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Lookup NU author(s): Professor John-Paul TaylorORCiD, Dr Sean Colloby, Professor Ian McKeith, Professor John O'Brien
Background: Fluctuating cognition (FC), particularly in attention, is a core and defining symptom in dementia with Lewy bodies (DLB) but is seen much less frequently in Alzheimer's dementia (AD). However, its neurobiological origin is poorly understood. The aim of our study was therefore to characterize perfusion patterns in DLB patients that are associated with the severity and frequency of FC as measured both clinically and using objective neuropsychological assessments. Methods: Spatial covariance analyses were applied to data derived from single photon emission computed tomography (SPECT) HMPAO brain imaging in 19 DLB and 23 AD patients. Patients underwent clinical assessment of their FC and cognitive function as well as objective testing of their attention. Results: Covariant perfusion principal components (PCs) were not associated with either FC or cognitive or attentional measures in AD. However, in DLB patients, the second PC (defined as DLB-cognitive motor pattern, DLB-PCI2) which was characterized by bilateral relative increases in cerebellum, basal ganglia, and supplementary motor areas and widespread bilateral decreases in parietal regions, positively correlated with poorer cognitive function, increased FC and worse attentional function measured both clinically and neurophysiologically (p < 0.05) as well as with the severity of bradykinesia (p = 0.04). Conclusions: FC in DLB appears distinct from those seen in AD, and likely to be driven by internal neurobiological perturbations in brain circuitry as evidenced using spatial covariance analyses of cerebral perfusion. FC and certain aspects of attentional dysfunction in DLB may, in part, depend upon both distributed motor and non-motor networks.
Author(s): Taylor JP, Colloby SJ, McKeith IG, O'Brien JT
Publication type: Article
Publication status: Published
Journal: International Psychogeriatrics
Year: 2013
Volume: 25
Issue: 12
Pages: 1917-1928
Print publication date: 01/12/2013
Online publication date: 23/10/2013
Date deposited: 26/02/2014
ISSN (print): 1041-6102
ISSN (electronic): 1741-203X
Publisher: Cambridge University Press
URL: http://dx.doi.org/10.1017/S1041610213001488
DOI: 10.1017/S1041610213001488
PubMed id: 24148774
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