonville, FL; Department of Quantitative Health Sciences (R.C.P., W.K.K.), and Department of Laboratory Medicine and Pathology (A.T.N., R.R.R.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL.
| |
Collapse
|
31
|
Carli G, Meles SK, Reesink FE, de Jong BM, Pilotto A, Padovani A, Galbiati A, Ferini-Strambi L, Leenders KL, Perani D. Comparison of univariate and multivariate analyses for brain [18F]FDG PET data in α-synucleinopathies. Neuroimage Clin 2023; 39:103475. [PMID: 37494757 PMCID: PMC10394024 DOI: 10.1016/j.nicl.2023.103475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/18/2023] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Brain imaging with [18F]FDG-PET can support the diagnostic work-up of patients with α-synucleinopathies. Validated data analysis approaches are necessary to evaluate disease-specific brain metabolism patterns in neurodegenerative disorders. This study compared the univariate Statistical Parametric Mapping (SPM) single-subject procedure and the multivariate Scaled Subprofile Model/Principal Component Analysis (SSM/PCA) in a cohort of patients with α-synucleinopathies. METHODS We included [18F]FDG-PET scans of 122 subjects within the α-synucleinopathy spectrum: Parkinson's Disease (PD) normal cognition on long-term follow-up (PD - low risk to dementia (LDR); n = 28), PD who developed dementia on clinical follow-up (PD - high risk of dementia (HDR); n = 16), Dementia with Lewy Bodies (DLB; n = 67), and Multiple System Atrophy (MSA; n = 11). We also included [18F]FDG-PET scans of isolated REM sleep behaviour disorder (iRBD; n = 51) subjects with a high risk of developing a manifest α-synucleinopathy. Each [18F]FDG-PET scan was compared with 112 healthy controls using SPM procedures. In the SSM/PCA approach, we computed the individual scores of previously identified patterns for PD, DLB, and MSA: PD-related patterns (PDRP), DLBRP, and MSARP. We used ROC curves to compare the diagnostic performances of SPM t-maps (visual rating) and SSM/PCA individual pattern scores in identifying each clinical condition across the spectrum. Specifically, we used the clinical diagnoses ("gold standard") as our reference in ROC curves to evaluate the accuracy of the two methods. Experts in movement disorders and dementia made all the diagnoses according to the current clinical criteria of each disease (PD, DLB and MSA). RESULTS The visual rating of SPM t-maps showed higher performance (AUC: 0.995, specificity: 0.989, sensitivity 1.000) than PDRP z-scores (AUC: 0.818, specificity: 0.734, sensitivity 1.000) in differentiating PD-LDR from other α-synucleinopathies (PD-HDR, DLB and MSA). This result was mainly driven by the ability of SPM t-maps to reveal the limited or absent brain hypometabolism characteristics of PD-LDR. Both SPM t-maps visual rating and SSM/PCA z-scores showed high performance in identifying DLB (DLBRP = AUC: 0.909, specificity: 0.873, sensitivity 0.866; SPM t-maps = AUC: 0.892, specificity: 0.872, sensitivity 0.910) and MSA (MSARP: AUC: 0.921, specificity: 0.811, sensitivity 1.000; SPM t-maps: AUC: 1.000, specificity: 1.000, sensitivity 1.000) from other α-synucleinopathies. PD-HDR and DLB were comparable for the brain hypo and hypermetabolism patterns, thus not allowing differentiation by SPM t-maps or SSM/PCA. Of note, we found a gradual increase of PDRP and DLBRP expression in the continuum from iRBD to PD-HDR and DLB, where the DLB patients had the highest scores. SSM/PCA could differentiate iRBD from DLB, reflecting specifically the differences in disease staging and severity (AUC: 0.938, specificity: 0.821, sensitivity 0.941). CONCLUSIONS SPM-single subject maps and SSM/PCA are both valid methods in supporting diagnosis within the α-synucleinopathy spectrum, with different strengths and pitfalls. The former reveals dysfunctional brain topographies at the individual level with high accuracy for all the specific subtype patterns, and particularly also the normal maps; the latter provides a reliable quantification, independent from the rater experience, particularly in tracking the disease severity and staging. Thus, our findings suggest that differences in data analysis approaches exist and should be considered in clinical settings. However, combining both methods might offer the best diagnostic performance.
Collapse
Affiliation(s)
- Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Fransje E Reesink
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bauke M de Jong
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Galbiati
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neuroscience, Sleep Disorders Center, San Raffaele Hospital, Milan, Italy
| | - Luigi Ferini-Strambi
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neuroscience, Sleep Disorders Center, San Raffaele Hospital, Milan, Italy
| | - Klaus L Leenders
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Daniela Perani
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy.
| |
Collapse
|
32
|
Kunz D, Stotz S, de Zeeuw J, Papakonstantinou A, Dümchen S, Haberecht M, Plotkin M, Bes F. Prognostic biomarkers in prodromal α-synucleinopathies: DAT binding and REM sleep without atonia. J Neurol Neurosurg Psychiatry 2023; 94:532-540. [PMID: 36725328 PMCID: PMC10314035 DOI: 10.1136/jnnp-2022-330048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) is a prodromal state of clinical α-synucleinopathies such as Parkinson's disease and Lewy body dementia. The lead-time until conversion is unknown. The most reliable marker of progression is reduced striatal dopamine transporter (DAT) binding, but low availability of imaging facilities limits general use. Our prospective observational study aimed to relate metrics of REM sleep without atonia (RWA)-a hallmark of RBD-to DAT-binding ratios in a large, homogeneous sample of patients with RBD to explore the utility of RWA as a marker of progression in prodromal α-synucleinopathies. METHODS DAT single-photon emission CT (SPECT) and video polysomnography (vPSG) were performed in 221 consecutive patients with clinically suspected RBD. RESULTS vPSG confirmed RBD in 176 patients (162 iRBD, 14 phenoconverted, 45 non-synucleinopathies). Specific DAT-binding ratios differed significantly between groups, but showed considerable overlap. Most RWA metrics correlated significantly with DAT-SPECT ratios (eg, Montreal tonic vs most-affected-region: r=-0.525; p<0.001). In patients taking serotonergic/noradrenergic antidepressants or dopaminergic substances or with recent alcohol abuse, correlations were weaker, suggesting a confounding influence, unlike other possible confounders such as beta-blocker use or comorbid sleep apnoea. CONCLUSIONS In this large single-centre prospective observational study, we found evidence that DAT-binding ratios in patients with iRBD can be used to describe a continuum in the neurodegenerative process. Overlap with non-synucleinopathies and clinical α-synucleinopathies, however, precludes the use of DAT-binding ratios as a precise diagnostic marker. The parallel course of RWA metrics and DAT-binding ratios suggests in addition to existing data that RWA, part of the routine diagnostic workup in these patients, may represent a marker of progression. Based on our findings, we suggest ranges of RWA values to estimate whether patients are in an early, medium or advanced state within the prodromal phase of α-synucleinopathies, providing them with important information about time until possible conversion.
