Journal Article Dementia with Lewy bodies can be well-differentiated from Alzheimer’s disease by measurement of brain acetylcholinesterase activity - A [11C]MP4A PET study -

Shimada, Hitoshi  ,  Shinotoh, Hitoshi  ,  Ota, Tsuneyoshi  ,  Sato, Koichi  ,  Yamada, Makiko  ,  Fukushi, Kiyoshi  ,  Irie, Toshiaki  ,  Ming-Rong, Zhang  ,  Higuchi, Makoto  ,  Kuwabara, Satoshi  ,  Suhara, Tetsuya  ,  Hirano, Shigeki  ,  al, et

30 ( 11 )  , pp.1105 - 1113 , 2015-08 , John Wiley
Objective: To investigate the diagnostic performance of brain acetylcholinesterase (AChE)activity measurement using N-[11C]-methyl-4-piperidyl acetate (MP4A) and PET in patientswith dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD).Methods: Participants were 14 DLB patients, 25 AD patients, and 18 age-matched healthycontrols (HC). All subjects underwent PET scans and MP4A to measure regional brain AChEactivity. We performed anatomical standardization of each brain image, and k3 values, anindex of AChE activity, in each voxel were estimated by nonlinear least squares analysis.Volumes of interest (VOIs) were identified on parametric k3 images in frontal, temporal,parietal and occipital cortices, and in anterior and posterior cingulate gyri (ACG, PCG). Ineach VOI, the differential diagnostic performance between AD and DLB of k3 values wasassessed by area under the curve (AUC) of the receiver-operating characteristic. Voxel-basedstatistical analyses were also performed.Results: Mean cortical AChE activities in AD patients (-8.2% compared with normal mean)and DLB patients (-27.8%) were lower than HCs (p < 0.05, p < 0.001, respectively). Therewas a significant difference in mean cortical AChE activities between AD and DLB patients(p < 0.001). All regional brain AChE activities of defined VOIs except ACG were able to welldiscriminate DLB from AD, and notably performance was the most significant in PCG (AUC= 0.989, 95% CI: 0.965-1.000).Conclusions: Brain cholinergic deficit is consistently prominent in DLB compared with AD.PET measurement of brain AChE activity may be useful for the differential diagnosis betweenDLB and AD.

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