Mild cognitive impairment associated with underlying Alzheimer's disease versus Lewy body disease

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Abstract

The objective of this paper is to compare and contrast the clinical, neuropsychological, and neuroimaging findings in patients with mild cognitive impairment (MCI) associated with underlying Alzheimer's disease (AD) versus Lewy body disease (LBD) pathology. MCI refers to a clinical syndrome with impairment in one or more cognitive domains, with essentially normal performance of activities of daily living. Patients with the amnesic subtype of MCI often develop the dementia syndrome and neuroimaging findings characteristic of AD [e.g., hippocampal atrophy on magnetic resonance imaging (MRI), temporoparietal and posterior cingulate hypometabolism on fluorodeoxyglucose positron emission tomography (FDG-PET), positive uptake on amyloid PET, normal striatonigral uptake on dopamine transporter scanning (DAT), etc.]. In contrast, the MCI syndrome associated with LBD pathology regardless of the coexisting presence or absence of parkinsonism is usually characterized by impairment in the executive and/or visuospatial domains, and the cognitive features are often preceded by REM sleep behavior disorder by many years. There is minimal hippocampal atrophy on MRI, minimal if any cortical uptake on amyloid-PET, and one would predict that hypometabolism would be maximal in the occipital cortex on FDG-PET and uptake would be decreased on DAT. The early data suggests that differentiating underlying AD vs LBD in the MCI phase will be feasible.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
Volume18
Issue numberSUPPL. 1
StatePublished - Jan 2012

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Lewy Body Disease
Alzheimer Disease
Dopamine Plasma Membrane Transport Proteins
Amyloid
Neuroimaging
Positron-Emission Tomography
Atrophy
REM Sleep Behavior Disorder
Magnetic Resonance Imaging
Pathology
Occipital Lobe
Gyrus Cinguli
Parkinsonian Disorders
Activities of Daily Living
Dementia
Cognitive Dysfunction

Keywords

  • Alzheimer's disease
  • Dementia
  • Dementia with Lewy bodies
  • Lewy body disease
  • Mild cognitive impairment
  • Neuropathology
  • Neuropsychology

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

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abstract = "The objective of this paper is to compare and contrast the clinical, neuropsychological, and neuroimaging findings in patients with mild cognitive impairment (MCI) associated with underlying Alzheimer's disease (AD) versus Lewy body disease (LBD) pathology. MCI refers to a clinical syndrome with impairment in one or more cognitive domains, with essentially normal performance of activities of daily living. Patients with the amnesic subtype of MCI often develop the dementia syndrome and neuroimaging findings characteristic of AD [e.g., hippocampal atrophy on magnetic resonance imaging (MRI), temporoparietal and posterior cingulate hypometabolism on fluorodeoxyglucose positron emission tomography (FDG-PET), positive uptake on amyloid PET, normal striatonigral uptake on dopamine transporter scanning (DAT), etc.]. In contrast, the MCI syndrome associated with LBD pathology regardless of the coexisting presence or absence of parkinsonism is usually characterized by impairment in the executive and/or visuospatial domains, and the cognitive features are often preceded by REM sleep behavior disorder by many years. There is minimal hippocampal atrophy on MRI, minimal if any cortical uptake on amyloid-PET, and one would predict that hypometabolism would be maximal in the occipital cortex on FDG-PET and uptake would be decreased on DAT. The early data suggests that differentiating underlying AD vs LBD in the MCI phase will be feasible.",
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