Clinical imaging in dementia with Lewy bodies.
Evidence-based mental health
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Surendranathan, A., & O'Brien, J. (2018). Clinical imaging in dementia with Lewy bodies.. Evidence-based mental health, 21 (2), 61-65. https://doi.org/10.1136/eb-2017-102848
Dementia with Lewy bodies(DLB) is a common neurodegenerative dementia in older people, however, the clinical features particularly cognitive fluctuations and REM sleep disorder are often hard to elicit, leading to difficulty in making the diagnosis clinically. Here we examine the literature for the evidence behind imaging modalities that could assist in making the diagnosis. Dopamine transporter(DAT) imaging remains the best modality for differentiation from dementia of Alzheimer’s type with high sensitivity and specificity reported based on pathological diagnoses. 123Iodine- metaiodobenzylguanidine myocardial scintigraphy (MIBG) however is rapidly becoming an alternative imaging modality for the diagnosis of DLB, though studies assessing its accuracy with post-mortem verification are still awaited. However, there are suggestions that MIBG may be better in the differentiation of vascular parkinsonism from DLB, than DAT scans, but may have lower sensitivity for detecting DLB compared to the 80% sensitivity seen in DAT imaging. Structural MRI scans have long been used for the diagnosis of dementia, however their utility in DLB is limited to revealing the presence of co-existing Alzheimer’s disease. Fluorodeoxyglucose (FDG) PET is an alternative biomarker that can also differentiate Alzheimer’s disease and DLB, but lacks the evidence base of both DAT and MIBG scans.
Humans, Lewy Body Disease, Positron-Emission Tomography, Tomography, Emission-Computed, Single-Photon, Magnetic Resonance Imaging, Myocardial Perfusion Imaging
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
External DOI: https://doi.org/10.1136/eb-2017-102848
This record's URL: https://www.repository.cam.ac.uk/handle/1810/276672