Collapse
Affiliation(s)
- Dieter Kunz
- Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Sophia Stotz
- Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Jan de Zeeuw
- Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Alexandra Papakonstantinou
- Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Susanne Dümchen
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Martin Haberecht
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Michail Plotkin
- Institute of Nuclear Medicine, Vivantes Hospitals, Berlin, Germany
| | - Frederik Bes
- Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinic for Sleep- & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| |
Collapse
|
33
|
Donaghy PC, Carrarini C, Ferreira D, Habich A, Aarsland D, Babiloni C, Bayram E, Kane JP, Lewis SJ, Pilotto A, Thomas AJ, Bonanni L. Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis. Alzheimers Dement 2023; 19:3186-3202. [PMID: 37096339 PMCID: PMC10695683 DOI: 10.1002/alz.13105] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Operationalized research criteria for mild cognitive impairment with Lewy bodies (MCI-LB) were published in 2020. The aim of this systematic review and meta-analysis was to review the evidence for the diagnostic clinical features and biomarkers in MCI-LB set out in the criteria. METHODS MEDLINE, PubMed, and Embase were searched on 9/28/22 for relevant articles. Articles were included if they presented original data reporting the rates of diagnostic features in MCI-LB. RESULTS Fifty-seven articles were included. The meta-analysis supported the inclusion of the current clinical features in the diagnostic criteria. Evidence for striatal dopaminergic imaging and meta-iodobenzylguanidine cardiac scintigraphy, though limited, supports their inclusion. Quantitative electroencephalogram (EEG) and fluorodeoxyglucose positron emission tomography (PET) show promise as diagnostic biomarkers. DISCUSSION The available evidence largely supports the current diagnostic criteria for MCI-LB. Further evidence will help refine the diagnostic criteria and understand how best to apply them in clinical practice and research. HIGHLIGHTS A meta-analysis of the diagnostic features of MCI-LB was carried out. The four core clinical features were more common in MCI-LB than MCI-AD/stable MCI. Neuropsychiatric and autonomic features were also more common in MCI-LB. More evidence is needed for the proposed biomarkers. FDG-PET and quantitative EEG show promise as diagnostic biomarkers in MCI-LB.
Collapse
Affiliation(s)
- Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claudia Carrarini
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- IRCCS San Raffaele Pisana, Rome, Italy
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele of Cassino, Cassino, Italy
| | - Ece Bayram
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, California, USA
| | - Joseph Pm Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Simon Jg Lewis
- Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, Australia
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Alan J Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
34
|
刘 玮, 姚 喜, 欧 晓. [The clinical value of 123I-metaiodobenzylguanidine myocardial imaging in the diagnosis of dementia with Lewy bodies]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2023; 40:595-601. [PMID: 37380402 PMCID: PMC10307608 DOI: 10.7507/1001-5515.202204082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 03/21/2023] [Indexed: 06/30/2023]
Abstract
Metaiodobenzylguanidine (MIBG) is an analog of norepinephrine that accumulates in sympathetic nerve endings soon after intravenous administration. The degree of accumulation reflects the uptake, storage and release of transmitters by noradrenergic neurons. Myocardial imaging with 123I labeled MIBG ( 123I-MIBG) can be used to estimate the extent of local myocardial sympathetic nerve damage, which has been widely used in the diagnosis and treatment of various heart diseases. In recent years, numerous studies have been carried out on the application of 123I-MIBG in the diagnosis of degenerative diseases of the nervous system (such as Parkinson's disease and dementia of Lewy body), and have made some achievements. The purpose of this review is to summarize the current clinical application of 123I-MIBG myocardial imaging in the diagnosis of dementia with Lewy bodies, the problems in imaging technology and the possible research directions in the future, so as to provide valuable reference information for clinicians to reasonably and accurately apply this technology in the early diagnosis and discrimination of dementia.
Collapse
Affiliation(s)
- 玮婷 刘
- 四川大学华西医院 核医学科(成都 610041)Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 喜兰 姚
- 四川大学华西医院 核医学科(成都 610041)Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 晓红 欧
- 四川大学华西医院 核医学科(成都 610041)Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| |
Collapse
|
35
|
Boccalini C, Nicastro N, Peretti DE, Caminiti SP, Perani D, Garibotto V. Sex differences in dementia with Lewy bodies: an imaging study of neurotransmission pathways. Eur J Nucl Med Mol Imaging 2023; 50:2036-2046. [PMID: 36826477 PMCID: PMC10199852 DOI: 10.1007/s00259-023-06132-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/29/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Dementia with Lewy bodies (DLB) is characterized by a wide clinical and biological heterogeneity, with sex differences reported in both clinical and pathologically confirmed DLB cohorts. No research evidence is available on sex differences regarding molecular neurotransmission. This study aimed to assess whether sex can influence neurotransmitter systems in patients with probable DLB (pDLB). METHODS We included 123 pDLB patients (male/female: 77/46) and 78 control subjects (male/female: 34/44) for comparison, who underwent 123I-FP-CIT SPECT imaging. We assessed sex differences in the dopaminergic activity of the nigrostriatal and mesolimbic systems using regional-based and voxel-wise analyses of 123I-FP-CIT binding. We tested whether sex-specific binding alterations would also pertain to the serotoninergic and noradrenergic systems by applying spatial correlation analyses. We applied molecular connectivity analyses to assess potential sex differences in the dopaminergic pathways. RESULTS We found comparable 123I-FP-CIT binding decreases in the striatum for pDLB males and females compared to controls. However, pDLB females showed lower binding in the extrastriatal projections of the nigrostriatal and mesolimbic dopaminergic systems compared to pDLB males. According to the spatial correlation analysis, sex-specific molecular alterations were also associated with serotonergic and noradrenergic systems. Nigrostriatal and mesolimbic systems' connectivity was impaired in both groups, with males showing local alterations and females presenting long-distance disconnections between subcortical and cortical regions. CONCLUSIONS Sex-specific differences in 123I-FP-CIT binding were found in our cohort, namely, a trend for lower 123I-FP-CIT binding in females, significant in the presence of a pDLB diagnosis. pDLB females showed also different patterns of connectivity compared to males, mostly involving extrastriatal regions. The results suggest the presence of a sex-related regional vulnerability to alpha-synuclein pathology, possibly complicated also by the higher prevalence of Alzheimer's disease co-pathology in females, as previously reported in pDLB populations.
