title: 123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies.
abstract: OBJECTIVE
  Evidence for the prodromal stage of dementia with Lewy bodies (DLB) is very limited. To address this issue, we investigate the123I-FP-CIT SPECT measure of dopamine transporter binding finding and its clinical relevance.
  
  
  METHODS
  We enrolled subjects into a prodromal DLB group (PRD-DLB) (n = 20) and clinical DLB group (CLIN-DLB) (n = 18) and compared these groups with an Alzheimer's disease control group (AD) (n = 10). PRD-DLB was defined as patients having the non-motor symptoms associated with Lewy body disease (LBD) [i.e. REM sleep behavior disorder (RBD), olfactory dysfunction, autonomic dysfunction, and depression] and showing characteristic diffuse occipital hypometabolism in18F-FDG PET. CLIN-DLB was defined as patients fulfilling the established criteria of probable DLB. Striatal specific binding ratio (SBR) of123I-FP-CIT SPECT was used for objective group comparisons. The correlations between SBR and cognitive function (MMSE), motor symptoms (UPDRS3), and duration of LBD-associated non-motor symptoms were compared between the two DLB groups.
  
  
  RESULTS
  Mean SBR scores of both PRD-DLB and CLIN-DLB were significantly lower than those of AD. No correlation was found between SBR and MMSE scores. Both in the CLIN-DLB and total DLB groups, SBR scores were negatively correlated with UPDRS3 scores, whereas no correlation was found in PRD-DLB. Among the LBD-related non-motor symptoms, duration of olfactory dysfunction, and RBD demonstrated negative correlation with SBR scores in PRD-DLB.
  
  
  CONCLUSIONS
  123I-FP-CIT SPECT may play a role for detecting DLB among the subjects in prodromal stage. During this stage, long-term olfactory dysfunction and/or RBD may indicate more severe degeneration of the nigro-striatal dopaminergic pathway.
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan. kasanuki.koji@mayo.edu.|Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan. kasanuki.koji@mayo.edu.|Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA. kasanuki.koji@mayo.edu.
authors.forename: Koji
authors.initials: K
authors.lastname: Kasanuki
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.|Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Eizo
authors.initials: E
authors.lastname: Iseki
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.|Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Ota
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kondo
authors.affiliation: Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ichimiya
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.
authors.forename: Heii
authors.initials: H
authors.lastname: Arai
mesh_terms: D000368:Aged; D003071:Cognition; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009068:Movement; D019275:Radiopharmaceuticals; D012890:Sleep; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
chemical_list: D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
keywords: 123I-FP-CIT SPECT; Dementia with Lewy bodies; Early diagnosis; Nigro-striatal dopaminergic pathway; Olfactory dysfunction; REM sleep behavior disorder