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Biomarkers in dementia with Lewy bodies: a review.
Int J Geriatr Psychiatry. 2012 May; 27(5):443-53.IJ

Abstract

BACKGROUND

Dementia with Lewy bodies (DLB) shares common clinical, neuropsychological and pathological features with other dementia subtypes, such as Alzheimer's disease (AD), making it difficult to differentiate in clinical practice. Despite the development of consensus diagnostic criteria, many cases are missed, and biomarkers to assist with diagnosis would represent important advances. Our aim was to review the literature to identify potential biomarkers that may distinguish DLB from other dementia subtypes, especially AD.

METHOD

The literature search was performed using Medline up to October 2010 for imaging studies [single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI) and amyloid imaging] and cerebrospinal fluid (CSF) markers in DLB. Individual articles were examined for additional references. The abstracts of the identified articles were read to determine the most relevant papers, which became the basis for this review.

RESULTS

The most robust evidence available was for striatal dopamine transporter activity visualised by (123) I-labelled N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ((123) I-FP-CIT) SPECT. Several other imaging techniques have also reported promising results, such as [(18) F]fluorodopa PET, which assesses nigrostriatal integrity; [(18) F]fluorodeoxyglucose PET, which assesses metabolic deficits; and meta-iodobenzylguanidine imaging, which assesses sympathetic cardiac denervation. Data from studies using CSF measures of amyloid and tau, occipital hypoperfusion on SPECT and preservation of medial temporal lobe structures on MRI suggest that they may offer less diagnostic discrimination.

CONCLUSION

Several potential biomarkers have shown good diagnostic accuracy for DLB, but apart from FP-CIT SPECT, there is now a need for larger clinical multi-site studies, as well as for studies with pathological verification of diagnosis, before their use could be recommended for routine clinical practice.

Authors+Show Affiliations

Institute for Ageing and Health, Newcastle University, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK. namrta.sinha@ntw.nhs.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21721045

Citation

Sinha, Namrta, et al. "Biomarkers in Dementia With Lewy Bodies: a Review." International Journal of Geriatric Psychiatry, vol. 27, no. 5, 2012, pp. 443-53.
Sinha N, Firbank M, O'Brien JT. Biomarkers in dementia with Lewy bodies: a review. Int J Geriatr Psychiatry. 2012;27(5):443-53.
Sinha, N., Firbank, M., & O'Brien, J. T. (2012). Biomarkers in dementia with Lewy bodies: a review. International Journal of Geriatric Psychiatry, 27(5), 443-53. https://doi.org/10.1002/gps.2749
Sinha N, Firbank M, O'Brien JT. Biomarkers in Dementia With Lewy Bodies: a Review. Int J Geriatr Psychiatry. 2012;27(5):443-53. PubMed PMID: 21721045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biomarkers in dementia with Lewy bodies: a review. AU - Sinha,Namrta, AU - Firbank,Michael, AU - O'Brien,John T, Y1 - 2011/07/01/ PY - 2011/03/07/received PY - 2011/05/02/accepted PY - 2011/7/2/entrez PY - 2011/7/2/pubmed PY - 2012/6/29/medline SP - 443 EP - 53 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 27 IS - 5 N2 - BACKGROUND: Dementia with Lewy bodies (DLB) shares common clinical, neuropsychological and pathological features with other dementia subtypes, such as Alzheimer's disease (AD), making it difficult to differentiate in clinical practice. Despite the development of consensus diagnostic criteria, many cases are missed, and biomarkers to assist with diagnosis would represent important advances. Our aim was to review the literature to identify potential biomarkers that may distinguish DLB from other dementia subtypes, especially AD. METHOD: The literature search was performed using Medline up to October 2010 for imaging studies [single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI) and amyloid imaging] and cerebrospinal fluid (CSF) markers in DLB. Individual articles were examined for additional references. The abstracts of the identified articles were read to determine the most relevant papers, which became the basis for this review. RESULTS: The most robust evidence available was for striatal dopamine transporter activity visualised by (123) I-labelled N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ((123) I-FP-CIT) SPECT. Several other imaging techniques have also reported promising results, such as [(18) F]fluorodopa PET, which assesses nigrostriatal integrity; [(18) F]fluorodeoxyglucose PET, which assesses metabolic deficits; and meta-iodobenzylguanidine imaging, which assesses sympathetic cardiac denervation. Data from studies using CSF measures of amyloid and tau, occipital hypoperfusion on SPECT and preservation of medial temporal lobe structures on MRI suggest that they may offer less diagnostic discrimination. CONCLUSION: Several potential biomarkers have shown good diagnostic accuracy for DLB, but apart from FP-CIT SPECT, there is now a need for larger clinical multi-site studies, as well as for studies with pathological verification of diagnosis, before their use could be recommended for routine clinical practice. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/21721045/Biomarkers_in_dementia_with_Lewy_bodies:_a_review_ L2 - https://doi.org/10.1002/gps.2749 DB - PRIME DP - Unbound Medicine ER -