Neurotransmitter changes in dementia with Lewy bodies and Parkinson disease dementia in vivo
| Autor: | Carina Hohmann, Johannes C. Klein, Rüdiger Hilker, S. Baudrexel, Simon Weisenbach, Stefan Vollmar, Nico J. Diederich, Carsten Eggers, Wolf-Dieter Heiss, Elke Kalbe |
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| Rok vydání: | 2010 |
| Předmět: |
Lewy Body Disease
Dopamine Neuropsychological Tests Statistical parametric mapping behavioral disciplines and activities Central nervous system disease Imaging Three-Dimensional Degenerative disease Fluorodeoxyglucose F18 mental disorders Image Processing Computer-Assisted medicine Humans Dementia Fluorodopa Aged Brain Mapping Basal forebrain Lewy body Dementia with Lewy bodies Brain Parkinson Disease Middle Aged medicine.disease Acetylcholine Dihydroxyphenylalanine nervous system Positron-Emission Tomography Lewy Bodies Neurology (clinical) Psychology Neuroscience |
| Zdroj: | Neurology. 74:885-892 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0b013e3181d55f61 |
| Popis: | Objective: Although Parkinson disease with dementia (PDD) and dementia with Lewy bodies (DLB) show a wide clinical and neuropathologic overlap, they are differentiated according to the order and latency of cognitive and motor symptom appearance. Whether both are distinct disease entities is an ongoing controversy. Therefore, we directly compared patients with DLB and PDD with multitracer PET.Methods: PET with 18fluorodopa (FDOPA), N-11C-methyl-4-piperidyl acetate (MP4A), and 18fluorodeoxyglucose (FDG) was performed in 8 patients with PDD, 6 patients with DLB, and 9 patients with PD without dementia vs age-matched controls. Data were analyzed with voxel-based statistical parametric mapping and region of interest–based statistics.Results: We found a reduced FDOPA uptake in the striatum and in limbic and associative prefrontal areas in all patient groups. Patients with PDD and patients with DLB showed a severe MP4A and FDG binding reduction in the neocortex with increasing signal diminution from frontal to occipital regions. Significant differences between PDD and DLB were not found in any of the radioligands used. Patients with PD without dementia had a mild cholinergic deficit and no FDG reductions vs controls.Conclusions: Patients with dementia with Lewy bodies and Parkinson disease dementia share the same dopaminergic and cholinergic deficit profile in the brain and seem to represent 2 sides of the same coin in a continuum of Lewy body diseases. Cholinergic deficits seem to be crucial for the development of dementia in addition to motor symptoms. The spatial congruence of cholinergic deficits and energy hypometabolism argues for cortical deafferentation due to the degeneration of projection fibers from the basal forebrain. |
| Databáze: | OpenAIRE |
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