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Dementia With Lewy Bodies Studied With Positron Emission Tomography
Rebecca J. Cordery, BSc, MRCP;
Philippa J. Tyrrell, MD, FRCP;
Peter L. Lantos, MD, PhD, DSc, FRCPath;
Martin N. Rossor, MD, FRCP
Arch Neurol. 2001;58:505-508.
Objective To report a case initially fulfilling the clinical criteria for probable
Alzheimer disease, although later clinical features suggested dementia with
Lewy bodies. Oxygen 15–labeled positron emission tomograms revealed
a pattern of hypometabolism characteristic of Alzheimer disease. At post mortem,
there was no evidence of the pathological features of Alzheimer disease, but
diffuse cortical Lewy bodies were seen in the pigmented brainstem nuclei and
cerebral cortex.
Design A case report.
Setting Tertiary referral center.
Patient A 65-year-old white man presented with a 3-year history of memory loss
and language difficulties.
Results Oxygen 15–labeled positron emission tomograms revealed hypometabolism
in the frontal, temporal, and parietal lobes, more severe on the left than
right. Metabolism in the left caudate was just outside the 95% reference range.
Occipital metabolism was normal.
Conclusions Positron emission tomographic studies have been reported to show occipital
hypometabolism in dementia with Lewy bodies, in addition to the characteristic
posterior bitemporal biparietal pattern of Alzheimer disease. We suggest that
although this finding may favor a diagnosis of dementia with Lewy bodies,
it is not necessary for diagnosis.
From the Dementia Research Group, Department of Clinical Neurology,
Institute of Neurology and Division of Neurosciences, Imperial College School
of Medicine (Drs Cordery and Rossor), the Medical Research Council Cyclotron
Unit, Hammersmith Hospital (Dr Tyrrell), and the Department of Neuropathology,
Institute of Psychiatry (Dr Lantos), London, England. Dr Tyrrell is now with
the Department of Geriatric Medicine, Hope Hospital, Salford, England.
Corresponding author and reprints: Martin N. Rossor, MD, FRCP, Dementia
Research Group, National Hospital for Neurology and Neurosurgery, Queen Square,
London WC1N 3BG, England (e-mail mrossor{at}dementia.ion.ucl.ac.uk).
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