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The relationship between hallucinations and FDG-PET in dementia with Lewy bodies

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Abstract

Visual hallucinations are common in dementia with Lewy bodies (DLB), although their etiology is unclear. This study aimed to investigate the relationship between severity and frequency of hallucinations and regional brain glucose metabolism. We performed brain FDG-PET scanning on 28 subjects with DLB (mean age 76). The neuropsychiatric index (NPI) was used to assess frequency and severity of hallucinations. We used the SPM package to investigate voxelwise correlations between NPI hallucination score (severity x frequency) and FDG uptake relative to the cerebellum. There was a bilateral medial occipital region where reduced FDG was associated with increased hallucination severity and frequency. We conclude that the reduced occipital metabolism frequently seen in DLB is associated with frequency and severity of visual hallucinations. Further studies are required to investigate whether this is the result of deficits in top-down or bottom-up visual processing pathways.

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Acknowledgments

We thank Nicky Barnett, Chris Davidson, Kirsty Olsen and the DeNDRoN Clinical Research Network for assistance with subject recruitment. This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-1207-13105). Support was also provided by the NIHR Newcastle Biomedical Research Centre and Lewy-body Dementia Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, and also the NIHR Biomedical Research Centre and Biomedical Research Unit in Dementia based at Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

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Funding

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-1207-13105).

Conflict of interest

JOB report grants and other from GE Healthcare, grants and other from Lilly, other from Bayer Healthcare, other from TauRx, other from Cytox, outside submitted work. MF and JL declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by Newcastle and North Tyneside Research Ethics Committee (REF 09/H0906/88), and all participants (or nominated Independent Mental Capacity Advocate where participant lacked capacity) gave informed consent before participating.

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Correspondence to Michael J. Firbank.

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Firbank, M.J., Lloyd, J. & O’Brien, J.T. The relationship between hallucinations and FDG-PET in dementia with Lewy bodies. Brain Imaging and Behavior 10, 636–639 (2016). https://doi.org/10.1007/s11682-015-9434-0

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