Neuroimaging findings and clinical trajectories of Lewy body disease in patients with MCI

Federico Massa, Dario Arnaldi, Francesca De Cesari, Nicola Girtler, Andrea Brugnolo, Matteo Grazzini, Matteo Bauckneht, Riccardo Meli, Silvia Morbelli, Matteo Pardini, Gianmario Sambuceti, Fabrizio De Carli, Pietro Tiraboschi, Flavio Nobili

Research output: Contribution to journalArticle

Abstract

Elderly patients with mild cognitive impairment (MCI) may develop a Lewy body disease; their neuroimaging features at presentation are largely unknown. We present an intriguing group of 13 patients with MCI preceding (2.9 ± 1.9 years) parkinsonism (MCI-P), and eventually dementia 4.6 ± 1.6 years later (6 patients), whereas 7 patients remained dementia free after 4.7 ± 2.7 years. Neuropsychological tests, dopamine transporter (DAT) single photon emission computed tomography, and 18F-fluorodeoxyglucose positron emission tomography were compared with healthy controls and with cognitively normal patients with Parkinson's disease (PD-MOT). Compared to controls, MCI-P but not PD-MOT showed significant posterior temporo-parieto-occipital hypometabolism. Basal ganglia DAT uptake was similar between MCI-P and PD-MOT. Patients who converted to dementia were older, tended to have higher movement disorder society-unified Parkinson's disease rating scale scores and developed at least another clinical core feature fulfilling the criteria for probable dementia with Lewy bodies (DLB). Concurrent impairment of Corsi span and semantic verbal fluency, or of temporal lobe hypometabolism at baseline and reduced putamen-to-caudate ratio on DAT-SPECT at parkinsonism onset, both predicted (p < 0.001) the evolution to dementia. The constructs of Park cognitive subtype and prodromal Lewy body dementia partially overlap; functional imaging and neuropsychology may help in characterizing the patients and in tracking the risk toward dementia.

Original languageEnglish
Pages (from-to)9-17
Number of pages9
JournalNeurobiology of Aging
Volume76
DOIs
Publication statusPublished - Apr 1 2019

Keywords

  • DAT-SPECT
  • Dementia with Lewy bodies
  • FDG-PET
  • Lewy body disease
  • Parkinson's disease

ASJC Scopus subject areas

  • Neuroscience(all)
  • Ageing
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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