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01-04-2014 | Review

Neuroimaging characteristics of dementia with Lewy bodies

Authors: Elijah Mak, Li Su, Guy B Williams, John T O’Brien

Published in: Alzheimer's Research & Therapy | Issue 2/2014

Abstract

This review summarises the findings and applications from neuroimaging studies in dementia with Lewy bodies (DLB), highlighting key differences between DLB and other subtypes of dementia. We also discuss the increasingly important role of imaging biomarkers in differential diagnosis and outline promising areas for future research in DLB. DLB shares common clinical, neuropsychological and pathological features with Parkinson’s disease dementia and other dementia subtypes, such as Alzheimer’s disease. Despite the development of consensus diagnostic criteria, the sensitivity for differential diagnosis of DLB in clinical practice remains low and many DLB patients will be misdiagnosed. The importance of developing accurate imaging markers in dementia is highlighted by the potential for treatments targeting specific molecular abnormalities as well as the responsiveness to cholinesterase inhibitors and marked neuroleptic sensitivity of DLB. We review various brain imaging techniques that have been applied to investigate DLB, including the characteristic nigrostriatal degeneration in DLB using positron emission tomography (PET) and single-photon emission computed tomography (SPECT) tracers. Dopamine transporter loss has proven to reliably differentiate DLB from other dementias and has been incorporated into the revised clinical diagnostic criteria for DLB. To date, this remains the 'gold standard' for diagnostic imaging of DLB. Regional cerebral blood flow, 18 F-fluorodeoxygluclose-PET and SPECT have also identified marked deficits in the occipital regions with relative sparing of the medial temporal lobe when compared to Alzheimer’s disease. In addition, structural, diffusion, and functional magnetic resonance imaging techniques have shown alterations in structure, white matter integrity, and functional activity in DLB. We argue that the multimodal identification of DLB-specific biomarkers has the potential to improve ante-mortem diagnosis and contribute to our understanding of the pathological background of DLB and its progression.

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Title: Neuroimaging characteristics of dementia with Lewy bodies
Authors: Elijah Mak
Li Su
Guy B Williams
John T O’Brien
Publication date: 01-04-2014
Publisher: BioMed Central
Published in: Alzheimer's Research & Therapy / Issue 2/2014
Electronic ISSN: 1758-9193
DOI: https://doi.org/10.1186/alzrt248

At a glance: The STEP trials

Springer Medicine

Neuroimaging characteristics of dementia with Lewy bodies

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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