Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease: a comparative study using positron emission tomography

Regional cerebral metabolic rate of glucose (rCMRglc) was studied in 19 patients with a clinical diagnosis of dementia with Lewy bodies (DLB) and 19 patients with a clinical diagnosis of Alzheimer's disease (AD), using [18F]fluorodeoxyglucose ([18F]FDG) and positron emission tomography (PET). The two groups were matched with age, gender, disease duration and severity of cognitive disturbances. In 'dementia with Lewy bodies' (DLB) patients, when compared with AD patients, significant rCMRglc decreases were distributed in the temporo-parieto-occipital association cortices and the cerebellar hemispheres. In contrast, the medial temporal and cingulate rCMRglc were significantly lower in AD patients than those in DLB patients. These different regional emphases of glucose hypometabolism are consistent with the pathological and neurochemical differences between DLB and AD and explain the different clinical features of the two diseases.

[1]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[2]  E. Hoffman,et al.  Tomographic measurement of local cerebral glucose metabolic rate in humans with (F‐18)2‐fluoro‐2‐deoxy‐D‐glucose: Validation of method , 1979, Annals of neurology.

[3]  E. Byrne,et al.  Clock-face drawing to differentiate Lewy body and Alzheimer type dementia syndromes , 1996, The Lancet.

[4]  Robert H. Perry,et al.  Senile dementia of Lewy body type A clinically and neuropathologically distinct form of Lewy body dementia in the elderly , 1990, Journal of the Neurological Sciences.

[5]  T. Taniwaki,et al.  Positron emission tomographic (PET) studies in dementia , 1993, Journal of the Neurological Sciences.

[6]  R. Albin,et al.  Cerebral metabolic differences in Parkinson's and Alzheimer's diseases matched for dementia severity. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[7]  M. Torrens Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[8]  Douglas Galasko,et al.  Neuropsychological Deficits Associated with Diffuse Lewy Body Disease , 1996, Brain and Cognition.

[9]  M Schulzer,et al.  Cerebral glucose metabolism in Parkinson's disease with and without dementia. , 1992, Archives of neurology.

[10]  C. Lippa,et al.  Alzheimer's disease and Lewy body disease: A comparative clinicopathological study , 1994, Annals of neurology.

[11]  D. Galasko,et al.  Neurotransmitters in basal ganglia and cortex of Alzheimer's disease with and without Lewy bodies , 1993, Neurology.

[12]  E. Perry,et al.  Dementia with Lewy Bodies: Altered consciousness and transmitter signalling in Lewy body dementia , 1996 .

[13]  L. Thal,et al.  The Lewy body variant of Alzheimer's disease , 1990, Neurology.

[14]  D. Irving,et al.  Alteration in nicotine binding sites in Parkinson's disease, Lewy body dementia and Alzheimer's disease: Possible index of early neuropathology , 1995, Neuroscience.

[15]  K. Kosaka,et al.  Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB) , 1996, Neurology.

[16]  R. Albin,et al.  Fluoro-deoxyglucose positron emission tomography in diffuse Lewy body disease , 1996, Neurology.

[17]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[18]  T. Imai,et al.  A Case of Diffuse Lewy Body and Alzheimer's Diseases with Periodic Synchronous Discharges , 1988, Journal of neuropathology and experimental neurology.

[19]  K. Davis,et al.  Neocortical cholinergic activities differentiate Lewy body dementia from classical Alzheimer's disease. , 1994, Neuroreport.

[20]  Karl J. Friston,et al.  Statistical parametric maps in functional imaging: A general linear approach , 1994 .

[21]  R. Levy,et al.  The Lewy-Body Variant of Alzheimer's Disease , 1993, British Journal of Psychiatry.

[22]  D. Brooks,et al.  Dementia with Lewy Bodies: Positron emission tomography findings in Parkinson's disease and Lewy body dementia , 1996 .

[23]  K. Ishii,et al.  Reduction of cerebellar glucose metabolism in advanced Alzheimer's disease. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.