title: Biomarkers in dementia with Lewy bodies: a review.
abstract: BACKGROUND
  Dementia with Lewy bodies (DLB) shares common clinical, neuropsychological and pathological features with other dementia subtypes, such as Alzheimer's disease (AD), making it difficult to differentiate in clinical practice. Despite the development of consensus diagnostic criteria, many cases are missed, and biomarkers to assist with diagnosis would represent important advances. Our aim was to review the literature to identify potential biomarkers that may distinguish DLB from other dementia subtypes, especially AD.
  
  
  METHODS
  The literature search was performed using Medline up to October 2010 for imaging studies [single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI) and amyloid imaging] and cerebrospinal fluid (CSF) markers in DLB. Individual articles were examined for additional references. The abstracts of the identified articles were read to determine the most relevant papers, which became the basis for this review.
  
  
  RESULTS
  The most robust evidence available was for striatal dopamine transporter activity visualised by (123) I-labelled N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ((123) I-FP-CIT) SPECT. Several other imaging techniques have also reported promising results, such as [(18) F]fluorodopa PET, which assesses nigrostriatal integrity; [(18) F]fluorodeoxyglucose PET, which assesses metabolic deficits; and meta-iodobenzylguanidine imaging, which assesses sympathetic cardiac denervation. Data from studies using CSF measures of amyloid and tau, occipital hypoperfusion on SPECT and preservation of medial temporal lobe structures on MRI suggest that they may offer less diagnostic discrimination.
  
  
  CONCLUSIONS
  Several potential biomarkers have shown good diagnostic accuracy for DLB, but apart from FP-CIT SPECT, there is now a need for larger clinical multi-site studies, as well as for studies with pathological verification of diagnosis, before their use could be recommended for routine clinical practice.
authors: Institute for Ageing and Health, Newcastle University, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK. namrta.sinha@ntw.nhs.uk
authors: Namrta
authors: N
authors: Sinha
authors: Michael
authors: M
authors: Firbank
authors: John T
authors: JT
authors: O'Brien
mesh_terms: D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers