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Imaging Improves Diagnosis of Dementia with Lewy Bodies

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Dementia with Lewy bodies (DLB) is the second most common cause of degenerative dementia after Alzheimer’s disease (AD), and is clinically characterized by the progressive cognitive decline with fluctuations in cognition and alertness, recurrent visual hallucinations and Parkinsonism. Once these characteristic symptoms of DLB emerge, discriminating it from AD is relatively easy. However, in the early disease stages, the clinical symptoms of various types of dementias largely overlap and it is difficult to distinguish DLB from other neurodegenerative dementias based on clinical manifestations alone. To increase the accuracy of antemortem diagnosis of DLB, the latest diagnostic criteria incorporate findings from 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, or from neuroimaging such as computed tomography (CT), magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET). In the present guidelines, decreased dopamine transporter uptake revealed by SPECT or PET receives the greatest importance among various neuroimaging findings and is listed as one of the suggestive features. Supportive features that commonly present but are not proven to have diagnostic specificity include relatively-preserved medial-temporal-lobe structures, occipital hypoperfusion, and abnormal MIBG myocardial scintigraphy. In this paper, we review the major findings on various neuroimaging modalities and discuss the clinical usefulness of them for the diagnosis of DLB. Although there is not enough evidence to reach the conclusion, considering the accessibility in clinical practice, in our personal views, we recommend the use of brain-perfusion SPECT and MIBG myocardial scintigraphy to improve the diagnosis of DLB.

Abstract

Dementia with Lewy bodies (DLB) is the second most common cause of degenerative dementia after Alzheimer’s disease (AD), and is clinically characterized by the progressive cognitive decline with fluctuations in cognition and alertness, recurrent visual hallucinations and Parkinsonism. Once these characteristic symptoms of DLB emerge, discriminating it from AD is relatively easy. However, in the early disease stages, the clinical symptoms of various types of dementias largely overlap and it is difficult to distinguish DLB from other neurodegenerative dementias based on clinical manifestations alone. To increase the accuracy of antemortem diagnosis of DLB, the latest diagnostic criteria incorporate findings from 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, or from neuroimaging such as computed tomography (CT), magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET). In the present guidelines, decreased dopamine transporter uptake revealed by SPECT or PET receives the greatest importance among various neuroimaging findings and is listed as one of the suggestive features. Supportive features that commonly present but are not proven to have diagnostic specificity include relatively-preserved medial-temporal-lobe structures, occipital hypoperfusion, and abnormal MIBG myocardial scintigraphy. In this paper, we review the major findings on various neuroimaging modalities and discuss the clinical usefulness of them for the diagnosis of DLB. Although there is not enough evidence to reach the conclusion, considering the accessibility in clinical practice, in our personal views, we recommend the use of brain-perfusion SPECT and MIBG myocardial scintigraphy to improve the diagnosis of DLB.

