RT Journal Article
SR Electronic
T1 Differentiation of dementia with Lewy bodies from Alzheimer's disease using a dopaminergic presynaptic ligand
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 134
OP 140
DO 10.1136/jnnp.73.2.134
VO 73
IS 2
A1 Z Walker
A1 D C Costa
A1 R W H Walker
A1 K Shaw
A1 S Gacinovic
A1 T Stevens
A1 G Livingston
A1 P Ince
A1 I G McKeith
A1 C L E Katona
YR 2002
UL http://jnnp.bmj.com/content/73/2/134.abstract
AB Background: Dementia with Lewy bodies (DLB) is one of the main differential diagnoses of Alzheimer's disease (AD). Key pathological features of patients with DLB are not only the presence of cerebral cortical neuronal loss, with Lewy bodies in surviving neurones, but also loss of nigrostriatal dopaminergic neurones, similar to that of Parkinson's disease (PD). In DLB there is 40–70% loss of striatal dopamine. Objective: To determine if detection of this dopaminergic degeneration can help to distinguish DLB from AD during life. Methods: The integrity of the nigrostriatal metabolism in 27 patients with DLB, 17 with AD, 19 drug naive patients with PD, and 16 controls was assessed using a dopaminergic presynaptic ligand, 123I-labelled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane (FP-CIT), and single photon emission tomography (SPET). A SPET scan was carried out with a single slice, brain dedicated tomograph (SME 810) 3.5 hours after intravenous injection of 185 MBq FP-CIT. With occipital cortex used as a radioactivity uptake reference, ratios for the caudate nucleus and the anterior and posterior putamen of both hemispheres were calculated. All scans were also rated by a simple visual method. Results: Both DLB and PD patients had significantly lower uptake of radioactivity than patients with AD (p<0.001) and controls (p<0.001) in the caudate nucleus and the anterior and posterior putamen. Conclusion: FP-CIT SPET provides a means of distinguishing DLB from AD during life.