title: Evolution of clinical features in possible DLB depending on FP-CIT SPECT result.
abstract: OBJECTIVE
  To test the hypothesis that core and suggestive features in possible dementia with Lewy bodies (DLB) would vary in their ability to predict an abnormal dopamine transporter scan and therefore a follow-up diagnosis of probable DLB. A further objective was to assess the evolution of core and suggestive features in patients with possible DLB over time depending on the (123)I-FP-CIT SPECT scan result.
  
  
  METHODS
  A total of 187 patients with possible DLB (dementia plus one core or one suggestive feature) were randomized to have dopamine transporter imaging or to follow-up without scan. DLB features were compared at baseline and at 6-month follow-up according to imaging results and follow-up diagnosis.
  
  
  RESULTS
  For the whole cohort, the baseline frequency of parkinsonism was 30%, fluctuations 29%, visual hallucinations 24%, and REM sleep behavior disorder 17%. Clinician-rated presence of parkinsonism at baseline was significantly (p = 0.001) more frequent and Unified Parkinson's Disease Rating Scale (UPDRS) score at baseline was significantly higher (p = 0.02) in patients with abnormal imaging. There was a significant increase in UPDRS score in the abnormal scan group over time (p < 0.01). There was relatively little evolution of the rest of the DLB features regardless of the imaging result.
  
  
  CONCLUSIONS
  In patients with possible DLB, apart from UPDRS score, there was no difference in the evolution of DLB clinical features over 6 months between cases with normal and abnormal imaging. Only parkinsonism and dopamine transporter imaging helped to differentiate DLB from non-DLB dementia.
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy. z.walker@ucl.ac.uk.
authors: Zuzana
authors: Z
authors: Walker
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Emilio
authors: E
authors: Moreno
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Alan
authors: A
authors: Thomas
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Fraser
authors: F
authors: Inglis
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Naji
authors: N
authors: Tabet
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Tim
authors: T
authors: Stevens
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Tim
authors: T
authors: Whitfield
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Dag
authors: D
authors: Aarsland
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Michael
authors: M
authors: Rainer
authors: From University College London (Z.W.); North Essex Partnership University NHS Foundation Trust (Z.W., T.S., T.W.), Braintree; GE Healthcare (E.M.), Buckinghamshire; Newcastle University (A.T.), Newcastle upon Tyne; Glasgow Memory Clinic Ltd. (F.I.); Brighton and Sussex Medical School (N.T.), Brighton, UK; Centre for Age-Related Diseases (D.A.), Stavanger University Hospital; Department of Geriatric Psychiatry (D.A.), Akershus University Hospital, Oslo, Norway; Department of Neurobiology, (D.A.) Care Sciences and Society Division of Alzheimer's Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Karl Landsteiner Institut für Gedächtnis und Alzheimerforschung Wien (M.R.), Austria; and University of Brescia (A.P.), Italy.
authors: Alessandro
authors: A
authors: Padovani
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D018450:Disease Progression; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008609:Mental Status Schedule; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D020187:REM Sleep Behavior Disorder / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
chemical_list: D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane