Neuroimaging in Lewy body dementia

J Neurol. 2019 Jan;266(1):1-26. doi: 10.1007/s00415-018-8892-x. Epub 2018 May 14.

Abstract

Lewy body dementia (DLB) is a common form of cognitive impairment, accounting for 30% of dementia cases in ages over 65 years. Early diagnosis of DLB has been challenging; particularly in the context of differentiation with Parkinson's disease dementia and other forms of dementias, such as Alzheimer's disease and rapidly progressive dementias. Current practice involves the use of [123I]FP-CIT-SPECT, [18F]FDG PET and [123I]MIBG molecular imaging to support diagnostic procedures. Structural imaging techniques have an essential role for excluding structural causes, which could lead to a DLB-like phenotype, as well as aiding differential diagnosis through illustrating disease-specific patterns of atrophy. Novel PET molecular imaging modalities, such as amyloid and tau imaging, may provide further insights into DLB pathophysiology and may aid in early diagnosis. A multimodal approach, through combining various established techniques and possibly using novel radioligands, might further aid towards an in-depth understanding of this highly disabling disease. In this review, we will provide an overview of neuroimaging applications in patients with DLB.

Keywords: Lewy body dementia; MRI; Molecular imaging; Neuroimaging; PET; SPECT.

Publication types

  • Review

MeSH terms

  • Humans
  • Lewy Body Disease / diagnostic imaging*
  • Lewy Body Disease / metabolism
  • Lewy Body Disease / pathology
  • Lewy Body Disease / physiopathology
  • Neuroimaging / methods*