Nicolas Nicastro1, Valentina Garibotto, Gilles Allali, Frederic Assal, Pierre R Burkhard. 1. From the *Division of Neurorehabilitation, Department of Clinical Neurosciences, †Department of Nuclear Medicine and Molecular Imaging, and ‡Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
Abstract
PURPOSE OF THE REPORT: To assess the validity of a semi-quantitative I-FP-CIT SPECT method, compared to the commonly used visual analysis, in patients with probable dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). We also studied DLB specific uptake impairment pattern and correlation of uptake in the presence or absence of parkinsonism. MATERIALS AND METHODS: Among 1202 scans performed at our center from 2003 to 2015, we identified 93 subjects with probable DLB (mean age 76.9 ± 6.8 years, 37% women) and 18 with AD (mean age 76.9 ± 8.1 years, 50% women). Independent visual and semi-quantitative assessments based on previously established on-site reference values (including volumes-of-interest uptake, caudate-to-putamen ratio and striatal asymmetry index) were performed and compared between both groups. RESULTS: Visual staging was considered abnormal in 96.8% of DLB patients, whereas 97.8% of subjects had an abnormal semi-quantitative assessment. Combining both methods yielded a 100% sensitivity. Patients with DLB exhibited a more pronounced impairment of putaminal uptake when associated with parkinsonism, whereas a more diffuse pattern and significantly higher uptake values were observed in the subgroup of DLB patients without parkinsonism (resp. striatal uptake 1.61 ± 0.66 vs. 2.28 ± 0.52, P = 0.01). A minority of AD subjects show minimal alterations of presynaptic dopaminergic transport (striatal uptake 3.07 ± 0.41), values being always significantly higher than those from DLB patients, irrespective of the presence of parkinsonism (P < 0.0001) or not (P = 0.002). CONCLUSIONS: Additional use of semi-quantitative analysis allows a higher discrimination of DLB from AD and demonstrates a specific pattern of degeneration in DLB patients according to their motor phenotype.
PURPOSE OF THE REPORT: To assess the validity of a semi-quantitative I-FP-CIT SPECT method, compared to the commonly used visual analysis, in patients with probable dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). We also studied DLB specific uptake impairment pattern and correlation of uptake in the presence or absence of parkinsonism. MATERIALS AND METHODS: Among 1202 scans performed at our center from 2003 to 2015, we identified 93 subjects with probable DLB (mean age 76.9 ± 6.8 years, 37% women) and 18 with AD (mean age 76.9 ± 8.1 years, 50% women). Independent visual and semi-quantitative assessments based on previously established on-site reference values (including volumes-of-interest uptake, caudate-to-putamen ratio and striatal asymmetry index) were performed and compared between both groups. RESULTS: Visual staging was considered abnormal in 96.8% of DLB patients, whereas 97.8% of subjects had an abnormal semi-quantitative assessment. Combining both methods yielded a 100% sensitivity. Patients with DLB exhibited a more pronounced impairment of putaminal uptake when associated with parkinsonism, whereas a more diffuse pattern and significantly higher uptake values were observed in the subgroup of DLB patients without parkinsonism (resp. striatal uptake 1.61 ± 0.66 vs. 2.28 ± 0.52, P = 0.01). A minority of AD subjects show minimal alterations of presynaptic dopaminergic transport (striatal uptake 3.07 ± 0.41), values being always significantly higher than those from DLB patients, irrespective of the presence of parkinsonism (P < 0.0001) or not (P = 0.002). CONCLUSIONS: Additional use of semi-quantitative analysis allows a higher discrimination of DLB from AD and demonstrates a specific pattern of degeneration in DLB patients according to their motor phenotype.
Authors: Elijah Mak; Nicolas Nicastro; Maura Malpetti; George Savulich; Ajenthan Surendranathan; Negin Holland; Luca Passamonti; P Simon Jones; Stephen F Carter; Li Su; Young T Hong; Tim D Fryer; Guy B Williams; Franklin Aigbirhio; James B Rowe; John T O'Brien Journal: Neurobiol Aging Date: 2020-11-14 Impact factor: 4.673
Authors: Alan J Thomas; Paul Donaghy; Gemma Roberts; Sean J Colloby; Nicky A Barnett; George Petrides; Jim Lloyd; Kirsty Olsen; John-Paul Taylor; Ian McKeith; John T O'Brien Journal: Psychol Med Date: 2018-04-25 Impact factor: 7.723
Authors: Tiago Fleming Outeiro; David J Koss; Daniel Erskine; Lauren Walker; Marzena Kurzawa-Akanbi; David Burn; Paul Donaghy; Christopher Morris; John-Paul Taylor; Alan Thomas; Johannes Attems; Ian McKeith Journal: Mol Neurodegener Date: 2019-01-21 Impact factor: 14.195