Deep gray matter hyperperfusion with occipital hypoperfusion in dementia with Lewy bodies.
Although decreased occipital perfusion is a characteristic feature of dementia with Lewy bodies (DLB), not all patients with DLB show a significant decreased perfusion in the occipital lobe. We explored characteristics of perfusion changes to improve the identification of DLB, in addition to occipital hypoperfusion. Statistical image analysis of single photon emission computed tomography data was performed on 22 patients with DLB and 25 patients with Alzheimer's disease (AD). A significant decreased perfusion in the occipital lobe was found in 16 patients with DLB (72%) and three patients with AD (12%), while a significant increased perfusion in the deep gray matter (striatum and/or thalamus) was found in 18 patients with DLB (81%) and eight patients with AD (31%), respectively. Either occipital hypoperfusion or deep gray matter hyperperfusion was found in 21 patients with DLB (95%), while in nine patients with AD (35%), indicating a sensitivity of 95% and a specificity of 65% in discriminating DLB from AD. Our results suggest that the addition of deep gray matter hyperperfusion to occipital hypoperfusion may be useful in the clinical differentiation of DLB and AD.
Sato
T
T
Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. tomohiko@tokyo-med.ac.jp
Hanyu
H
H
Hirao
K
K
Shimizu
S
S
Kanetaka
H
H
Iwamoto
T
T
D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex / Q000098:blood supply* / Q000503:physiopathology; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D009778:Occipital Lobe / Q000098:blood supply* / Q000473:pathology