Collapse
Affiliation(s)
- Cecilia Boccalini
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Nicastro
- Division of Neurorehabilitation, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Debora Elisa Peretti
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland.
- CIBM Center for Biomedical Imaging, Geneva, Switzerland.
| |
Collapse
|
36
|
Jreige M, Kurian GK, Perriraz J, Potheegadoo J, Bernasconi F, Stampacchia S, Blanke O, Alessandra G, Lejay N, Chiabotti PS, Rouaud O, Nicod Lalonde M, Schaefer N, Treglia G, Allali G, Prior JO. The diagnostic performance of functional dopaminergic scintigraphic imaging in the diagnosis of dementia with Lewy bodies: an updated systematic review. Eur J Nucl Med Mol Imaging 2023; 50:1988-2035. [PMID: 36920494 PMCID: PMC10199865 DOI: 10.1007/s00259-023-06154-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/13/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Dopaminergic scintigraphic imaging is a cornerstone to support the diagnosis in dementia with Lewy bodies. To clarify the current state of knowledge on this imaging modality and its impact on clinical diagnosis, we performed an updated systematic review of the literature. METHODS This systematic review was carried out according to PRISMA guidelines. A comprehensive computer literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases for studies published through June 2022 was performed using the following search algorithm: (a) "Lewy body" [TI] OR "Lewy bodies" [TI] and (b) ("DaTscan" OR "ioflupane" OR "123ip" OR "123?ip" OR "123 ip" OR "123i-FP-CIT" OR "FPCIT" OR "FP-CIT" OR "beta?CIT" OR "beta CIT" OR "CIT?SPECT" OR "CIT SPECT" OR "Dat?scan*" OR "dat scan*" OR "dat?spect*" OR "SPECT"). Risk of bias and applicability concerns of the studies were evaluated using the QUADAS-2 tool. RESULTS We performed a qualitative analysis of 59 studies. Of the 59 studies, 19 (32%) addressed the diagnostic performance of dopamine transporter imaging, 15 (25%) assessed the identification of dementia with Lewy bodies in the spectrum of Lewy body disease and 18 (31%) investigated the role of functional dopaminergic imaging in distinguishing dementia with Lewy bodies from other dementias. Dopamine transporter loss was correlated with clinical outcomes in 19 studies (32%) and with other functional imaging modalities in 15 studies (25%). Heterogeneous technical aspects were found among the studies through the use of various radioligands, the more prevalent being the [123I]N‑ω‑fluoropropyl‑2β‑carbomethoxy‑3β‑(4‑iodophenyl) nortropane (123I-FP-CIT) in 54 studies (91.5%). Image analysis used visual analysis (9 studies, 15%), semi-quantitative analysis (29 studies, 49%), or a combination of both (16 studies, 27%). CONCLUSION Our systematic review confirms the major role of dopaminergic scintigraphic imaging in the assessment of dementia with Lewy bodies. Early diagnosis could be facilitated by identifying the prodromes of dementia with Lewy bodies using dopaminergic scintigraphic imaging coupled with emphasis on clinical neuropsychiatric symptoms. Most published studies use a semi-quantitative analytical assessment of tracer uptake, while there are no studies using quantitative analytical methods to measure dopamine transporter loss. The superiority of a purely quantitative approach to assess dopaminergic transmission more accurately needs to be further clarified.
Collapse
Affiliation(s)
- Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - George K Kurian
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Jérémy Perriraz
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Sara Stampacchia
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Griffa Alessandra
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Noemie Lejay
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Paolo Salvioni Chiabotti
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Rouaud
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Giorgio Treglia
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Gilles Allali
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
| |
Collapse
|
37
|
Ge J, Lin H, Chen K, Wang M, He Z, Lu J, Ju Z, Sun Y, Liu F, Guan Y, Zhao Q, Zuo C, Wu P. Optimized Cingulate Island Sign in Discriminating Dementia With Lewy Bodies From Alzheimer Disease. Clin Nucl Med 2023; 48:400-403. [PMID: 36947853 PMCID: PMC10082053 DOI: 10.1097/rlu.0000000000004627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/30/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE This study aimed to optimize the analysis of cingulate island sign (CIS) to improve its diagnostic accuracy in discriminating dementia with Lewy bodies (DLB) from Alzheimer disease (AD). PATIENTS AND METHODS Patients with DLB (n = 80), AD (n = 75), and normal controls (n = 22) with 18 F-FDG PET imaging were enrolled in this study. Sixty-two DLB patients also underwent dopaminergic PET scans. The optimized/conventional CIS ratios and metabolism in associated brain regions were evaluated by diagnostic accuracy among groups and correlation with cognitive/dopaminergic dysfunction. RESULTS In discriminating DLB from AD, the optimized CIS ratio calculated by dorsal posterior cingulate cortex (PCC)/lateral occipital lobe metabolism achieved the highest specificity, sensitivity, and accuracy at 0.907, 0.750, and 0.825, respectively. The metabolism of dorsal-PCC positively correlated with cognitive impairment in DLB patients cross-sectionally and longitudinally ( P < 0.001, r = 0.601; P = 0.044, r = 0.645), and also correlated with dopaminergic impairment in the caudate ( P = 0.048, r = 0.315). CONCLUSIONS Optimized CIS ratios of incorporated metabolic activity of dorsal-PCC and occipital subregions are clinically useful for differentiating DLB from AD, in which dorsal-PCC metabolism may provide an objective biomarker to reflect the severity of cognitive impairment in DLB.