참고문헌 (97)

  1. Kosaka K, "Presenile dementia with Alzheimer-, Pick- and Lewy-body changes", Acta Neuropathol, 36, pp.221~233 (1976)
  2. Kosaka K, "Lewy bodies in cerebral cortex, report of three cases", Acta Neuropathol, 42, pp.127~134 (1978)
  3. Rosenblum WI, "Lewy bodies in the presence of Alzheimer’s disease", Arch Neurol, 36, pp.170~171 (1979)
  4. Kosaka K, "Diffuse type of Lewy body disease: progressive dementia with abundant cortical Lewy bodies and senile changes of varying degree--a new disease?", Clin Neuropathol, 3, pp.185~192 (1984)
  5. McKeith IG, "Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop", Neurology, 47, pp.1113~1124 (1996)
  6. McKeith IG, "Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies", Neurology, 54, pp.1050~1058 (2000)
  7. McKeith I, "Dementia with Lewy bodies", Lancet Neurol, 3, pp.19~28 (2004)
  8. McKeith IG, "Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium", Neurology, 65, pp.1863~1872 (2005)
  9. Gómez-Tortosa E, "Dementia with Lewy bodies", J Am Geriatr Soc, 46, pp.1449~1458 (1998)
  10. Weisman D, "Dementia with Lewy bodies", Semin Neurol, 27, pp.42~47 (2007)
  11. Rahkonen T, "Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older", J Neurol Neurosurg Psychiatry, 74, pp.720~724 (2003)
  12. Kemp PM, "Imaging in dementia with Lewy bodies: a review", Nucl Med Commun, 28, pp.511~519 (2007)
  13. Varma AR, "Diagnostic patterns of regional atrophy on MRI and regional cerebral blood flow change on SPECT in young onset patients with Alzheimer’s disease, frontotemporal dementia and vascular dementia", Acta Neurol Scand, 105, pp.261~269 (2002)
  14. O’Brien JT, "Vascular cognitive impairment", Lancet Neurol, 2, pp.89~98 (2003)
  15. Barber R, "White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer’s disease, vascular dementia, and normal aging", J Neurol Neurosurg Psychiatry, 67, pp.66~72 (1999)
  16. Barber R, "Medial temporal lobe atrophy on MRI in dementia with Lewy bodies", Neurology, 52, pp.1153~1158 (1999)
  17. Hashimoto M, "Medial temporal and whole-brain atrophy in dementia with Lewy bodies: a volumetric MRI study", Neurology, 51, pp.357~362 (1998)
  18. Barber R, "MRI volumetric study of dementia with Lewy bodies: a comparison with AD and vascular dementia", Neurology, 54, pp.1304~1309 (2000)
  19. Tam CW, "Temporal lobe atrophy on MRI in Parkinson disease with dementia: a comparison with Alzheimer disease and dementia with Lewy bodies", Neurology, 64, pp.861~865 (2005)
  20. Barber R, "A comparison of medial and lateral temporal lobe atrophy in dementia with Lewy bodies and Alzheimer’s disease: magnetic resonance imaging volumetric study", Dement Geriatr Cogn Disord, 12, pp.198~205 (2001)
  21. Almeida OP, "MRI study of caudate nucleus volume in Parkinson’s disease with and without dementia with Lewy bodies and Alzheimer’s disease", Dement Geriatr Cogn Disord, 16, pp.57~63 (2003)
  22. Cousins DA, "Atrophy of the putamen in dementia with Lewy bodies but not Alzheimer’s disease: an MRI study", Neurology, 61, pp.1191~1195 (2003)
  23. Hanyu H, "MR features of the substantia innominata and therapeutic implications in dementias", Neurobiol Aging, 28, pp.548~554 (2007)
  24. Ashburner J, "Voxel-based morphometry--the methods", Neuroimage, 11(6), pp.805~821 (2000)
  25. Ashburner J, "Why voxel-based morphometry should be used", Neuroimage, 14, pp.1238~1243 (2001)
  26. Burton EJ, "Patterns of cerebral atrophy in dementia with Lewy bodies using voxel-based morphometry", Neuroimage, 17, pp.618~630 (2002)
  27. Whitwell JL, "Focal atrophy in dementia with Lewy bodies on MRI: a distinct pattern from Alzheimer’s disease", Brain, 130, pp.708~719 (2007)
