Abstract:
OBJECTIVES:To investigate clinical, imaging, and pathologic associations of the cingulate island sign (CIS) in dementia with Lewy bodies (DLB). METHODS:We retrospectively identified and compared patients with a clinical diagnosis of DLB (n=39); patients with Alzheimer disease (AD) matched by age, sex, and education (n=39); and cognitively normal controls (n=78) who underwent 18F-fluorodeoxyglucose (FDG) and C11 Pittsburgh compound B (PiB)-PET scans. Among these patients, we studied those who came to autopsy and underwent Braak neurofibrillary tangle (NFT) staging (n=10). RESULTS:Patients with a clinical diagnosis of DLB had a higher ratio of posterior cingulate to precuneus plus cuneus metabolism, cingulate island sign (CIS), on FDG-PET than patients with AD (p<0.001), a finding independent of β-amyloid load on PiB-PET (p=0.56). Patients with CIS positivity on visual assessment of FDG-PET fit into the group of high- or intermediate-probability DLB pathology and received clinical diagnosis of DLB, not AD. Higher CIS ratio correlated with lower Braak NFT stage (r=-0.96; p<0.001). CONCLUSIONS:Our study found that CIS on FDG-PET is not associated with fibrillar β-amyloid deposition but indicates lower Braak NFT stage in patients with DLB. Identifying biomarkers that measure relative contributions of underlying pathologies to dementia is critical as neurotherapeutics move toward targeted treatments.
journal_name
Neurologyjournal_title
Neurologyauthors
Graff-Radford J,Murray ME,Lowe VJ,Boeve BF,Ferman TJ,Przybelski SA,Lesnick TG,Senjem ML,Gunter JL,Smith GE,Knopman DS,Jack CR Jr,Dickson DW,Petersen RC,Kantarci Kdoi
10.1212/WNL.0000000000000734subject
Has Abstractpub_date
2014-08-26 00:00:00pages
801-9issue
9eissn
0028-3878issn
1526-632Xpii
WNL.0000000000000734journal_volume
83pub_type
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