Imaging of the dopaminergic system in differential diagnosis of dementia.

European Journal of Nuclear Medicine and Molecular Imaging
Klaus Tatsch

Abstract

Neurodegenerative dementia is an increasingly common disorder with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) accounting for most cases. Due to the overlap in clinical symptoms, their differential diagnosis may be challenging. As clinical classification is not completely satisfying, there is a need to improve the diagnostic accuracy by complementary methods such as functional single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. The latter may be helpful to address one distinct biological difference between DLB and AD, the severe nigrostriatal degeneration which occurs in DLB, but not to any significant extent in AD. Based on this principle, autoradiographic studies targeting presynaptic dopaminergic functions have consistently demonstrated the ability to distinguish DLB from AD in postmortem series. At the same time, several single-site and one multicentre study have independently confirmed--no matter what technique was used (SPECT or PET) and which presynaptic function was addressed (dopamine turnover, dopamine transporter, vesicular monoamine transporter)--significantly compromised scan results in DLB subjects, whereas AD patients maintained almost normal finding...Continue Reading

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Citations

Nov 1, 2009·Expert Opinion on Medical Diagnostics·Nobuyuki OkamuraVictor L Villemagne
Jan 1, 2010·PET Clinics·John P Seibyl
Dec 5, 2009·Neuroimaging Clinics of North America·Klaus Tatsch
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Jul 19, 2013·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Klaus Tatsch, Gabriele Poepperl

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