  28. Brenneis C, "Basal forebrain atrophy is a distinctive pattern in dementia with Lewy bodies", Neuroreport, 15, pp.1711~1714 (2004)
  29. Beyer MK, "Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies", Neurology, 69, pp.747~754 (2007)
  30. Le Bihan D, "Looking into the functional architecture of the brain with diffusion MRI", Nat Rev Neurosci, 4, pp.469~480 (2003)
  31. Conturo TE, "Tracking neuronal fiber pathways in the living human brain", Proc Natl Acad Sci, pp.10422~10427 (1999)
  32. Jones DK, "Optimal strategies for measuring diffusion in anisotropic systems by magnetic resonance imaging", Magn Reson Med, 42, pp.515~525 (1999)
  33. Mori S, "Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging", Ann Neurol, 45, pp.265~269 (1999)
  34. Bozzali M, "Diffusion tensor MRI to investigate dementias:a brief review", Magn Reson Imaging, 25, pp.969~977 (2007)
  35. Burn DJ, "Use of functional imaging in Parkinsonism and dementia", Mov Disord, 18(6), pp.S88~S95 (2003)
  36. Firbank MJ, "Diffusion tensor imaging in dementia with Lewy bodies and Alzheimer’s disease", Psychiatry Res, 155, pp.135~145 (2007)
  37. Firbank MJ, "Atrophy is associated with posterior cingulate white matter disruption in dementia with Lewy bodies and Alzheimer’s disease", Neuroimage, 36, pp.1~7 (2007)
  38. Bozzali M, "Brain tissue damage in dementia with Lewy bodies: an in vivo diffusion tensor MRI study", Brain, 128, pp.1595~1604 (2005)
  39. Bozzali M, "White matter damage in Alzheimer’s disease assessed in vivo using diffusion tensor magnetic resonance imaging", J Neurol Neurosurg Psychiatry, 72, pp.742~746 (2002)
  40. Ota M, "Degeneration of dementia with Lewy bodies measured by diffusion tensor imaging", NMR Biomed, 22, pp.280~284 (2009)
  41. Kobayashi S, "Quantitative analysis of brain perfusion SPECT in Alzheimer’s disease using a fully automated regional cerebral blood flow quantification software, 3DSRT", J Neurol Sci, 264, pp.27~33 (2008)
  42. Minoshima S, "Posterior cingulate cortex in Alzheimer’s disease", Lancet, 344, pp.895~ (1994)
  43. Kemp PM, "Alzheimer’s disease: differences in technetium-99m HMPAO SPECT scan findings between early onset and late onset dementia", J Neurol Neurosurg Psychiatry, 74, pp.715~719 (2003)
  44. Rodriguez G, "Hippocampal perfusion in mild Alzheimer’s disease", Psychiatry Res, 100, pp.65~74 (2000)
  45. Friston K, "Analyzing brain images: principles and overview. in: Human Brain Function", pp.25~41 (1997), Academic Press
  46. Martin AJ, "Decreases in regional cerebral blood flow with normal aging", J Cereb Blood Flow Metab, 11, pp.684~689 (1991)
  47. Minoshima S, "Anatomic standardization:linear scaling and nonlinear warping of functional brain images", J Nucl Med, 35, pp.1528~1537 (1994)
  48. Kasama S, "Cerebral blood flow in Parkinson’s disease, dementia with Lewy bodies, and Alzheimer’s disease according to three-dimensional stereotactic surface projection imaging", Dement Geriatr Cogn Disord, 19, pp.266~275 (2005)
  49. Mito Y, "Brain SPECT analysis by 3D-SSP and phenotype of Parkinson’s disease", J Neurol Sci, 241, pp.67~72 (2006)
  50. Mito Y, "Brain 3D-SSP SPECT analysis in dementia with Lewy bodies, Parkinson’s disease with and without dementia, and Alzheimer’s disease", Clin Neurol Neurosurg, 107, pp.396~403 (2005)
  51. Kaneko K, "Posterior cingulate hypoperfusion in Alzheimer’s disease, senile dementia of Alzheimer type, and other dementias evaluated by threedimensional stereotactic surface projections using Tc-99m HMPAO SPECT", Clin Nucl Med, 29, pp.362~366 (2004)
  52. Waragai M, "Evaluation of brain perfusion SPECT using an easy Z-score imaging system (eZIS) as an adjunct to early-diagnosis of neurodegenerative diseases", J Neurol Sci, 260, pp.57~64 (2007)
