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Three presenile patients in which neuropsychological and neuroimaging examinations suggest possible progression to dementia with L ewy bodies
Author(s) -
Ota Kazumi,
Iseki Eizo,
Murayama Norio,
Chiba Yuhei,
Fujishiro Hiroshige,
Kasanuki Koji,
Manabe Yuta,
Arai Heii,
Sato Kiyoshi
Publication year - 2014
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12039
Subject(s) - dementia , neuropsychology , neuroimaging , atrophy , occipital lobe , psychology , magnetic resonance imaging , neuroscience , medicine , temporal lobe , cognition , pathology , radiology , disease , epilepsy
We report three presenile patients who were initially suspected of having A lzheimer's disease ( AD ) or being in the prodromal stage of AD , regardless of visuoperceptual dysfunctions in daily living, because they lacked the core features and prodromal non‐motor symptoms of dementia with L ewy bodies. Subsequently, progression to dementia with L ewy bodies was suspected based on neuropsychological and neuroimaging findings; additionally, one of the three patients suffered from visual hallucinations. Neuropsychological examinations such as subjective contours, cube copying and block design in the W echsler A dult I ntelligence S cale‐ III revealed visuoperceptual dysfunction in all three patients even when other cognitive functions were rather preserved. Brain magnetic resonance imaging revealed no significant brain atrophy, including in the parieto‐occipital area and the hippocampus, while brain 18 F ‐fluorodeoxyglucose positron emission tomography demonstrated right dominant metabolic reductions in the occipital lobe, including the primary visual cortex, in all three patients. We suggest the possibility of progression to dementia with L ewy bodies, but not AD or posterior cortical atrophy. Regardless of the presence of core features and prodromal non‐motor symptoms, this progression is suggested when there are difficulties only in higher‐level visual processing such as subjective contours and block design in the W echsler A dult I ntelligence S cale‐ III , no significant atrophy of the parieto‐occipital area and hippocampus on brain magnetic resonance imaging, and hypometabolism in the occipital lobe including the primary visual cortex on brain 18 F ‐fluorodeoxyglucose positron emission tomography.