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123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Evidence for the prodromal stage of dementia with Lewy bodies (DLB) is very limited. To address this issue, we investigate the 123I-FP-CIT SPECT measure of dopamine transporter binding finding and its clinical relevance.

Methods

We enrolled subjects into a prodromal DLB group (PRD-DLB) (n = 20) and clinical DLB group (CLIN-DLB) (n = 18) and compared these groups with an Alzheimer’s disease control group (AD) (n = 10). PRD-DLB was defined as patients having the non-motor symptoms associated with Lewy body disease (LBD) [i.e. REM sleep behavior disorder (RBD), olfactory dysfunction, autonomic dysfunction, and depression] and showing characteristic diffuse occipital hypometabolism in 18F-FDG PET. CLIN-DLB was defined as patients fulfilling the established criteria of probable DLB. Striatal specific binding ratio (SBR) of 123I-FP-CIT SPECT was used for objective group comparisons. The correlations between SBR and cognitive function (MMSE), motor symptoms (UPDRS3), and duration of LBD-associated non-motor symptoms were compared between the two DLB groups.

Results

Mean SBR scores of both PRD-DLB and CLIN-DLB were significantly lower than those of AD. No correlation was found between SBR and MMSE scores. Both in the CLIN-DLB and total DLB groups, SBR scores were negatively correlated with UPDRS3 scores, whereas no correlation was found in PRD-DLB. Among the LBD-related non-motor symptoms, duration of olfactory dysfunction, and RBD demonstrated negative correlation with SBR scores in PRD-DLB.

Conclusion

123I-FP-CIT SPECT may play a role for detecting DLB among the subjects in prodromal stage. During this stage, long-term olfactory dysfunction and/or RBD may indicate more severe degeneration of the nigro-striatal dopaminergic pathway.

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References

  1. McKeith IG, Dickson DW, Lowe J, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65:1863–72.

    Article  CAS  PubMed  Google Scholar 

  2. Chaudhuri KR, Martinez-Martin P, Schapira AH, et al. International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study. Mov Disord. 2006;21:916–23.

    Article  PubMed  Google Scholar 

  3. Chiba Y, Fujishiro H, Iseki E, et al. Retrospective survey of prodromal symptoms in dementia with Lewy bodies: comparison with Alzheimer's disease. Dement Geriatr Cogn Disord. 2012;33:273–81.

    Article  PubMed  Google Scholar 

  4. Papathanasiou ND, Boutsiadis A, Dickson J, Bomanji JB. Diagnostic accuracy of 123I-FP-CIT (DaTSCAN) in dementia with Lewy bodies: a meta-analysis of published studies. Parkinsonism Relat Disord. 2012;18:225–9.

    Article  PubMed  Google Scholar 

  5. Fujishiro H, Iseki E, Kasanuki K, et al. Glucose hypometabolism in primary visual cortex is commonly associated with clinical features of dementia with Lewy bodies regardless of cognitive conditions. Int J Geriatr Psychiatr. 2012;27:1138–46.

    Article  Google Scholar 

  6. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med;256:183–194.

  7. McKhann GM, Knopman DS, Chertkow H, et al. 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. Alzheimers Dement. 2011;7:263–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Scheltens P, Leys D, Barkhof F, et al. 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;55:967–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fazekas F, Kleinert R, Offenbacher H, et al. The morphologic correlate of incidental punctate white matter hyperintensities on MR images. Am J Neuroradiol. 1991;12:915–21.

    CAS  PubMed  Google Scholar 

  10. E. Iseki, N. Murayama, R. Yamamoto, H, et al. Construction of a (18)F-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.

  11. Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer’s disease using three-dimensional Stereotactic surface projections of Fluorine-19-FDG PET. J Nucl Med. 1995;36:1238–48.

    CAS  PubMed  Google Scholar 

  12. Mizumura S, Kumita S, Cho K, et al. Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation. Ann Nucl Med. 2003;17:289–95.

    Article  PubMed  Google Scholar 

  13. Japanese society of nuclear medicine. Japanese ioflupane guideline working group recommendation. http://www.jsnm.org/guideline/ioflupane. Accessed 3 Jun 2016.

  14. Kuya K, Shinohara Y, Miyoshi F, Fujii S, Tanabe Y, Ogawa T. Correlation between neuromelanin-sensitive MR imaging and 123I-FP-CIT SPECT in patients with parkinsonism. Neuroradiology. 2016;58:351–6.

    Article  PubMed  Google Scholar 

  15. Dickson JC, Tossici-Bolt L, Sera T, et al. The impact of reconstruction method on the quantification of DaTSCAN images. Eur J Nucl Med Mol Imaging. 2010;37:23–35.

    Article  PubMed  Google Scholar 

  16. Tossici-Bolt L, Hoffmann SM, Kemp PM, Mehta RL, Fleming JS. Quantification of [123I] FP-CIT SPECT brain images: an accurate technique for measurement of the specific binding ratio. Eur J Nucl Med Mol Imaging. 2006;33:1491–9.

