The difference of regional cerebral perfusion between dementia with Lewy bodies and Parkinson’s disease dementia

Aim: Background and purpose: Dementia with Lewy bodies (DLB) is diagnosed when dementia develops either before or within 1 year of developing Parkinson’s-like symptoms. If patients develop dementia at least one year after known to have Parkinson’s symptoms, they will be diagnosed as Parkinson’s disease dementia (PDD). Previous studies of limited cases showed that the patterns of regional cerebral perfusion were similar for DLB and PDD. The purpose of this study aimed to evaluate the difference of cerebral perfusion between DLB and PPD with more case numbers. Methods: Seventy-eight patients, including 48 clinically probable DLB and 30 PDD, were enrolled. No significant difference was noted for age (78 ± 7.7 vs. 74 ± 9.7), male gender (52% vs. 53%) and severity of dementia (CDR: 1.3 ± 0.7 vs. 1.1 ± 0.8) between DLB and PDD. All patients received ^99mTc-ECD brain SPECT imaging. Statistical parametrical mapping (SPM) was performed for comparison of cerebral perfusion SPECT between two groups of patients.

Results: : PDD showed significantly greater perfusion reduction in occipital lobes than DLB. On the contrary, PDD did not show any significant perfusion increase as compared to DLB. Conclusion: Our results suggested that the pattern of regional cerebral perfusion was not completely the same between DLB and PDD. PDD tended to have more hypoperfusion in occipital lobes, which may be related to the underlying pathophysiological difference between DLB and PDD.

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