TY - JOUR
T1 - Dementia with Lewy bodies
T2 - Basis of cingulate island sign
AU - Graff-Radford, Jonathan
AU - Murray, Melissa E.
AU - Lowe, Val J.
AU - Boeve, Bradley F.
AU - Ferman, Tanis J.
AU - Przybelski, Scott A.
AU - Lesnick, Timothy G.
AU - Senjem, Matthew L.
AU - Gunter, Jeffrey L.
AU - Smith, Glenn E.
AU - Knopman, David S.
AU - Jack, Clifford R.
AU - Dickson, Dennis W.
AU - Petersen, Ronald C.
AU - Kantarci, Kejal
PY - 2014
Y1 - 2014
N2 - Objectives: To investigate clinical, imaging, and pathologic associations of the cingulate island sign (CIS) in dementia with Lewy bodies (DLB). Methods: We retrospectively identified and compared patients with a clinical diagnosis of DLB (n 5 39); patients with Alzheimer disease (AD) matched by age, sex, and education (n 5 39); and cognitively normal controls (n 5 78) who underwent 18F-fluorodeoxyglucose (FDG) and C11 Pittsburgh compound B (PiB)-PET scans. Among these patients, we studied those who came to autopsy and underwent Braak neurofibrillary tangle (NFT) staging (n 5 10). Results: Patients with a clinical diagnosis of DLB had a higher ratio of posterior cingulate to precuneus plus cuneus metabolism, cingulate island sign (CIS), on FDG-PET than patients with AD (p , 0.001), a finding independent of b-amyloid load on PiB-PET (p 5 0.56). Patients with CIS positivity on visual assessment of FDG-PET fit into the group of high- or intermediate-probability DLB pathology and received clinical diagnosis of DLB, not AD. Higher CIS ratio correlated with lower Braak NFT stage (r 5 20.96; p , 0.001). Conclusions: Our study found that CIS on FDG-PET is not associated with fibrillar b-amyloid deposition but indicates lower Braak NFT stage in patients with DLB. Identifying biomarkers that measure relative contributions of underlying pathologies to dementia is critical as neurotherapeutics move toward targeted treatments.
AB - Objectives: To investigate clinical, imaging, and pathologic associations of the cingulate island sign (CIS) in dementia with Lewy bodies (DLB). Methods: We retrospectively identified and compared patients with a clinical diagnosis of DLB (n 5 39); patients with Alzheimer disease (AD) matched by age, sex, and education (n 5 39); and cognitively normal controls (n 5 78) who underwent 18F-fluorodeoxyglucose (FDG) and C11 Pittsburgh compound B (PiB)-PET scans. Among these patients, we studied those who came to autopsy and underwent Braak neurofibrillary tangle (NFT) staging (n 5 10). Results: Patients with a clinical diagnosis of DLB had a higher ratio of posterior cingulate to precuneus plus cuneus metabolism, cingulate island sign (CIS), on FDG-PET than patients with AD (p , 0.001), a finding independent of b-amyloid load on PiB-PET (p 5 0.56). Patients with CIS positivity on visual assessment of FDG-PET fit into the group of high- or intermediate-probability DLB pathology and received clinical diagnosis of DLB, not AD. Higher CIS ratio correlated with lower Braak NFT stage (r 5 20.96; p , 0.001). Conclusions: Our study found that CIS on FDG-PET is not associated with fibrillar b-amyloid deposition but indicates lower Braak NFT stage in patients with DLB. Identifying biomarkers that measure relative contributions of underlying pathologies to dementia is critical as neurotherapeutics move toward targeted treatments.
UR - http://www.scopus.com/inward/record.url?scp=84921983758&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921983758&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000000734
DO - 10.1212/WNL.0000000000000734
M3 - Article
C2 - 25056580
AN - SCOPUS:84921983758
SN - 0028-3878
VL - 83
SP - 801
EP - 809
JO - Neurology
JF - Neurology
IS - 9
ER -