Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;268(4):1284-1294.
doi: 10.1007/s00415-020-10271-1. Epub 2020 Oct 21.

Mild cognitive impairment with Lewy bodies: blood perfusion with arterial spin labelling

Michael J Firbank  1 , John T O'Brien  2 , Rory Durcan  3 , Louise M Allan  4 , Sally Barker  3 , Joanna Ciafone  3 , Paul C Donaghy  3 , Calum A Hamilton  3 , Sarah Lawley  3 , Jim Lloyd  5 , Gemma Roberts  3   5 , John-Paul Taylor  3 , Alan J Thomas  3
Affiliations

Mild cognitive impairment with Lewy bodies: blood perfusion with arterial spin labelling

Michael J Firbank et al. J Neurol. 2021 Apr.

Abstract

Objective: To use arterial spin labelling to investigate differences in perfusion in mild cognitive impairment with Lewy bodies (MCI-LB) compared to Alzheimer type MCI (MCI-AD) and healthy controls.

Methods: We obtained perfusion images on 32 MCI-LB, 30 MCI-AD and 28 healthy subjects of similar age. Perfusion relative to cerebellum was calculated, and we aimed to examine differences in relative perfusion between MCI-LB and the other groups. This included whole brain voxelwise comparisons, as well as using predefined region-of-interest ratios of medial occipital to medial temporal, and posterior cingulate to precuneus. Differences in occipital perfusion in eyes open vs eyes closed conditions were also examined.

Results: Compared to controls, the MCI-LB showed reduced perfusion in the precuneus, parietal, occipital and fusiform gyrus regions. In our predefined regions, the ratio of perfusion in occipital/medial temporal was significantly lower, and the posterior cingulate/precuneus ratio was significantly higher in MCI-LB compared to controls. Overall, the occipital perfusion was greater in the eyes open vs closed condition, but this did not differ between groups.

Conclusion: We found patterns of altered perfusion in MCI-LB which are similar to those seen in dementia with Lewy bodies, with reduction in posterior parietal and occipital regions, but relatively preserved posterior cingulate.

Keywords: Arterial spin labelling; Lewy body disease; Magnetic resonance imaging; Mild cognitive impairment; Perfusion imaging.

PubMed Disclaimer

Conflict of interest statement

MJF, LMA, SB, JC, CH, SL, JJL, declare that they have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Flow chart showing exclusions and number of MRI scans in the patient groups
Fig. 2
Fig. 2
Significant perfusion reductions in MCI-LB relative to the control group. T statistic map overlaid on study specific average structural scan. Results thresholded at p < 0.001 voxelwise
Fig. 3
Fig. 3
Areas where perfusion is greater during eyes open vs closed in the entire group. Statistic map thresholded at p = 0.05 voxelwise family wise error corrected. Overlaid on study specific average structural scan
Fig. 4
Fig. 4
Medial occipital/medial temporal lobe perfusion ratio in the groups, with the probable MCI-LB group split by the number of core diagnostic features
See this image and copyright information in PMC

References

    1. McKeith IG, Ferman TJ, Thomas AJ, Blanc F, Boeve B, Fujishiro H, Kantarci K, et al. Research criteria for the diagnosis of prodromal dementia with Lewy bodies. Neurology. 2020;94:743–755. doi: 10.1212/WNL.0000000000009323. - DOI - PMC - PubMed
    1. Sala A, Caprioglio C, Santangelo R, Vanoli EG, Iannaccone S, Magnani G, Perani D. Brain metabolic signatures across the Alzheimer's disease spectrum. Eur J Nucl Med Mol Imaging. 2020;47:256–269. doi: 10.1007/s00259-019-04559-2. - DOI - PubMed
    1. Nedelska Z, Senjem ML, Przybelski SA, Lesnick TG, Lowe VJ, Boeve BF, Arani A, et al. Regional cortical perfusion on arterial spin labeling MRI in dementia with Lewy bodies: associations with clinical severity, glucose metabolism and tau PET. NeuroImage Clin. 2018;19:939–947. doi: 10.1016/j.nicl.2018.06.020. - DOI - PMC - PubMed
    1. Fong TG, Inouye SK, Dai W, Press DZ, Alsop DC. Association cortex hypoperfusion in mild dementia with Lewy bodies: a potential indicator of cholinergic dysfunction. Brain Imaging Behav. 2011;5:25–35. doi: 10.1007/s11682-010-9108-x. - DOI - PMC - PubMed
    1. Durcan R, Donaghy P, Osborne C, Taylor J-P, Thomas AJ. Imaging in prodromal dementia with Lewy bodies: where do we stand? Int J Geriatr Psychiatry. 2019;34:635–646. doi: 10.1002/gps.5071. - DOI - PubMed