Topography of Cholinergic Changes in Dementia With Lewy Bodies and Key Neural Network Hubs.

Abstract

OBJECTIVES:

The authors investigated the topography of cholinergic vulnerability in patients with dementia with Lewy bodies (DLB) using positron emission tomography (PET) imaging with the vesicular acetylcholine transporter (VAChT) [18F]-fluoroethoxybenzovesamicol ([18F]-FEOBV) radioligand.

METHODS:

Five elderly participants with DLB (mean age, 77.8 years [SD=4.2]) and 21 elderly healthy control subjects (mean age, 73.62 years [SD=8.37]) underwent clinical assessment and [18F]-FEOBV PET.

RESULTS:

Compared with the healthy control group, reduced VAChT binding in patients with DLB demonstrated nondiffuse regionally distinct and prominent reductions in bilateral opercula and anterior cingulate to mid-cingulate cortices, bilateral insula, right (more than left) lateral geniculate nuclei, pulvinar, right proximal optic radiation, bilateral anterior and superior thalami, and posterior hippocampal fimbria and fornices.

CONCLUSIONS:

The topography of cholinergic vulnerability in DLB comprises key neural hubs involved in tonic alertness (cingulo-opercular), saliency (insula), visual attention (visual thalamus), and spatial navigation (fimbria/fornix) networks. The distinct denervation pattern suggests an important cholinergic role in specific clinical disease-defining features, such as cognitive fluctuations, visuoperceptual abnormalities causing visual hallucinations, visuospatial changes, and loss of balance caused by DLB.

• Authors: Prabesh Kanel, Martijn L T M Müller, Sygrid van der Zee, Carlos A Sanchez-Catasus, Robert A Koeppe, Kirk A Frey, Nicolaas I Bohnen
• Journal: The Journal of neuropsychiatry and clinical neurosciences (J Neuropsychiatry Clin Neurosci) Vol. 32 Issue 4 Pg. 370-375 ( 2020) ISSN: 1545-7222 [Electronic] United States
• PMID: 32498602 (Publication Type: Journal Article)

Chemical References

• Piperidines
• fluoroethoxy-benzovesamicol
• Acetylcholine

Topics

• Acetylcholine (metabolism)
• Aged
• Aged, 80 and over
• Cerebral Cortex (diagnostic imaging, metabolism, physiopathology)
• Cross-Sectional Studies
• Female
• Fornix, Brain (diagnostic imaging, metabolism, physiopathology)
• Humans
• Lewy Body Disease (diagnostic imaging, metabolism, physiopathology)
• Male
• Nerve Net (diagnostic imaging, metabolism, physiopathology)
• Piperidines
• Positron-Emission Tomography
• Thalamus (diagnostic imaging, metabolism, physiopathology)