Regional glucose metabolic reduction in dementia with Lewy bodies is independent of amyloid deposition
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ORIGINAL ARTICLE
Regional glucose metabolic reduction in dementia with Lewy bodies is independent of amyloid deposition Kazunari Ishii • Chisa Hosokawa • Tomoko Hyodo • Kenta Sakaguchi • Kimio Usami • Kenji Shimamoto • Makoto Hosono • Yuzuru Yamazoe • Takamichi Murakami
Received: 18 May 2014 / Accepted: 21 September 2014 / Published online: 1 October 2014 Ó The Japanese Society of Nuclear Medicine 2014
Abstract Purpose There is evidence that some cases of patients with dementia with Lewy bodies (DLB) can demonstrate Alzheimer disease (AD) like reduced glucose metabolism without amyloid deposition. The aim of this study was to clarify whether regional hypometabolism is related to amyloid deposits in the DLB brain and measure the degree of regional hypometabolism. Methods Ten consecutive subjects with DLB and 10 AD patients who underwent both Pittsburgh compound B (PiB)-PET and 18F-fluoro-2-deoxyglucose (FDG)-PET were included in this study. Regional standardized uptake value ratio (SUVR)s normalised to cerebellar cortices were calculated in the FDG- and PiB-PET images. Results All AD patients and five DLB patients showed amyloid deposits (PiB positive). In the DLB group the parietotemporal and occipital metabolism were significantly lower than those in the AD group but there was no difference between the posterior cingulate hypometabolism between DLB and AD groups. There were no differences in regional glucose metabolism between PiB positive and negative DLB patients.
K. Ishii (&) Neurocognitive Disorders Center, Kinki University Hospital, 377-2 Ohnohigashi, Osakasayama, Osaka 589-8511, Japan e-mail: [email protected] K. Ishii C. Hosokawa T. Hyodo T. Murakami Department of Radiology, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan K. Sakaguchi K. Usami K. Shimamoto M. Hosono Y. Yamazoe T. Murakami Institute of Advanced Clinical Medicine, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
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Conclusions In the DLB brain, it is suggested that decreased regional glucose metabolism is unrelated to amyloid deposits, although the hypometabolic area overlaps with the AD hypometabolic area and the degree of parietotemporal and occipital hypometabolism in DLB brain is much larger than that in AD brain. Keywords Dementia with Lewy bodies Glucose metabolism Amyloid deposit PET
Introduction Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease (AD). The clinical core features of DLB include fluctuating cognition, recurrent visual hallucinations, and Parkinsonism. DLB is characterised pathologically by the presence of Lewy bodies in cortical, subcortical, and brainstem structures, and belongs to the spectrum of Lewy body diseases including Parkinson disease (PD), where Lewy bodies remain in the brainstem. The criteria for clinical and pathological diagnoses of DLB were revised in 2005, and included an important role for functional and morphological imaging [1]. Suggestive features for DLB include low dopamine
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