  53. Matsuda H, "Automated discrimination between very early Alzheimer disease and controls using an easy Z-score imaging system for multicenter brain perfusion single-photon emission tomography", AJNR Am J Neuroradiol, 28, pp.731~736 (2007)
  54. Matsuda H, "An easy Z-score imaging system for discrimination between very early Alzheimer’s disease and controls using brain perfusion SPECT in a multicentre study", Nucl Med Commun, 28, pp.199~205 (2007)
  55. Kobayashi S, "Two-layer appearance on brain perfusion SPECT in idiopathic normal pressure hydrocephalus: a qualitative analysis by using easy Z-score imaging system, eZIS", Dement Geriatr Cogn Disord, 28, pp.330~337 (2009)
  56. Takeuchi R, "Fully automated quantification of regional cerebral blood flow with three-dimensional stereotaxic region of interest template: validation using magnetic resonance imaging--technical note", Neurol Med Chir, 43, pp.153~162 (2003)
  57. Takeuchi R, "Cerebral blood flow SPET in transient global amnesia with automated ROI analysis by 3DSRT", Eur J Nucl Med Mol Imaging, 31, pp.578~589 (2004)
  58. Tateno M, "Decreased blood perfusion in right thalamus after transient global amnesia demonstrated by an automated program, 3DSRT", Psychiatry Clin Neurosci, 62, pp.244~ (2008)
  59. Tateno M, "Quantitative analysis of the effects of donepezil on regional cerebral blood flow in Alzheimer’s disease by using an automated program, 3DSRT", Neuroradiology, 50, pp.723~727 (2008)
  60. Defebvre LJ, "Technetium HMPAO SPECT study in dementia with Lewy bodies, Alzheimer’s disease and idiopathic Parkinson’s disease", J Nucl Med, 40, pp.956~962 (1999)
  61. Talbot PR, "A clinical role for 99mTc-HMPAO SPECT in the investigation of dementia?", J Neurol Neurosurg Psychiatry, 64, pp.306~313 (1998)
  62. Donnemiller E, "Brain perfusion scintigraphy with 99mTc-HMPAO or 99mTc-ECD and 123I-beta-CIT single-photon emission tomography in dementia of the Alzheimer-type and diffuse Lewy body disease", Eur J Nucl Med, 24, pp.320~325 (1997)
  63. Ishii K, "Regional cerebral blood flow difference between dementia with Lewy bodies and AD", Neurology, 53, pp.413~416 (1999)
  64. Lobotesis K, "Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD", Neurology, 56, pp.643~649 (2001)
  65. Varma AR, "A 99mTc-HMPAO single-photon emission computed tomography study of Lewy body disease", J Neurol, 244, pp.349~359 (1997)
  66. Colloby SJ, "A comparison of (99m)Tc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer’s disease using statistical parametric mapping", Eur J Nucl Med Mol Imaging, 29, pp.615~622 (2002)
  67. Pasquier J, "Value of (99m)Tc-ECD SPET for the diagnosis of dementia with Lewy bodies", Eur J Nucl Med Mol Imaging, 29, pp.1342~1348 (2002)
  68. Tateno M, "Comparison of the usefulness of brain perfusion SPECT and MIBG myocardial scintigraphy for the diagnosis of dementia with Lewy bodies", Dement Geriatr Cogn Disord, 26, pp.453~457 (2008)
  69. Tateno M, "Usefulness of a blood flow analyzing program 3DSRT to detect occipital hypoperfusion in dementia with Lewy bodies", Prog Neuropsychopharmacol Biol Psychiatry, 32, pp.1206~1209 (2008)
  70. Herholz K, "PET studies in dementia", Ann Nucl Med, 17, pp.79~89 (2003)
  71. Albin RL, "Fluoro-deoxyglucose positron emission tomography in diffuse Lewy body disease", Neurology, 47, pp.462~466 (1996)
  72. Imamura T, "Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer’s disease: a comparative study using positron emission tomography", Neurosci Lett, 235, pp.49~52 (1997)
  73. Ishii K, "Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer’s disease", Neurology, 51, pp.125~130 (1998)
  74. Imamura T, "Visual hallucinations and regional cerebral metabolism in dementia with Lewy bodies (DLB)", Neuroreport, 10, pp.1903~1907 (1999)
