Neurobiology Research Unit and Cimbi, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
J Nucl Med. 2013 Jul;54(7):1072-6. doi: 10.2967/jnumed.112.114025. Epub 2013 May 1.
Patients who have dementia with Lewy bodies (DLB) show both clinical and histopathologic overlap with Alzheimer disease patients and Parkinson disease patients. In this study, we correlated the core features of DLB (dementia, parkinsonism, hallucinations, and fluctuations) with striatal dopamine transporter (DAT) availability as assessed with SPECT and (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) nortropane ((123)I-PE2I) in patients with newly diagnosed DLB.
Two hundred eighty-eight patients were consecutively included in the study as they were referred for diagnostic SPECT scanning of DAT with (123)I-PE2I. Of those patients, 51 had, on the basis of clinical guideline criteria, a probable-DLB diagnosis at follow-up 16 ± 11.6 mo later. Before or on the day of the SPECT scan, DLB patients had a routine neurologic examination including Hoehn and Yahr grading and were cognitively evaluated with the Mini Mental State Examination.
There was no correlation between Mini Mental State Examination, Hoehn and Yahr score, fluctuations or hallucinations, and striatal DAT availability as measured with (123)I-PE2I and SPECT.
In patients with newly diagnosed DLB, symptoms are not associated with a reduction in striatal DAT despite its firm involvement in DLB pathology.
患有路易体痴呆症（DLB）的患者在临床表现和组织病理学上与阿尔茨海默病患者和帕金森病患者均有重叠。在这项研究中，我们将 DLB 的核心特征（痴呆、帕金森病、幻觉和波动）与纹状体多巴胺转运蛋白（DAT）的可用性进行了关联，该可用性通过 SPECT 和（123）I-N-（3-碘丙-2E-烯基）-2-β- 羧甲基-3β-（4-甲基苯基）-nortropane（（123）I-PE2I）评估，评估对象为新诊断为 DLB 的患者。
288 名患者连续被纳入研究，他们因诊断性 SPECT 扫描而接受（123）I-PE2I 检测 DAT。其中，51 名患者在随后的 16±11.6 个月的随访中根据临床指南标准被诊断为可能的 DLB。在 SPECT 扫描之前或当天，DLB 患者进行了常规神经检查，包括 Hoehn 和 Yahr 分级，并使用 Mini Mental State Examination 进行认知评估。
Mini Mental State Examination、Hoehn 和 Yahr 评分、波动或幻觉与 SPECT 测量的纹状体 DAT 可用性之间没有相关性。
在新诊断的 DLB 患者中，尽管 DLB 病理学中确实涉及纹状体 DAT，但症状与纹状体 DAT 减少无关。
