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Molecular Imaging and Updated Diagnostic Criteria in Lewy Body Dementias

  • Neuroimaging (N Pavese, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aims of the study were to review recent advances in molecular imaging in the Lewy body dementias (LBD) and determine if these may support the clinical but contested temporal profile distinction between Parkinson disease (PD) with dementia (PDD) versus dementia with Lewy bodies (DLB).

Recent Findings

There do not appear to be major regional cerebral metabolic or neurotransmitter distinctions between PDD and DLB. However, recent studies highlight the relative discriminating roles of Alzheimer proteinopathies. PDD patients have lower cortical β-amyloid deposition than DLB. Preliminary tau PET studies suggest a gradient of increasing tau binding from cognitively normal PD (absent to lowest) to cognitively impaired PD (low) to DLB (intermediate) to Alzheimer disease (AD; highest). However, tau binding in DLB, including the medial temporal lobe, is substantially lower than in AD.

Summary

Alzheimer-type proteinopathies appear to be more common in DLB compared to PDD with relative but no absolute differences. Given the spectrum of overlapping pathologies, future α-synuclein ligands are expected to have the best potential to distinguish the LBD from pure AD.

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Abbreviations

AD:

Alzheimer disease

DAT:

Dopamine transporter

DLB:

Dementia with Lewy bodies

FDG:

Fluorodeoxyglucose

MCI:

Mild cognitive impairment

MIBG:

Metaiodobenzylguanidine

MMSE:

Mini-mental state examination

PCA:

Posterior cortical atrophy

PD:

Parkinson disease

PDD:

Parkinson disease with dementia

RBD:

REM sleep behavior disorder

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Acknowledgements

The presented research data from the authors’ work was supported by grants from the NIH (P01 NS015655, RO1 NS070856, with additional support from P50 NS091856), the Department of Veterans Affairs (I01 RX000317), and the Michael J. Fox Foundation.

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Correspondence to Nicolaas I. Bohnen.

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Conflict of Interest

Nicolaas I. Bohnen and Martijn L.T.M. Müller report grants from NIH, Department of Veterans Affairs, Michael J. Fox Foundation, Axovant Sciences, and Chase Pharmaceuticals.

Kirk A. Frey is a consultant to Avid Radio Pharmaceuticals.

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All reported studies/experiments with human subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Neuroimaging

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Bohnen, N.I., Müller, M.L.T.M. & Frey, K.A. Molecular Imaging and Updated Diagnostic Criteria in Lewy Body Dementias. Curr Neurol Neurosci Rep 17, 73 (2017). https://doi.org/10.1007/s11910-017-0789-z

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