Differentiation of Alzheimer's disease from dementia with Lewy bodies utilizing positron emission tomography with [ 18F]fluorodeoxyglucose and neuropsychological testing

Sid Gilman, Robert A. Koeppe, Roderick Little, Hyonggin An, Larry Junck, Bruno Giordani, Carol Persad, Mary Heumann, Kris Wernette

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

We compared the relative utility of neuropsychological testing and positron emission tomography (PET) with [ 18F]fluorodeoxyglucose ([ 18F]FDG) in differentiating Alzheimer's disease (AD) from dementia with Lewy bodies (DLB). We studied 25 patients with AD, 20 with DLB, and 19 normal elderly controls. There was no difference between patient groups for MMSE, confrontational naming, or verbal learning. The DLB group was significantly more impaired than the AD group for verbal fluency, and the AD group was significantly more impaired than the DLB group for verbal delayed recall. The DLB group had greater difficulty than the AD group on a visual discrimination task that does not require motor functioning, but the difference did not reach significance. Family ratings of motor functioning suggested significantly greater impairment in DLB patients than in AD patients. PET studies revealed significantly lower local cerebral metabolic rates for glucose (lCMRglc) for visual cortex (Brodmann areas 17, 18, and 19) in the DLB than the AD group, but no differences for other regions commonly affected in AD, including posterior cingulate, superior parietal lobe, lateral temporal lobe, and the prefrontal region. Motor ratings were significantly correlated with lCMRglc in all areas of cerebral cortex, including Brodmann areas 17, 18, and 19. The results demonstrate a similar profile of cerebral hypometabolism in the two patient groups except in the visual cortex, where the DLB group shows markedly lower lCMRglc than the AD group. Neuropsychological testing also differentiates the groups, and family ratings of motor functioning are as robust as PET in these later stages of the disorders.

Original languageEnglish
Pages (from-to)S95-S103
JournalExperimental Neurology
Volume191
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 2005 Feb

Keywords

  • Alzheimer's disease
  • Dementia with Lewy bodies
  • Local cerebral metabolic rate for glucose
  • Magnetic resonance imaging
  • Neuropsychological testing
  • Positron emission tomography
  • [ F]fluorodeoxyglucose

ASJC Scopus subject areas

  • Neurology
  • Developmental Neuroscience

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