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Journal of Nuclear Medicine Vol. 48 No. 5 704-711
© 2007 by Society of Nuclear Medicine
doi: 10.2967/jnumed.106.035691

Clinical Investigation

Comparison of Regional Brain Volume and Glucose Metabolism Between Patients with Mild Dementia with Lewy Bodies and Those with Mild Alzheimer's Disease

Kazunari Ishii1, Tsutomu Soma2,3, Atsushi K. Kono1, Keitaro Sofue1, Naokazu Miyamoto1, Toshiki Yoshikawa1, Etsuro Mori4 and Kenya Murase5

1 Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan; 2 Department of Medical Engineering, School of Allied Health Sciences, Faculty of Medicine, Osaka University, Suita, Osaka, Japan; 3 Clinical Application Technology Group, Daiichi Radioisotope Laboratories, Tokyo, Japan; 4 Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; and 5 Division of Medical Technology and Science, Health Science Course, Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan

Correspondence: For correspondence or reprints contact: Kazunari Ishii, MD, Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo 670-0981, Japan. E-mail: kishii{at}hbhc.jp

The aim of this study was to investigate regional differences between morphologic and functional changes in patients with mild dementia with Lewy bodies (DLB) compared with those with Alzheimer's disease (AD). Methods: Twenty patients with very mild DLB (mean age, 74.5 y; mean Mini-Mental State Examination [MMSE] score, 24.0), 20 patients with very mild AD (mean age, 74.1 y; mean MMSE score, 24.0), and 20 age- and sex-matched healthy volunteers (normal controls [NC]) underwent both 18F-FDG PET and 3-dimensional spoiled gradient echo MRI. Fully automatic volumetry of the MRI data was used to obtain whole brain, hippocampal, occipital, and striatal volumes, which were compared with the results of a similar analysis of glucose metabolic data. Results: In DLB patients, volumetric data indicated a significant volume decrease in the striatum, whereas 18F-FDG PET showed significant glucose metabolic reductions in the temporal, parietal, and frontal areas—including in the occipital lobe—compared with those in the NC group. In contrast, in AD patients, both the hippocampal volume and glucose metabolism were significantly decreased, whereas the occipital volume and metabolism were preserved. Conclusion: Comparison of very mild DLB and AD revealed different morphologic and metabolic changes occurring in the medial temporal lobes and the occipital lobe, demonstrating characteristic pathophysiologic differences between these 2 diseases.

Key Words: dementia • Lewy bodies • Alzheimer's disease • 18F-FDG • PET • MRI • glucose metabolism • volumetry

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.


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