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Distinct FP-CIT PET patterns of Alzheimer’s disease with parkinsonism and dementia with Lewy bodies

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Abstract

Purpose

Little is known regarding the clinical relevance or neurobiology of subtle motor disturbance in Alzheimer’s disease (AD). This study aims to investigate the patterns of striatal 18F-FP-CIT uptake in patients with AD-related cognitive impairment (ADCI) with mild parkinsonism.

Methods

We recruited 29 consecutive patients with ADCI with mild parkinsonism. All patients underwent 18F-FP-CIT PET scans and dopamine transporter (DAT) availability in striatal subregions (anterior/posterior caudate, anterior/posterior putamen, ventral putamen, ventral striatum) was quantified. Additionally, 32 patients with dementia with Lewy bodies (DLB) and 21 healthy controls were included to perform inter-group comparative analyses of the striatal DAT availability. The discriminatory power of striatal DAT availability to differentiate ADCI from DLB was assessed using receiver operating characteristics (ROC) analyses. The Spearman’s correlation coefficient was calculated to assess the relationship between motor severity and DAT availability in striatal subregions.

Results

Patients with ADCI with mild parkinsonism exhibited decreased DAT availability in the caudate that was intermediate between healthy controls and patients with DLB. The DAT availability in other striatal subregions, including the posterior putamen, did not differ between the ADCI with parkinsonism and healthy control groups. The ROC analysis showed that DAT availability of all striatal subregions, especially the whole striatum, had a fair discriminatory power. Parkinsonian motor severity did not correlate with the striatal DAT availability in ADCI with parkinsonism.

Conclusions

The present study demonstrated that patients with ADCI with mild parkinsonism had distinct DAT scan patterns and suggests that parkinsonism is associated with the extranigral source of pathology.

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Funding

This research was supported by a grant from the Korea Health Technology R&D Project through the Korean Healthy Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C1118).

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Authors and Affiliations

  1. Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 30722, South Korea

    Seok Jong Chung, Yang Hyun Lee, Han Soo Yoo, Young H. Sohn, Byoung Seok Ye & Phil Hyu Lee

  2. Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea

    Seok Jong Chung

  3. Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA

    Jungho Cha

  4. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea

    Phil Hyu Lee

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  1. Seok Jong Chung
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Correspondence to Jungho Cha or Phil Hyu Lee.

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Chung, S.J., Lee, Y.H., Yoo, H.S. et al. Distinct FP-CIT PET patterns of Alzheimer’s disease with parkinsonism and dementia with Lewy bodies. Eur J Nucl Med Mol Imaging 46, 1652–1660 (2019). https://doi.org/10.1007/s00259-019-04315-6

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