Topography of Cholinergic Changes in Dementia With Lewy Bodies and Key Neural Network Hubs

Prabesh Kanel*, Martijn L. T. M. Mueller, Sygrid van der Zee, Carlos A. Sanchez-Catasus, Robert A. Koeppe, Kirk A. Frey, Nicolaas I. Bohnen

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    17 Citations (Scopus)
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    Objectives: The authors investigated the topography of cholinergic vulnerability in patients with dementia with Lewy bodies (DLB) using positron emission tomography (PET) imaging with the vesicular acetylcholine transporter (VAChT) [F-18]- fluoroethoxybenzovesamicol ([F-18]- FEOBV) radioligand.

    Methods: Five elderly participants with DLB (mean age, 77.8 years [SD=4.2]) and 21 elderly healthy control subjects (mean age, 73.62 years [SD=8.37]) underwent clinical assessment and [F-18]-FEOBV PET.

    Results: Compared with the healthy control group, reduced VAChT binding in patients with DLB demonstrated non-diffuse regionally distinct and prominent reductions in bilateral opercula and anterior cingulate to mid-cingulate cortices, bilateral insula, right (more than left) lateral geniculate nuclei, pulvinar, right proximal optic radiation, bilateral anterior and superior thalami, and posterior hippocampal fimbria and fornices.

    Conclusions: The topography of cholinergic vulnerability in DLB comprises key neural hubs involved in tonic alertness (cingulo-opercular), saliency (insula), visual attention (visual thalamus), and spatial navigation (fimbria/fornix) networks. The distinct denervation pattern suggests an important cholinergic role in specific clinical disease-defining features, such as cognitive fluctuations, visuoperceptual abnormalities causing visual hallucinations, visuospatial changes, and loss of balance caused by DLB.

    Original languageEnglish
    Pages (from-to)370-375
    Number of pages6
    JournalJournal of neuropsychiatry and clinical neurosciences
    Issue number4
    Publication statusPublished - 2020



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