  75. Higuchi M, "Glucose hypometabolism and neuropathological correlates in brains of dementia with Lewy bodies", Exp Neurol, 162, pp.247~256 (2000)
  76. Minoshima S, "Alzheimer’s disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation", Ann Neurol, 50, pp.358~365 (2001)
  77. Ransmayr G, "Striatal dopamine transporter function in dementia with Lewy bodies and Parkinson’s disease", Eur J Nucl Med, 28, pp.1523~1528 (2001)
  78. O’Brien JT, "Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies", Arch Neurol, 61, pp.919~925 (2004)
  79. McKeith I, "Sensitivity and specificity of dopamine transporter imaging with 123IFP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study", Lancet Neurol, 6, pp.305~313 (2007)
  80. Nestor PJ, "Dopamine transporter brain imaging--can it improve the differential diagnosis of dementia with Lewy bodies?", Nat Clin Pract Neurol, 3, pp.602~603 (2007)
  81. Kline RC, "Myocardial imaging in man with I-123 meta-iodobenzylguanidine", J Nucl Med, 22, pp.129~132 (1981)
  82. Wieland DM, "Myocardial imaging with a radioiodinated norepinephrine storage analog", J Nucl Med, 22, pp.22~31 (1981)
  83. Tobes MC, "Effect of uptake-one inhibitors on the uptake of norepinephrine and metaiodobenzylguanidine", J Nucl Med, 26, pp.897~907 (1985)
  84. Minardo JD, "Scintigraphic and electrophysiological evidence of canine myocardial sympathetic denervation and reinnervation produced by myocardial infarction or phenol application", Circulation, 78, pp.1008~1019 (1988)
  85. Stanton MS, "Regional sympathetic denervation after myocardial infarction in humans detected noninvasively using I-123-metaiodobenzylguanidine", J Am Coll Cardiol, 14, pp.1519~1526 (1989)
  86. Merlet P, "Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure", J Nucl Med, 33, pp.471~477 (1992)
  87. Yoshita M, "Differentiation of idiopathic Parkinson’s disease from striatonigral degeneration and progressive supranuclear palsy using iodine-123 meta-iodobenzylguanidine myocardial scintigraphy", J Neurol Sci, 155, pp.60~67 (1998)
  88. Orimo S, "(123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease", J Neurol Neurosurg Psychiatry, 67, pp.189~194 (1999)
  89. MIBG separates Parkinson’s disease from multiple system atrophy, "Neurology", 1999, 1020~1025
  90. MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer’s-type and dementia with Lewy bodies, "J Neurol Neurosurg Psychiatry", 2001, 583~588
  91. Taki J, "Significance of 123I-MIBG scintigraphy as a pathophysiological indicator in the assessment of Parkinson’s disease and related disorders: it can be a specific marker for Lewy body disease", Ann Nucl Med, 18, pp.453~461 (2004)
  92. Suzuki M, "Impaired myocardial 123I-metaiodobenzylguanidine uptake in Lewy body disease: comparison between dementia with Lewy bodies and Parkinson’s disease", J Neurol Sci, 240, pp.15~19 (2006)
  93. Kobayashi S, "Decreased cardiac MIBG uptake, its correlation with clinical symptoms in dementia with Lewy bodies", Psychiat Res Neuroim, 174, pp.76~80 (2009)
  94. Hanyu H, "The role of 123I-metaiodobenzylguanidine myocardial scintigraphy in the diagnosis of Lewy body disease in patients with dementia in a memory clinic", Dement Geriatr Cogn Disord, 22, pp.379~384 (2006)
  95. Yoshita M, "Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD", Neurology, 66, pp.1850~1854 (2006)
  96. MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer’s disease, "Eur J Nucl Med Mol Imaging", 2006, 248~253
  97. Estorch M, "Cardiac (123)I-metaiodobenzylguanidine imaging allows early identification of dementia with Lewy bodies during life", Eur J Nucl Med Mol Imaging, 35, pp.1636~1641 (2008)

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