Amyloid and glucose imaging in dementia with Lewy bodies and multiple systems atrophy

Daniel O. Claassen, Val J. Lowe, Patrick J. Peller, Ronald C. Petersen, Keith A. Josephs

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background: Multiple Systems Atrophy (MSA) and Dementia with Lewy bodies (DLB) can present with both REM behavior disorder and severe autonomic dysfunction. In rare occasions, patients with MSA progress to cognitive impairment and even dementia. Positron emission topography (PET) imaging using both the amyloid ligand Pittsburgh Compound B (11C-PiB) and 18 flurodeoxyglucose (18F-FDG) was used to ascertain the presence of amyloid and pattern of glucose metabolic derangement in both disorders. Methods: Patients diagnosed with probable DLB or MSA, with clinical symptoms of either REM Behavior Disorder (RBD), Parkinsonism, or dysautonomia were prospectively identified. All underwent both 11C-PiB and 18F-FDG PET imaging. Statistical comparison between DLB, MSA, and normal controls was performed. Results: Six patients, 3 with DLB, 2 with Parkinson predominant MSA (MSA-P), and 1 with cerebellar predominant MSA (MSA-C) were identified. Increased level of PiB retention was noted in all patients diagnosed with DLB, but was absent in MSA. In those with DLB, glucose hypometabolism corresponded with regions of amyloid presence, and included prefrontal, parietotemporal, occipital and primary visual cortex regions. MSA patients were distinguished by cerebellar glucose hypometabolism. Conclusions: These findings emphasize the distinguishing characteristics between the alpha-synuclein related disorders of DLB and MSA. The absence of amyloid in the cases of MSA is a possible distinguishing characteristic of the disorder.

Original languageEnglish (US)
Pages (from-to)160-165
Number of pages6
JournalParkinsonism and Related Disorders
Volume17
Issue number3
DOIs
StatePublished - Mar 1 2011

Keywords

  • Autonomic diseases
  • Dementia with Lewy bodies
  • Multiple system atrophy
  • PIB PET
  • Parasomnias

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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