TY - JOUR
T1 - Topography of Cholinergic Changes in Dementia With Lewy Bodies and Key Neural Network Hubs
AU - Kanel, Prabesh
AU - Mueller, Martijn L. T. M.
AU - van der Zee, Sygrid
AU - Sanchez-Catasus, Carlos A.
AU - Koeppe, Robert A.
AU - Frey, Kirk A.
AU - Bohnen, Nicolaas I.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - PARKINSONS-DISEASE
KW - COGNITIVE IMPAIRMENT
KW - DENERVATION
KW - ATTENTION
U2 - 10.1176/appi.neuropsych.19070165
DO - 10.1176/appi.neuropsych.19070165
M3 - Article
SN - 0895-0172
VL - 32
SP - 370
EP - 375
JO - Journal of neuropsychiatry and clinical neurosciences
JF - Journal of neuropsychiatry and clinical neurosciences
IS - 4
ER -