123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies

  • Koji Kasanuki
  • Eizo Iseki
  • Kazumi Ota
  • Daizo Kondo
  • Yosuke Ichimiya
  • Kiyoshi Sato
  • Heii Arai
Original Article



Evidence for the prodromal stage of dementia with Lewy bodies (DLB) is very limited. To address this issue, we investigate the 123I-FP-CIT SPECT measure of dopamine transporter binding finding and its clinical relevance.


We enrolled subjects into a prodromal DLB group (PRD-DLB) (n = 20) and clinical DLB group (CLIN-DLB) (n = 18) and compared these groups with an Alzheimer’s disease control group (AD) (n = 10). PRD-DLB was defined as patients having the non-motor symptoms associated with Lewy body disease (LBD) [i.e. REM sleep behavior disorder (RBD), olfactory dysfunction, autonomic dysfunction, and depression] and showing characteristic diffuse occipital hypometabolism in 18F-FDG PET. CLIN-DLB was defined as patients fulfilling the established criteria of probable DLB. Striatal specific binding ratio (SBR) of 123I-FP-CIT SPECT was used for objective group comparisons. The correlations between SBR and cognitive function (MMSE), motor symptoms (UPDRS3), and duration of LBD-associated non-motor symptoms were compared between the two DLB groups.


Mean SBR scores of both PRD-DLB and CLIN-DLB were significantly lower than those of AD. No correlation was found between SBR and MMSE scores. Both in the CLIN-DLB and total DLB groups, SBR scores were negatively correlated with UPDRS3 scores, whereas no correlation was found in PRD-DLB. Among the LBD-related non-motor symptoms, duration of olfactory dysfunction, and RBD demonstrated negative correlation with SBR scores in PRD-DLB.


123I-FP-CIT SPECT may play a role for detecting DLB among the subjects in prodromal stage. During this stage, long-term olfactory dysfunction and/or RBD may indicate more severe degeneration of the nigro-striatal dopaminergic pathway.


Dementia with Lewy bodies Early diagnosis 123I-FP-CIT SPECT Nigro-striatal dopaminergic pathway Olfactory dysfunction REM sleep behavior disorder 



None authors declare that they have conflicts of interest. The present study was supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (grant number: 90648859).


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Koji Kasanuki
    • 1
    • 2
    • 3
  • Eizo Iseki
    • 1
    • 2
  • Kazumi Ota
    • 1
    • 2
  • Daizo Kondo
    • 1
  • Yosuke Ichimiya
    • 2
  • Kiyoshi Sato
    • 1
  • Heii Arai
    • 2
  1. 1.PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical CenterJuntendo University School of MedicineTokyoJapan
  2. 2.Department of PsychiatryJuntendo University School of MedicineTokyoJapan
  3. 3.Department of NeuroscienceMayo ClinicJacksonvilleUSA

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