Collapse
Affiliation(s)
- Jingjie Ge
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Huamei Lin
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Keliang Chen
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University
| | - Min Wang
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University
| | - Zhijie He
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
- Department of Rehabilitation Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaying Lu
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Zizhao Ju
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Yimin Sun
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University
| | - Fengtao Liu
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University
| | - Yihui Guan
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Qianhua Zhao
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University
| | - Chuantao Zuo
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| | - Ping Wu
- From the Department of Nuclear Medicine/PET Center
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine
| |
Collapse
|
38
|
Ferreira D, Przybelski SA, Lesnick TG, Schwarz CG, Diaz-Galvan P, Graff-Radford J, Senjem ML, Fields JA, Knopman DS, Jones DT, Savica R, Ferman TJ, Graff-Radford N, Lowe VJ, Jack CR, Petersen RC, Westman E, Boeve BF, Kantarci K. Cross-sectional Associations of β-Amyloid, Tau, and Cerebrovascular Biomarkers With Neurodegeneration in Probable Dementia With Lewy Bodies. Neurology 2023; 100:e846-e859. [PMID: 36443011 PMCID: PMC9984215 DOI: 10.1212/wnl.0000000000201579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although alpha-synuclein-related pathology is the hallmark of dementia with Lewy bodies (DLB), cerebrovascular and Alzheimer disease pathologies are common in patients with DLB. Little is known about the contribution of these pathologies to neurodegeneration in DLB. We investigated associations of cerebrovascular, β-amyloid, and tau biomarkers with gray matter (GM) volume in patients with probable DLB. METHODS We assessed patients with probable DLB and cognitively unimpaired (CU) controls with 11C-Pittsburgh compound B (PiB) and 18F-flortaucipir PET as markers of β-amyloid and tau, respectively. MRI was used to assess white matter hyperintensity (WMH) volume (a marker of cerebrovascular lesion load) and regional GM volume (a marker of neurodegeneration). We used correlations and analysis of covariance (ANCOVA) in the entire cohort and structural equation models (SEMs) in patients with DLB to investigate associations of WMH volume and regional β-amyloid and tau PET standardized uptake value ratios (SUVrs) with regional GM volume. RESULTS We included 30 patients with DLB (69.3 ± 10.2 years, 87% men) and 100 CU controls balanced on age and sex. Compared with CU controls, patients with DLB showed a lower GM volume across all cortical and subcortical regions except for the cuneus, putamen, and pallidum. A larger WMH volume was associated with a lower volume in the medial and orbital frontal cortices, insula, fusiform cortex, and thalamus in patients with DLB. A higher PiB SUVr was associated with a lower volume in the inferior temporal cortex, while flortaucipir SUVr did not correlate with GM volume. SEMs showed that a higher age and absence of the APOE ε4 allele were significant predictors of higher WMH volume, and WMH volume in turn was a significant predictor of GM volume in medial and orbital frontal cortices, insula, and inferior temporal cortex. By contrast, we observed 2 distinct paths for the fusiform cortex, with age having an effect through PiB and flortaucipir SUVr on one path and through WMH volume on the other path. DISCUSSION Patients with probable DLB have widespread cortical atrophy, most of which is likely influenced by alpha-synuclein-related pathology. Although cerebrovascular, β-amyloid, and tau pathologies often coexist in probable DLB, their contributions to neurodegeneration seem to be region specific.
Collapse
Affiliation(s)
- Daniel Ferreira
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Scott A Przybelski
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Timothy G Lesnick
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Christopher G Schwarz
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Patricia Diaz-Galvan
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jonathan Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Matthew L Senjem
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Julie A Fields
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David S Knopman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David T Jones
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Rodolfo Savica
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Tanis J Ferman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Neill Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Val J Lowe
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Clifford R Jack
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ronald C Petersen
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Eric Westman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Brad F Boeve
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Kejal Kantarci
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| |
Collapse
|
39
|
Sevenich M, Honold D, Willuweit A, Kutzsche J, Mohrlüder J, Willbold D. Development of an α-synuclein fibril and oligomer specific tracer for diagnosis of Parkinson's disease, dementia with Lewy bodies and multiple system atrophy. Neurochem Int 2022; 161:105422. [PMID: 36252819 DOI: 10.1016/j.neuint.2022.105422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/26/2022] [Accepted: 10/02/2022] [Indexed: 11/08/2022]
Abstract
The development of specific disease-associated PET tracers is one of the major challenges, the realization of which in neurodegenerative diseases would enable not only the efficiency of diagnosis but also support the development of disease-modifying therapeutics. Parkinson's disease (PD) is the most common neurodegenerative movement disorder and is characterized by neuronal fibrillary inclusions composed of aggregated α-synuclein (α-syn). However, these deposits are not only found in PD, but also in other related diseases such as multiple system atrophy (MSA) and dementia with Lewy bodies (DLB), which are grouped under the term synucleinopathies. In this study, we used NGS-guided phage display selection to identify short peptides that bind aggregated α-syn. By surface plasmon resonance (SPR)-based affinity screening, we identified the peptide SVLfib-5 that recognizes aggregated α-syn with high complex stability and sequence specificity. Further analysis SPR showed that SVLfib-5 is not only specific for aggregated α-syn, but in particular recognizes fibrillary and oligomeric structures. Moreover, fluorescence microscopy of human brain tissue sections from PD, MSA, and DLB patients with SVLfib-5 allowed specific recognition of α-syn and a clear discrimination between diseased and non-diseased samples. These findings provide the basis for the further development of an α-syn PET tracer for early diagnosis and monitoring of disease progression and therapy progress.
