Correlation between clinical symptoms and striatal DAT uptake in patients with DLB
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ORIGINAL ARTICLE
Correlation between clinical symptoms and striatal DAT uptake in patients with DLB Soichiro Shimizu1 · Disuke Hirose1 · Nayuta Namioka1 · Hidekazu Kanetaka1 · Kentaro Hirao1 · Hirokuni Hatanaka1 · Naoto Takenoshita1 · Yoshitsugu Kaneko1 · Yusuke Ogawa1 · Takahiko Umahara1 · Hirofumi Sakurai1 · Haruo Hanyu1
Received: 7 March 2017 / Accepted: 22 March 2017 © The Japanese Society of Nuclear Medicine 2017
Abstract Objective It is widely known that there is low striatal 123 I-FP-CIT dopamine transporter-single photon emission tomography (DAT-SPECT) uptake in patients with dementia with Lewy bodies (DLB). We assessed the correlation between symptom and regional low DAT uptake in the striatum. Methods Patients with Alzheimer’s disease (AD) (n = 95) and patients with DLB (n = 133) who underwent DATSPECT were enrolled. We examined the correlation between symptoms [cognitive function decline, fluctuations, visual hallucinations, parkinsonism, and REM sleep behavior disorder (RBD)] and regional striatal DAT uptake in the patients with DLB. Results When comparing the DLB patients with or without fluctuations, visual hallucinations, or RBD, there were no significant differences in DAT uptake in any regions of the striatum. DLB patients with parkinsonism had significantly lower DAT uptake in entire striatum, entire putamen, and anterior putamen compared to DLB patients without parkinsonism. Moreover, there was weak but significant correlation between severity of parkinsonism and DAT uptake in entire regions of the striatum in patients with DLB. There was no significant correlation between cognitive function and DAT uptake in any regions of the striatum in patients with DLB. Conclusions In patients with DLB, only parkinsonism is associated with a reduction in striatal DAT uptake. * Soichiro Shimizu [email protected] 1
Department of Geriatric Medicine, Tokyo Medical University, 6‑7‑1 Nishishinjuku, Shinjuku‑ku, Tokyo 160‑0023, Japan
Keywords Dementia with Lewy bodies · Parkinsonism · 123 I-FP-CIT · DAT scan · Alzheimer’s disease
Introduction Dementia with Lewy bodies (DLB) is recognized as the second most common cause of degenerative dementia in older people, following Alzheimer’s disease (AD). To improve the diagnosis of DLB, the latest diagnostic criteria [1] incorporate the low dopamine transporter (DAT) uptake in the brain’s basal ganglia by single photon emission tomography (SPECT) or positron emission tomography (PET) imaging as a suggestive feature. 123 I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3fluoropropyl) nortropane (123I-FP-CIT), a ligand that binds to the presynaptic dopamine transporter, can be used to analyze the integrity of the nigrostriatal projection pathway. 123I-FP-CIT dopamine transporter-single photon emission tomography (DAT-SPECT) has been used in a large number of trials to identify the in vivo loss of dopamine transporters in the striatum of patients with presynaptic parkinsonism [2–5]. The previous studies showed that DAT-SPECT substantially enhanced the accuracy
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