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Clinical and imaging correlates of amyloid deposition in dementia with Lewy bodies.

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Peer-reviewed

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Authors

Firbank, Michael J 
Thomas, Alan J 
Lloyd, Jim 
Petrides, George 

Abstract

BACKGROUND: Amyloid deposition is common in dementia with Lewy bodies, but its pathophysiological significance is unclear. OBJECTIVE: The objective of this study was to investigate the relationship between amyloid deposition and clinical profile, gray matter volume, and brain perfusion in dementia with Lewy bodies. METHODS: Dementia with Lewy bodies (n = 37), Alzheimer's disease (n = 20), and controls (n = 20) underwent a thorough clinical assessment, 3T MRI, and early- and late-phase 18 F-Florbetapir PET-CT to assess cortical perfusion and amyloid deposition, respectively. Amyloid scans were visually categorized as positive or negative. Image analysis was carried out using statistical parametric mapping (SPM) 8. RESULTS: There were no significant differences between amyloid-positive and amyloid-negative dementia with Lewy bodies cases in age (P = .78), overall cognitive impairment (P = .83), level of functional impairment (P = .80), or any other clinical or cognitive scale. There were also no significant differences in hippocampal or gray matter volumes. However, amyloid-positive dementia with Lewy bodies cases had lower medial temporal lobe perfusion (P = .03) than amyloid-negative cases, although a combination of medial temporal lobe perfusion, hippocampal volume, and cognitive measures was unable to accurately predict amyloid status in dementia with Lewy bodies. CONCLUSIONS: Amyloid deposition was not associated with differences in clinical or neuropsychological profiles in dementia with Lewy bodies, but was associated with imaging evidence of medial temporal lobe dysfunction. The presence of amyloid in dementia with Lewy bodies cannot be identified on the basis of clinical and other imaging features and will require direct assessment via PET imaging or CSF. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Description

Keywords

Dementia with Lewy bodies, amyloid, florbetapir, positron emission tomography, Aged, Aged, 80 and over, Alzheimer Disease, Amyloid, Aniline Compounds, Brain, Cognition Disorders, England, Ethylene Glycols, Female, Humans, Imaging, Three-Dimensional, Lewy Body Disease, Magnetic Resonance Imaging, Male, Middle Aged, Positron-Emission Tomography, Prospective Studies, Tomography Scanners, X-Ray Computed

Journal Title

Mov Disord

Conference Name

Journal ISSN

0885-3185
1531-8257

Volume Title

33

Publisher

Wiley
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Avid, Eli Lilly, NIHR Cambridge and Newcastle Biomedical Research Centre