Collapse
Affiliation(s)
- Marc Sevenich
- Priavoid GmbH, Düsseldorf, Germany; Institute of Biological Information Processing (IBI-7), Forschungszsentrum Jülich, Jülich, Germany
| | - Dominik Honold
- Institute of Biological Information Processing (IBI-7), Forschungszsentrum Jülich, Jülich, Germany
| | - Antje Willuweit
- Priavoid GmbH, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich, Jülich, Germany
| | - Janine Kutzsche
- Institute of Biological Information Processing (IBI-7), Forschungszsentrum Jülich, Jülich, Germany
| | - Jeannine Mohrlüder
- Institute of Biological Information Processing (IBI-7), Forschungszsentrum Jülich, Jülich, Germany
| | - Dieter Willbold
- Institute of Biological Information Processing (IBI-7), Forschungszsentrum Jülich, Jülich, Germany; Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; JuStruct, Forschungszentrum Jülich, Jülich, Germany.
| |
Collapse
|
40
|
Urso D, Gnoni V, De Blasi R, Anastasia A, Aarsland D, Chaudhuri Ray K, Logroscino G. Neuroimaging Biomarkers in a Patient With Probable Psychiatric-Onset Prodromal Dementia With Lewy Bodies. Neurology 2022; 99:654-657. [PMID: 35953291 DOI: 10.1212/wnl.0000000000201166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Psychiatric-onset prodromal dementia with Lewy bodies (DLBs) is a recently proposed clinical entity characterized by psychiatric presentation that may predate clinical dementia by many years. It is not yet clear how to identify patients with prominent late-onset psychiatric symptoms who may have underlying Lewy body disease. In this article, we describe how neuroimaging can assist in the identification of this condition. METHODS A 77-year-old man presented with late-onset psychosis. He underwent an extensive clinical and neuropsychological evaluation. These included brain MRI with arterial spin labeling (ASL) which quantifies perfusion. [123I] FP-CIT SPECT and I-metaiodobenzylguanidine scintigraphy assessed striatal dopaminergic and cardiac adrenergic integrity, respectively. RESULTS Clinical evaluation revealed a history of REM sleep behavior disorder and parkinsonism induced by antipsychotics. The patient's cognitive function was normal. Conventional MRI showed parieto-occipital atrophy, and posterior hypoperfusion was revealed by ASL-MRI. Of note, the "cingulate island sign" was present. [123I]FP-CIT SPECT and I-metaiodobenzylguanidine endorsed the suspicion of α-synucleinopathy. The patient fulfils the recently proposed key features of psychiatric-onset prodromal DLB. DISCUSSION Prodromal DLB is an emerging concept. Biomarkers have not been yet established. We propose that nuclear imaging and advanced MRI technics showing posterior hypoperfusion and the presence of the "cingulate island sign" could be promising biomarker candidates.
Collapse
Affiliation(s)
- Daniele Urso
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Valentina Gnoni
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Roberto De Blasi
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Antonio Anastasia
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Dag Aarsland
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Kallo Chaudhuri Ray
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Giancarlo Logroscino
- From the Center for Neurodegenerative Diseases and the Aging Brain (D.U., V.G., G.L.), Department of Clinical Research in Neurology, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy; Department of Neurosciences (D.U., V.G., D.A., K.R.C.), King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, United Kingdom; Department of Diagnostic Imaging (R.D.B., A.A.), Pia Fondazione di Culto e Religione "Card. G. Panico", Tricase, Italy; and Department of Basic Medicine (G.L.), Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
| |
Collapse
|
41
|
Gallucci M, Fiore V, Grassivaro F, Da Ronch C, Bonanni L. "Occipital Pole" Sign on 18 F-FDG PET for Dementia With Lewy Bodies and Posterior Cortical Atrophy : Evidence From the Treviso Dementia (TREDEM) Registry. Clin Nucl Med 2022; 47:811-812. [PMID: 35473924 DOI: 10.1097/rlu.0000000000004136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ABSTRACT The 18 F-FDG PET images of dementia with Lewy bodies and posterior cortical atrophy, a visual-cognitive phenotype described in patients with Alzheimer disease, show occipital lobe hypometabolism with relative sparing of the primary visual cortex (PVC) generating the "occipital tunnel" sign proposed by Sawyer and Kuo in 2017, which is viewable on the medial sagittal projection. We believe that the saving of PVC compared with the lateral occipital cortex can be better appreciated by capturing the posterior projection of the PVC in a 3D stereotactic surface projection map, and we propose the name of "occipital pole" sign for this evidence.