    Article  PubMed  Google Scholar 

  17. Boeve BF. REM sleep behavior disorder: Updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions. Ann N Y Acad Sci. 2010;1184:15–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Tolosa E, Borght TV, Moreno E. Accuracy of DaTSCAN (123I-Ioflupane) SPECT in diagnosis of patients with clinically uncertain parkinsonism: 2-year follow-up of an open-label study. Mov Disord. 2007;22:2346–51.

    Article  PubMed  Google Scholar 

  19. Siepel FJ, Rongve A, Buter TC, et al. FP-CIT SPECT in suspected dementia with Lewy bodies: A longitudinal case study. BMJ Open. 123I. doi:10.1136/bmjopen-2013-002642.

  20. Fujishiro H, Iseki E, Murayama N, et al. Diffuse occipital hypometabolism on [18F]-FDG PET scans in patients with idiopathic REM sleep behavior disorder: Prodomal dementia with Lewy bodies? Psychogeriatrics. 2010;10:144–52.

    Article  PubMed  Google Scholar 

  21. Fujishiro H, Iseki E, Kasanuki K, et al. A follow up study of non-demented patients with primary visual cortical hypometabolism: prodromal dementia with Lewy bodies. J Neurol Sci. 2013;334:48–54.

    Article  CAS  PubMed  Google Scholar 

  22. Bohnen NI, Koeppe RA, Minoshima S, et al. Cerebral glucose metabolic features of Parkinson disease and incident dementia: longitudinal study. J Nucl Med. 2011;52:848–55.

    Article  CAS  PubMed  Google Scholar 

  23. Booij J, Tissingh G, Boer GJ, et al. [123I]FP-CIT SPECT shows a pronounced decline of striatal dopamine transporter labelling in early and advanced Parkinson's disease. J Neurol Neurosurg Psych. 1997;62:133–40.

    Article  CAS  Google Scholar 

  24. Rektorova I, Srovnalova H, Kubikova R, Prasek J. Striatal dopamine transporter imaging correlates with depressive symptoms and tower of London task performance in Parkinson’s disease. Mov Disord. 2008;23:1580–7.

    Article  PubMed  Google Scholar 

  25. Remy P, Doder M, Lees A, Turjanski N, Brooks D. Depression in Parkinson’s disease: loss of dopamine and noradrenaline innervation in the limbic system. Brain. 2005;128:1314–22.

    Article  PubMed  Google Scholar 

  26. Burruss JW, Hurley RA, Taber KH, Rauch RA, Norton RE, Hayman LA. Functional neuroanatomy of the frontal lobe circuits. Radiology. 2000;214:227–30.

    Article  CAS  PubMed  Google Scholar 

  27. Ziebell M, Andersen BB, Pinborg LH, et al. Striatal dopamine transporter binding does not correlate with clinical severity in dementia with Lewy bodies. J Nucl Med. 2013;54:1072–6.

    Article  PubMed  Google Scholar 

  28. Del Sole A, Perini G, Lecchi M, Mariani C, Lucignani G, Clerici F. Correlation between 123I-FP-CIT brain SPECT and parkinsonism in dementia with Lewy bodies: caveat for clinical use. Clin Nucl Med. 2015;40:32–5.

    Article  PubMed  Google Scholar 

  29. Roselli F, Pisciotta NM, Perneczky R, et al. Severity of neuropsychiatric symptoms and dopamine transporter levels in dementia with Lewy bodies: A 123I-FP-CIT SPECT study. Mov Disord. 2009;24:2097–103.

    Article  PubMed  Google Scholar 

  30. Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003;24:197–211.

    Article  PubMed  Google Scholar 

  31. Marsden CD. Parkinson’s disease. Lancet. 1990;335:948–52.

    Article  CAS  PubMed  Google Scholar 

  32. Attems J, Quass M, Jellinger KA. Tau and alpha-synuclein brainstem pathology in Alzheimer disease: relation with extrapyramidal signs. Acta Neuropathol. 2007;113:53–62.

    Article  CAS  PubMed  Google Scholar 

  33. Walker Z, Jaros E, Walker RW, et al. Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry. 2007;78:1176–81.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Taylor JP, Colloby SJ, McKeith IG, et al. Cholinesterase inhibitor use does not significantly influence the ability of 123I-FP-CIT imaging to distinguish Alzheimer’s disease from dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2007;78:1069–71.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Parkinson Study Group. Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA. 2002;287:1653–61.

    Article  Google Scholar 

Download references

Acknowledgments

None authors declare that they have conflicts of interest. The present study was supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (grant number: 90648859).

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Authors and Affiliations

  1. PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan

    Koji Kasanuki, Eizo Iseki, Kazumi Ota, Daizo Kondo & Kiyoshi Sato

  2. Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan

    Koji Kasanuki, Eizo Iseki, Kazumi Ota, Yosuke Ichimiya & Heii Arai

  3. Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA

    Koji Kasanuki

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  1. Koji Kasanuki
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  2. Eizo Iseki
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  3. Kazumi Ota
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Correspondence to Koji Kasanuki.

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Kasanuki, K., Iseki, E., Ota, K. et al. 123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies. Eur J Nucl Med Mol Imaging 44, 358–365 (2017). https://doi.org/10.1007/s00259-016-3466-6

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  • DOI: https://doi.org/10.1007/s00259-016-3466-6

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