Prabesh Kanel1, Martijn L T M Müller1, Sygrid van der Zee1, Carlos A Sanchez-Catasus1, Robert A Koeppe1, Kirk A Frey1, Nicolaas I Bohnen1. 1. Department of Radiology (Kanel, Müller, Sanchez-Catasus, Koeppe, Frey, Bohnen) and Department of Neurology (Frey, Bohnen), University of Michigan, Ann Arbor; Neurology Service and Geriatric Research Education and Clinical Center, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, Mich. (Bohnen); Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor (Kanel, Müller, Sanchez-Catasus, Bohnen); and Department of Neurology, University of Groningen, University Medical Center Groningen, the Netherlands (van der Zee).
Abstract
OBJECTIVES: The authors investigated the topography of cholinergic vulnerability in patients with dementia with Lewy bodies (DLB) using positron emission tomography (PET) imaging with the vesicular acetylcholine transporter (VAChT) [18F]-fluoroethoxybenzovesamicol ([18F]-FEOBV) radioligand. METHODS: Five elderly participants with DLB (mean age, 77.8 years [SD=4.2]) and 21 elderly healthy control subjects (mean age, 73.62 years [SD=8.37]) underwent clinical assessment and [18F]-FEOBV PET. RESULTS: Compared with the healthy control group, reduced VAChT binding in patients with DLB demonstrated nondiffuse regionally distinct and prominent reductions in bilateral opercula and anterior cingulate to mid-cingulate cortices, bilateral insula, right (more than left) lateral geniculate nuclei, pulvinar, right proximal optic radiation, bilateral anterior and superior thalami, and posterior hippocampal fimbria and fornices. CONCLUSIONS: The topography of cholinergic vulnerability in DLB comprises key neural hubs involved in tonic alertness (cingulo-opercular), saliency (insula), visual attention (visual thalamus), and spatial navigation (fimbria/fornix) networks. The distinct denervation pattern suggests an important cholinergic role in specific clinical disease-defining features, such as cognitive fluctuations, visuoperceptual abnormalities causing visual hallucinations, visuospatial changes, and loss of balance caused by DLB.
OBJECTIVES: The authors investigated the topography of cholinergic vulnerability in patients with dementia with Lewy bodies (DLB) using positron emission tomography (PET) imaging with the vesicular acetylcholine transporter (VAChT) [18F]-fluoroethoxybenzovesamicol ([18F]-FEOBV) radioligand. METHODS: Five elderly participants with DLB (mean age, 77.8 years [SD=4.2]) and 21 elderly healthy control subjects (mean age, 73.62 years [SD=8.37]) underwent clinical assessment and [18F]-FEOBV PET. RESULTS: Compared with the healthy control group, reduced VAChT binding in patients with DLB demonstrated nondiffuse regionally distinct and prominent reductions in bilateral opercula and anterior cingulate to mid-cingulate cortices, bilateral insula, right (more than left) lateral geniculate nuclei, pulvinar, right proximal optic radiation, bilateral anterior and superior thalami, and posterior hippocampal fimbria and fornices. CONCLUSIONS: The topography of cholinergic vulnerability in DLB comprises key neural hubs involved in tonic alertness (cingulo-opercular), saliency (insula), visual attention (visual thalamus), and spatial navigation (fimbria/fornix) networks. The distinct denervation pattern suggests an important cholinergic role in specific clinical disease-defining features, such as cognitive fluctuations, visuoperceptual abnormalities causing visual hallucinations, visuospatial changes, and loss of balance caused by DLB.
Entities:
Keywords:
Cognition; Dementia; Dementia With Lewy Bodies; Neurology; Saliency
Authors: Prabesh Kanel; C Chauncey Spears; Stiven Roytman; Robert A Koeppe; Kirk A Frey; Peter J H Scott; Roger L Albin; Nicolaas I Bohnen Journal: J Neural Transm (Vienna) Date: 2022-10-12 Impact factor: 3.850
Authors: Sygrid van der Zee; Martijn L T M Müller; Prabesh Kanel; Teus van Laar; Nicolaas I Bohnen Journal: Mov Disord Date: 2020-11-02 Impact factor: 10.338
Authors: Prabesh Kanel; Sygrid van der Zee; Carlos A Sanchez-Catasus; Robert A Koeppe; Peter J H Scott; Teus van Laar; Roger L Albin; Nicolaas I Bohnen Journal: Aging Brain Date: 2022-03-28
Authors: Sygrid van der Zee; Prabesh Kanel; Marleen J J Gerritsen; Jeffrey M Boertien; Anne C Slomp; Martijn L T M Müller; Nicolaas I Bohnen; Jacoba M Spikman; Teus van Laar Journal: Mov Disord Date: 2022-01-17 Impact factor: 9.698
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