Collapse
Affiliation(s)
| | - Vittorio Fiore
- Nuclear Medicine Unit, Local Health Authority, Marca Trevigiana, Treviso, Italy
| | - Francesca Grassivaro
- From the Cognitive Impairment Center, Local Health Authority, Marca Trevigiana, Treviso, Italy
| | - Chiara Da Ronch
- From the Cognitive Impairment Center, Local Health Authority, Marca Trevigiana, Treviso, Italy
| | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
42
|
Lu J, Ge J, Chen K, Sun Y, Liu F, Yu H, Xu Q, Li L, Ju Z, Lin H, Guan Y, Guo Q, Wang J, Zuo C, Wu P. Consistent Abnormalities in Metabolic Patterns of Lewy Body Dementias. Mov Disord 2022; 37:1861-1871. [PMID: 35857319 DOI: 10.1002/mds.29138] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Whether dementia with Lewy bodies (DLB) and Parkinson's disease (PD) dementia (PDD) represent the same disease, distinct entities, or conditions within the same spectrum remains controversial. OBJECTIVE The objective of this study was to provide new insight into this debate by separately identifying disease-specific metabolic patterns and comparing them with each other and with previously established PD-related pattern (PDRP). METHODS Patients with DLB (n = 67), patients with PDD (n = 50), and healthy control subjects (HCs; n = 15) with brain 18 F-fluorodeoxyglucose positron emission tomography were enrolled as cohorts A and B for pattern identification and validation, respectively. Patients with PD (n = 30) were included for discrimination. Twenty-one participants had two scans. The principal component analysis was applied for pattern identification (DLB-related pattern [DLBRP], PDD-related pattern [PDDRP]). Similarities and differences among three patterns were assessed by pattern topography, pattern expression, clinical correlations cross-sectionally, and pattern expression changes longitudinally. RESULTS DLBRP and PDDRP shared highly similar topographies, with relative hypometabolism mainly in the middle temporal gyrus, middle occipital gyrus, lingual gyrus, precuneus, cuneus, angular gyrus, superior and inferior parietal gyrus, middle and inferior frontal gyrus, cingulate, and caudate, and relative hypermetabolism in the cerebellum, putamen, thalamus, precentral/postcentral gyrus, and paracentral lobule, which were more extensive than the PDRP. Patients with DLB and PDD could not be distinguished successfully by any pattern, but patients with PD were easily recognized, especially by DLBRP and PDDRP. The pattern expression of DLBRP and PDDRP showed similar efficacy in cross-sectional disease severity assessment and longitudinal progression monitoring. CONCLUSIONS The consistent abnormalities in metabolic patterns of DLB and PDD might underline the potential continuum across the clinical spectrum from PD to DLB. © 2022 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Keliang Chen
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yimin Sun
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fengtao Liu
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Yu
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qian Xu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zizhao Ju
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huamei Lin
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jian Wang
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University, Shanghai, China
| | - Ping Wu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
43
|
Nakajima K, Saito S, Chen Z, Komatsu J, Maruyama K, Shirasaki N, Watanabe S, Inaki A, Ono K, Kinuya S. Diagnosis of Parkinson syndrome and Lewy-body disease using 123I-ioflupane images and a model with image features based on machine learning. Ann Nucl Med 2022; 36:765-776. [PMID: 35798937 PMCID: PMC9304062 DOI: 10.1007/s12149-022-01759-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES 123I-ioflupane has been clinically applied to dopamine transporter imaging and visual interpretation assisted by region-of-interest (ROI)-based parameters. We aimed to build a multivariable model incorporating machine learning (ML) that could accurately differentiate abnormal profiles on 123I-ioflupane images and diagnose Parkinson syndrome or disease and dementia with Lewy bodies (PS/PD/DLB). METHODS We assessed 123I-ioflupane images from 239 patients with suspected neurodegenerative diseases or dementia and classified them as having PS/PD/DLB or non-PS/PD/DLB. The image features of high or low uptake (F1), symmetry or asymmetry (F2), and comma- or dot-like patterns of caudate and putamen uptake (F3) were analyzed on 137 images from one hospital for training. Direct judgement of normal or abnormal profiles (F4) was also examined. Machine learning methods included logistic regression (LR), k-nearest neighbors (kNNs), and gradient boosted trees (GBTs) that were assessed using fourfold cross-validation. We generated the following multivariable models for the test database (n = 102 from another hospital): Model 1, ROI-based measurements of specific binding ratios and asymmetry indices; Model 2, ML-based judgement of abnormalities (F4); and Model 3, features F1, F2 and F3, plus patient age. Diagnostic accuracy was compared using areas under receiver-operating characteristics curves (AUC). RESULTS The AUC was high with all ML methods (0.92-0.96) for high or low uptake. The AUC was the highest for symmetry or asymmetry with the kNN method (AUC 0.75) and the comma-dot feature with the GBT method (AUC 0.94). Based on the test data set, the diagnostic accuracy for a diagnosis of PS/PD/DLB was 0.86 ± 0.04 (SE), 0.87 ± 0.04, and 0.93 ± 0.02 for Models 1, 2 and 3, respectively. The AUC was optimal for Model 3, and significantly differed between Models 3 and 1 (p = 0.027), and 3 and 2 (p = 0.029). CONCLUSIONS Image features such as high or low uptake, symmetry or asymmetry, and comma- or dot-like profiles can be determined using ML. The diagnostic accuracy of differentiating PS/PD/DLB was the highest for the multivariate model with three features and age compared with the conventional ROI-based method.
Collapse
Affiliation(s)
- Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Shintaro Saito
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Zhuoqing Chen
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Junji Komatsu
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Koji Maruyama
- Wolfram Research Inc., Champaign, IL, USA
- Department of Chemistry and Materials Science, Osaka City University, Osaka, Japan
| | - Naoki Shirasaki
- Department of Neurosurgery, Kaga Medical Center, Kaga, Japan
| | - Satoru Watanabe
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Anri Inaki
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
44
|
Roberts G, Kane JP, Lloyd J, Firbank M, Donaghy PC, Petrides GS, Taylor JP, O’Brien J, Thomas AJ. Can early phase cardiac [123I]mIBG images be used to diagnose Lewy body disease? Nucl Med Commun 2022; 43:770-777. [PMID: 35603421 PMCID: PMC9177152 DOI: 10.1097/mnm.0000000000001581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Some studies have suggested that cardiac [123I]metaiodobenzylguanidine images obtained 15-20 min after tracer administration are as accurate for dementia with Lewy bodies (DLB) diagnosis as standard images acquired after a delay of 3-4 h; some suggest delayed imaging is preferable. We compare early and delayed heart-to-mediastinum ratios (HMR) in a well-characterised research dataset and make recommendations for clinical practice. METHODS Images were acquired using a Siemens gamma camera with medium energy collimators. Early images were obtained at 20 min and delayed at 4 h (± 30) min. In total 167 pairs of images were reviewed: 30 controls, 39 people with dementia and 98 with mild cognitive impairment. HMR normal cutoff values derived from control data were ≥2.10 for early imaging and ≥1.85 for delayed. RESULTS HMR tended to drop between early and delayed for abnormal images, but increase for normal images. Histograms of early and delayed HMR showed a slightly better separation of results into two groups for delayed imaging. Accuracy results were slightly higher for delayed imaging than early imaging (73 vs. 77%), sensitivity 63 vs. 65% and specificity 82 vs. 88%. However, this was not statistically significant - in total only 8/167 (5%) of scans changed designation between early and delayed imaging. CONCLUSION We suggest that a delayed image could be acquired only if the early result is borderline. This removes the need for delayed imaging in about 70% of patients. Adopting this protocol in clinical practice would reduce the time most patients have to wait and could free up scanner time.
