Mild cognitive impairment with Lewy bodies: blood perfusion with arterial spin labelling
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Mild cognitive impairment with Lewy bodies: blood perfusion with arterial spin labelling Michael J. Firbank1 · John T. O’Brien2 · Rory Durcan1 · Louise M. Allan3 · Sally Barker1 · Joanna Ciafone1 · Paul C. Donaghy1 · Calum A. Hamilton1 · Sarah Lawley1 · Jim Lloyd4 · Gemma Roberts1,4 · John‑Paul Taylor1 · Alan J. Thomas1 Received: 25 August 2020 / Revised: 8 October 2020 / Accepted: 10 October 2020 © The Author(s) 2020
Abstract Objective To use arterial spin labelling to investigate differences in perfusion in mild cognitive impairment with Lewy bodies (MCI-LB) compared to Alzheimer type MCI (MCI-AD) and healthy controls. Methods We obtained perfusion images on 32 MCI-LB, 30 MCI-AD and 28 healthy subjects of similar age. Perfusion relative to cerebellum was calculated, and we aimed to examine differences in relative perfusion between MCI-LB and the other groups. This included whole brain voxelwise comparisons, as well as using predefined region-of-interest ratios of medial occipital to medial temporal, and posterior cingulate to precuneus. Differences in occipital perfusion in eyes open vs eyes closed conditions were also examined. Results Compared to controls, the MCI-LB showed reduced perfusion in the precuneus, parietal, occipital and fusiform gyrus regions. In our predefined regions, the ratio of perfusion in occipital/medial temporal was significantly lower, and the posterior cingulate/precuneus ratio was significantly higher in MCI-LB compared to controls. Overall, the occipital perfusion was greater in the eyes open vs closed condition, but this did not differ between groups. Conclusion We found patterns of altered perfusion in MCI-LB which are similar to those seen in dementia with Lewy bodies, with reduction in posterior parietal and occipital regions, but relatively preserved posterior cingulate. Keywords Mild cognitive impairment · Magnetic resonance imaging · Perfusion imaging · Arterial spin labelling · Lewy body disease
Introduction There is increased recognition that identification and treatment of dementia should be performed as early as possible in the disease process to optimise chances of treatment success, and to be able to offer specific healthcare advice to patients * Michael J. Firbank [email protected] 1
Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
2
Department of Psychiatry, University of Cambridge, Cambridge, UK
3
College of Medicine and Health, Exeter University, Exeter, UK
4
Nuclear Medicine Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
and care givers. As such, there has been a research focus on earlier, prodromal stages, of dementia such as the condition of mild cognitive impairment (MCI), which represents a high risk state for progression to dementia. Whilst most previous work and diagnostic criteria for MCI has focussed around it as a risk state for progression to Alzheimer’s disease, criteria for mi
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