Abstract
We previously reported non-demented patients with glucose hypometabolism in the primary
visual cortex (PVC), which is the preferentially affected region in patients with
dementia with Lewy bodies (DLB). It remains unknown, however, whether these patients
represent a prodromal DLB state. Eleven non-demented patients who attended our memory
clinic for more than three years (mean follow-up period: 44 ± 5 months) were examined. All the patients had glucose hypometabolism in the PVC on [18F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans at baseline. Four patients,
including one with a clinical history of occipital bleeding, exhibited no core or
suggestive features of DLB. Seven patients reported recurrent nocturnal dream-enactment
behavior, which is consistent with probable rapid eye movement (REM) sleep behavior
disorder (RBD). The condition of the patient with occipital bleeding was stable, which
is consistent with an underlying non-neurodegenerative disorder. Of the remaining
10 patients, 5 had stable cognitive conditions (non-converters) and 5 exhibited progression
to dementia (converters). The clinical diagnoses of 4 patients with probable RBD were
changed to probable DLB. Despite no differences in psychological profiles at baseline
between non-converters and converters, the initial pattern of cortical metabolism
differed: converters had lower glucose hypometabolism in the parietal and the lateral
occipital cortex compared to non-converters. The metabolic reduction in the PVC is
present in patients with prodromal DLB. Moreover, the spatial profiles of reduced
glucose metabolism at baseline could help to define the distinct prognostic subgroup
that has a greater risk of conversion to DLB.
Keywords
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References
- Consortium on DLB. Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium.Neurology. 2005; 65: 1863-1872
- Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias.J Nucl Med. 2008; 49: 390-398
- The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging—Alzheimer's Association workgroup.Alzheimer's Dement. 2011; 7: 270-279
- The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging—Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease.Alzheimer's Dement. 2011; 7: 263-269
- Prodromal clinical manifestations of neuropathologically confirmed Lewy body disease.Neurobiol Aging. 2010; 31: 1805-1813
- Mild cognitive impairment associated with limbic and neocortical Lewy body disease: a clinicopathological study.Brain. 2010; 133: 540-556
- Dementia with Lewy bodies: early diagnostic challenges.Psychogeriatrics. 2013; 13: 128-138
- Alzheimer's disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation.Ann Neurol. 2001; 50: 358-365
- Diffuse occipital hypometabolism on [18F]-FDG PET scans in patients with idiopathic REM sleep behavior disorder: prodromal dementia with Lewy bodies?.Psychogeriatrics. 2010; 10: 144-152
- Glucose hypometabolism in primary visual cortex is commonly associated with clinical features of dementia with Lewy bodies regardless of cognitive conditions.Int J Geriatr Psychiatry. 2012; 27: 1138-1146
- Rapid eye movement sleep behavior disorder and subtypes in autopsy-confirmed dementia with Lewy bodies.Mov Disord. 2012; 27: 72-78
- REM sleep behavior disorder: updated review of the core features, the RBD-neurodegenerative disease association, evolving concepts, controversies, and future directions.Ann N Y Acad Sci. 2010; 1184: 15-54
- UPDRS development committee. The unified Parkinson's disease rating scale.in: Fahn S. Marsden C.D. Calne D.B. Goldstein M. Recent developments in Parkinson's disease. Macmillan Healthcare Information, Florham Park, NJ1987: 153-163
- Association between mild Parkinsonian signs and mild cognitive impairment in a community.Neurology. 2005; 64: 1157-1161
- 123I-MIBG cardiac scintigraphy provides clues to the underlying neurodegenerative disorder in idiopathic REM sleep behavior disorder.Sleep. 2008; 31: 717-723
- Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD.Neurology. 2006; 66: 1850-1854
- Atrophy of medial temporal lobes on MRI in ‘probable’ Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates.J Neurol Neurosurg Psychiatry. 1992; 55: 967-972
- The morphologic correlate of incidental punctuate white matter hyperintensities on MR images.Am J Neuroradiol. 1991; 2: 915-921
- Construction of a 18F-FDG PET normative database of Japanese healthy elderly subjects and its application to demented and mild cognitive impairment patients.Int J Geriatr Psychiatry. 2010; 25: 352-361
- A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET.J Nucl Med. 1995; 36: 1238-1248
- Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation.Ann Nucl Med. 2003; 17: 289-295
- What best differentiates Lewy body from Alzheimer's disease in early-stage dementia?.Brain. 2006; 129: 729-735
- Mild Parkinsonian signs: an overview of an emerging concept.Mov Disord. 2007; 22: 1681-1688
- Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.J Neurol Neurosurg Psychiatry. 1992; 55: 181-184
- The 18F-FDG PET cingulate island sign and comparison to 123I-beta-CIT SPECT for diagnosis of dementia with Lewy bodies.J Nucl Med. 2009; 50: 1638-1645
- Diagnostic procedures for Parkinson's disease dementia: recommendations from the movement disorder society task force.Mov Disord. 2007; 22: 2314-2324
- Biomarkers in dementia with Lewy bodies: a review.Int J Geriatr Psychiatry. 2012; 27: 443-453
- Early detection of dementia with Lewy bodies in patients with amnestic mild cognitive impairment using 123I-MIBG cardiac scintigraphy.J Neurol Sci. 2012; 315: 115-119
- Evidence that incidental Lewy body disease is pre-symptomatic Parkinson's disease.Acta Neuropathol. 2008; 115: 437-444
- Cardiac sympathetic denervation correlates with clinical and pathologic stages of Parkinson's disease.Mov Disord. 2008; 23: 1085-1092
- Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies.Neurology. 2011; 77: 875-882
- Symptoms of rapid eye movement sleep behavior disorder are associated with cholinergic denervation in Parkinson disease.Ann Neurol. 2012; 71: 560-568
- Depletion of cholinergic neurons in the nucleus of the medial septum and the vertical limb of the diagonal band in dementia with Lewy bodies.Acta Neuropathol. 2006; 111: 109-114
- The cholinergic system and Parkinson disease.Behav Brain Res. 2011; 221: 564-573
- Mapping of brain acetylcholinesterase alterations in Lewy body disease by PET.Neurology. 2009; 73: 273-278
- Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder.Neurology. 2009; 72: 1296-1300
- Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study.Mov Disord. 2012; 27: 720-726
- Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson's disease.Ann Neurol. 2009; 66: 39-47
- Synaptic proteins and choline acetyltransferase loss in visual cortex in dementia with Lewy bodies.J Neuropathol Exp Neurol. 2013; 72: 53-60
- Improved visual hallucination by donepezil and occipital glucose metabolism in dementia with Lewy bodies: the Osaki-Tajiri project.Eur Neurol. 2010; 64: 337-344
- The progression of pathology in Parkinson's disease.Ann N Y Acad Sci. 2010; 16: 653-661
- Distribution of cerebral amyloid deposition and its relevance to clinical phenotype in Lewy body dementia.Neurosci Lett. 2010; 486: 19-23
- Brain amyloid and cognition in Lewy body diseases.Mov Disord. 2012; 27: 965-973
- Multimodality imaging characteristics of dementia with Lewy bodies.Neubiol Aging. 2012; 33: 2091-2105
- Low sensitivity in clinical diagnoses of dementia with Lewy bodies.J Neurol. 2010; 257: 359-366
Article info
Publication history
Published online: August 07, 2013
Accepted:
July 20,
2013
Received in revised form:
June 27,
2013
Received:
May 1,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