Collapse
Affiliation(s)
- Gemma Roberts
- Translational and Clinical Research Institute, Newcastle University
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Joseph P.M. Kane
- Translational and Clinical Research Institute, Newcastle University
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Jim Lloyd
- Translational and Clinical Research Institute, Newcastle University
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Michael Firbank
- Translational and Clinical Research Institute, Newcastle University
| | | | - George S. Petrides
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University
| | - John O’Brien
- Centre for Public Health, Institute of Clinical Sciences, Queen’s University Belfast, Belfast and Department of Psychiatry, University of Cambridge School of Clinical Medicine, UK
| | - Alan J. Thomas
- Translational and Clinical Research Institute, Newcastle University
| |
Collapse
|
45
|
Bousiges O, Blanc F. Biomarkers of Dementia with Lewy Bodies: Differential Diagnostic with Alzheimer's Disease. Int J Mol Sci 2022; 23:ijms23126371. [PMID: 35742814 PMCID: PMC9223587 DOI: 10.3390/ijms23126371] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Abstract
Dementia with Lewy Bodies (DLB) is a common form of cognitive neurodegenerative disease. Only one third of patients are correctly diagnosed due to the clinical similarity mainly with Alzheimer’s disease (AD). In this review, we evaluate the interest of different biomarkers: cerebrospinal fluid (CSF), brain MRI, FP-CIT SPECT, MIBG SPECT, PET by focusing more specifically on differential diagnosis between DLB and AD. FP-CIT SPECT is of high interest to discriminate DLB and AD, but not at the prodromal stage (i.e., MCI). MIBG SPECT with decreased cardiac sympathetic activity, perfusion SPECT with occipital hypoperfusion, FDG PET with occipital hypometabolism and cingulate island signs are of interest at the dementia stage but with a lower validity. Brain MRI has shown differences in group study with lower grey matter concentration of the Insula in prodromal DLB, but its interest in clinical routines is not demonstrated. Concerning CSF biomarkers, many studies have already examined the relevance of AD biomarkers but also alpha-synuclein assays in DLB, so we will focus as comprehensively as possible on other biomarkers (especially those that do not appear to be directly related to synucleinopathy) that may be of interest in the differential diagnosis between AD and DLB. Furthermore, we would like to highlight the growing interest in CSF synuclein RT-QuIC, which seems to be an excellent discrimination tool but its application in clinical routine remains to be demonstrated, given the non-automation of the process.
Collapse
Affiliation(s)
- Olivier Bousiges
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, 67000 Strasbourg, France
- Team IMIS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg and CNRS, 67000 Strasbourg, France;
- CM2R (Research and Resources Memory Centre), Geriatrics Department, Day Hospital and Cognitive-Behavioral Unit University Hospitals of Strasbourg, 67000 Strasbourg, France
- Correspondence:
| | - Frédéric Blanc
- Team IMIS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg and CNRS, 67000 Strasbourg, France;
- CM2R (Research and Resources Memory Centre), Geriatrics Department, Day Hospital and Cognitive-Behavioral Unit University Hospitals of Strasbourg, 67000 Strasbourg, France
| |
Collapse
|
46
|
Ingram M, Colloby SJ, Firbank MJ, Lloyd JJ, O'Brien JT, Taylor JP. Spatial covariance analysis of FDG-PET and HMPAO-SPECT for the differential diagnosis of dementia with Lewy bodies and Alzheimer's disease. Psychiatry Res Neuroimaging 2022; 322:111460. [PMID: 35247828 DOI: 10.1016/j.pscychresns.2022.111460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
We investigated diagnostic characteristics of spatial covariance analysis (SCA) of FDG-PET and HMPAO-SPECT scans in the differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), in comparison with visual ratings and region of interest (ROI) analysis. Sixty-seven patients (DLB 29, AD 38) had both HMPAO-SPECT and FDG-PET scans. Spatial covariance patterns were used to separate AD and DLB in an initial derivation group (DLB n=15, AD n=19), before being forward applied to an independent group (DLB n=14, AD n=19). Visual ratings were by consensus, with ROI analysis utilising medial occipital/medial temporal uptake ratios. SCA of HMPAO-SPECT performed poorly (AUC 0.59±0.10), whilst SCA of FDG-PET (AUC 0.83±0.07) was significantly better. For FDG-PET, SCA showed similar diagnostic performance to ROI analysis (AUC 0.84±0.08) and visual rating (AUC 0.82±0.08). In contrast to ROI analysis, there was little concordance between SCA and visual ratings of FDG-PET scans. We conclude that SCA of FDG-PET outperforms that of HMPAO-SPECT. SCA of FDG-PET also performed similarly to the other analytical approaches, despite the limitations of a relatively small SCA derivation group. Compared to visual rating, SCA of FDG-PET relies on different sources of group variance to separate DLB from AD.
Collapse
Affiliation(s)
- Matthew Ingram
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom.
| | - Sean J Colloby
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Michael J Firbank
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Jim J Lloyd
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - John-Paul Taylor
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| |
Collapse
|
47
|
Abstract
PURPOSE OF REVIEW This article discusses neuroimaging in dementia diagnosis, with a focus on new applications of MRI and positron emission tomography (PET). RECENT FINDINGS Although the historical use of MRI in dementia diagnosis has been supportive to exclude structural etiologies, recent innovations allow for quantification of atrophy patterns that improve sensitivity for supporting the diagnosis of dementia causes. Neuronuclear approaches allow for localization of specific amyloid and tau neuropathology on PET and are available for clinical use, in addition to dopamine transporter scans in dementia with Lewy bodies and metabolic studies with fludeoxyglucose PET (FDG-PET). SUMMARY Using computerized software programs for MRI analysis and cross-sectional and longitudinal evaluations of hippocampal, ventricular, and lobar volumes improves sensitivity in support of the diagnosis of Alzheimer disease and frontotemporal dementia. MRI protocol requirements for such quantification are three-dimensional T1-weighted volumetric imaging protocols, which may need to be specifically requested. Fluid-attenuated inversion recovery (FLAIR) and 3.0T susceptibility-weighted imaging (SWI) sequences are useful for the detection of white matter hyperintensities as well as microhemorrhages in vascular dementia and cerebral amyloid angiopathy. PET studies for amyloid and/or tau pathology can add additional specificity to the diagnosis but currently remain largely inaccessible outside of research settings because of prohibitive cost constraints in most of the world. Dopamine transporter PET scans can help identify Lewy body dementia and are thus of potential clinical value.
