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P4‐148: Multimodality imaging differentiates dementia with lewy bodies from Alzheimer's disease
Author(s) -
Kantarci Kejal,
Boeve Bradley,
Lowe Val,
Senjem Mathew,
Weigand Stephen,
Przybelski Scott,
Preboske Gregory,
Knopman David,
Smith Glenn,
Ferman Tanis,
Petersen Ronald,
Jack Clifford
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.2170
Subject(s) - dementia with lewy bodies , pittsburgh compound b , atrophy , dementia , medicine , pathology , neurodegeneration , alzheimer's disease , psychology , disease
Background: The two most common neurodegenerative disorders associated with dementia in the elderly are Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Imaging markers that are associated with specific pathophysiological processes of AD and DLB may be complementary distinguishing these disorders. Pittsburgh Compound-B (PiB) retention on PET is a surrogate marker for b-amyloid pathology and cortical atrophy on MRI is associated with neurodegeneration and the neurofibrillary pathology of AD. Patients with DLB are characterized by occipital hypometabolism on FDG PET. Our objective was to determine whether PiB retention, cortical atrophy and decreased glucose metabolism are complementary in differentiating patients with DLB from AD. Methods: We studied age, gender and education matched patients with DLB (n 1⁄4 19), AD (n 1⁄4 19), from the Mayo Clinic Alzheimer’s Disease Research Center and cognitively normal subjects (CN) (n1⁄4 38) from the Mayo Clinic Study on Aging. Subjects underwent clinical evaluation, MRI, FDG PET and PiB PET within six weeks. A global cortical PiB retention summary measure was formed by combining frontal, temporal and parietal PiB retention scaled to cerebellar retention. Cortical FDG PET uptake was scaled to pons uptake. Voxel-based analysis was performed on SPM5 to determine regional differences in cortical atrophy, PiB retention, and glucose metabolism among the clinical groups. Results: Glucose metabolism on FDG PET was significantly reduced in the parietooccipital cortex in patients with DLB compared to CN but only the occipital hypometabolism distinguished patients with DLB from AD. Global cortical PiB retention in DLB patients was significantly higher than CN but lower than AD subjects and AD patients had significantly greater atrophy in the hippocampus compared to DLB patients (p < 0.05 corrected for family-wise error for all comparisons). The area under receiver operating characteristic (AUROC) for distinguishing AD and DLB using logistic regression were 0.87 for PiB retention, 0.83 for occipital hypometabolism and 0.90 for hippocampal volumes. The AUROC increased to 0.97 when all three imaging markers were included in the model. Conclusions: Both MRI and PET contribute to characterizing distinct neurodegenerative mechanisms in AD and DLB. Hippocampal atrophy, global cortical PiB retention and occipital lobe FDG uptake were complimentary in distinguishing AD and DLB patients. P4-149 APOE IS ASSOCIATEDWITH VASCULAR DEMENTIA USING ALZGENE-LIKE APPROACHES TO INVESTIGATE SUSCEPTIBILITY GENES FOR VASCULAR COGNITIVE IMPAIRMENT Patrick Kehoe*, Rebecca Dwyer, Olivia Skrobot, Marcus Munafo, Patrick Kehoe, Bristol University, Bristol, United Kingdom; Univeristy of Bristol, Bristol, United Kingdom; University of Bristol, Bristol, United Kingdom.