Dement Geriatr Cogn Disord 2008;25:195–205

Early Discriminatory Diagnosis of Dementia with Lewy Bodies

The Emerging Role of CSF and Imaging Biomarkers

Aarsland D.a, c · Kurz M.a · Beyer M.b · Bronnick K.a · Piepenstock Nore S.d · Ballard C.e
aNorwegian Centre for Movement Disorders and bDepartment of Radiology, Stavanger University Hospital, Stavanger, and cInstitute of Clinical Medicine, University of Bergen, and dGeriatric section, Haraldsplass Deaconess University Hospital, Bergen, Norway; eWolfson Centre for Age-Related Diseases, King’s College London, London, UK
email Corresponding Author

 goto top of outline Key Words

  • Dementia with Lewy bodies, early diagnosis
  • Cerebrospinal fluid
  • Imaging biomarkers

 goto top of outline Abstract

Background: The clinical diagnostic criteria for dementia with Lewy bodies (DLB) have a low sensitivity, and there are no generally accepted biomarkers to distinguish DLB from other dementias. Our aim was to identify biomarkers that may differentiate DLB from Alzheimer’s disease (AD). Method: We performed a systematic literature search for studies of EEG, imaging techniques and genetic and CSF markers that provide sensitivity and specificity in the identification of DLB. Results: The best evidence was for scintigraphy of the striatal dopamine transporter system using FP-CIT SPECT. Several small scintigraphy studies of cardiovascular autonomic function using metaiodobenzylguanidine SPECT have reported promising results. Studies exploring innovative techniques based on CSF have reported interesting findings for the combination of amyloid β (aβ) isoforms as well as α-synuclein, and there are interesting results emerging from preliminary studies applying proteomic techniques. Data from studies using structural MRI, perfusion SPECT, genetics and EEG studies show differences between DLB and AD but only at a group level. Conclusion: Several potential biomarkers for the differential diagnosis of probable DLB and AD have shown good diagnostic accuracy in the research setting. Data from large multicentre studies and from studies with autopsy confirmation exist for scintigraphy of the dopamine transporter system. Future studies should explore its value in possible DLB and for clinical management and health economics.

Copyright © 2008 S. Karger AG, Basel

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 goto top of outline Author Contacts

Dag Aarsland
Stavanger University Hospital
Arm Hansen v 20
NO–4005 Stavanger (Norway)
Tel. +47 5151 5062, Fax +47 5151 5195, E-Mail

 goto top of outline Article Information

Accepted: October 21, 2007
Published online: January 17, 2008
Number of Print Pages : 11
Number of Figures : 0, Number of Tables : 1, Number of References : 100

 goto top of outline Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 25, No. 3, Year 2008 (Cover Date: March 2008)

Journal Editor: Chan-Palay, V. (New York, N.Y.)
ISSN: 1420–8008 (Print), eISSN: 1421–9824 (Online)

For additional information:

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