Collapse
Affiliation(s)
- Cyrus A. Raji
- Washington University in St. Louis Mallinckrodt Institute of Radiology, Division of Neuroradiology
- Washington University in St. Louis Department of Neurology
- Washington University in St. Louis Neuroimaging Laboratories
- Knight Alzheimer Disease Research Center, Washington University in St. Louis
| | - Tammie L. S. Benzinger
- Washington University in St. Louis Mallinckrodt Institute of Radiology, Division of Neuroradiology
- Washington University in St. Louis Neuroimaging Laboratories
- Knight Alzheimer Disease Research Center, Washington University in St. Louis
- Washington University in St. Louis Department of Neurosurgery
| |
Collapse
|
48
|
Ota M, Nemoto K, Nemoto M, Numata Y, Kitabatake A, Yamada Y, Shinkawa K, Kobayashi M, Arai T. Structural Cerebral Network Differences in Prodromal Alzheimer's Disease and Prodromal Dementia with Lewy Bodies. Dement Geriatr Cogn Disord 2022; 51:421-427. [PMID: 36574761 DOI: 10.1159/000527443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/03/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) have long prodromal phases without dementia. However, the patterns of cerebral network alteration in this early stage of the disease remain to be clarified. METHOD Participants were 48 patients with mild cognitive impairment (MCI) due to AD (MCI-AD), 18 patients with MCI with DLB (MCI with Lewy bodies: MCI-LB), and 23 healthy controls who underwent a 1.5-Tesla magnetic resonance imaging scan. Cerebral networks were extracted from individual T1-weighted images based on the intracortical similarity, and we estimated the differences of network metrics among the three diagnostic groups. RESULTS Whole-brain analyses for degree, betweenness centrality, and clustering coefficient images were performed using SPM8 software. The patients with MCI-LB showed significant reduction of degree in right putamen, compared with healthy subjects. The MCI-AD patients showed significant lower degree in left insula and bilateral posterior cingulate cortices compared with healthy subjects. There were no significant differences in small-world properties and in regional gray matter volume among the three groups. CONCLUSIONS We found the change of degree in the patients with MCI-AD and with MCI-LB, compared with healthy controls. These findings were consistent with the past single-photon emission computed tomography studies focusing on AD and DLB. The disease-related difference in the cerebral neural network might provide an adjunct biomarker for the early detection of AD and DLB.
Collapse
Affiliation(s)
- Miho Ota
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kiyotaka Nemoto
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | | | | | | | | | - Tetsuaki Arai
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| |
Collapse
|
49
|
Roberts G, Lloyd JJ, Jefferson E, Kane JPM, Durcan R, Lawley S, Petrides GS, Howe K, Haq I, O'Brien JT, Thomas AJ. Uniformity of cardiac 123I-MIBG uptake on SPECT images in older adults with normal cognition and patients with dementia. J Nucl Cardiol 2021; 28:2151-2163. [PMID: 31820410 PMCID: PMC8648658 DOI: 10.1007/s12350-019-01977-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/17/2019] [Accepted: 11/18/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Some studies report that assessing regional 123I-cardiac MIBG uptake can aid in the diagnosis of Lewy body disease, but others report heterogeneity in healthy controls. We aimed to evaluate regional cardiac MIBG uptake patterns in healthy older adults and patients with dementia. METHODS 31 older adults with normal cognition, 15 Alzheimer's disease (AD), and 17 Dementia with Lewy bodies (DLB) patients were recruited. 5 individuals had previous myocardial infarction. Participants with sufficient cardiac uptake for regional SPECT analysis (29/31 controls, 15/15 AD, 5/17 DLB) had relative uptake pattern recorded. Controls were assessed for risk of future cardiovascular events using QRISK2, a validated online tool. RESULTS In controls uptake was reduced in the inferior wall (85%), apex (23%), septum (15%), and lateral wall (8%). AD and DLB showed similar patterns to controls. Lung or liver interference was present in 61% of cases. Myocardial infarction cases showed regional reductions in uptake, but normal/borderline planar uptake. In controls, there was no relationship between cardiovascular risk score and uptake pattern. CONCLUSIONS Significant variability of regional cardiac 123I-MIBG uptake is common in cases with normal planar cardiac uptake. Heterogeneity of regional uptake appears non-specific and unlikely to aid in the diagnosis of Lewy body disease.
Collapse
Affiliation(s)
- Gemma Roberts
- Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK.
- Nuclear Medicine Department, Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK.
| | - Jim J Lloyd
- Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
- Nuclear Medicine Department, Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Elizabeth Jefferson
- Nuclear Medicine Department, Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Joseph P M Kane
- Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Rory Durcan
- Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
| | - Sarah Lawley
- Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
| | - George S Petrides
- Nuclear Medicine Department, Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Kim Howe
- Nuclear Medicine Department, Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Iftikhar Haq
- Cardiology Department, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne, NE1 4LP, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, CB2 0SP, UK
| | - Alan J Thomas
- Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
| |
Collapse
|
50
|
Choudhary G, Bhambhvani P. Myocardial Sympathetic Innervation Imaging with MIBG in Dementia with Lewy Bodies. J Nucl Cardiol 2021; 28:2164-2166. [PMID: 32002846 DOI: 10.1007/s12350-020-02042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Gagandeep Choudhary
- Division of Molecular Imaging and Therapeutics, Department of Radiology, The University of Alabama at Birmingham, 619 19th Street South, JT 779, Birmingham, AL, 35249, USA
| | - Pradeep Bhambhvani
- Division of Molecular Imaging and Therapeutics, Department of Radiology, The University of Alabama at Birmingham, 619 19th Street South, JT 779, Birmingham, AL, 35249, USA.
| |
Collapse
|