Comparison of brain perfusion patterns in dementia with Lewy bodies patients with or without cingulate island sign

The aim of the present study was to examine the differences in the brain perfusion single-photon emission computed tomography patterns compared in dementia with Lewy bodies (DLB) with or without cingulate island sign (CIS).

A total of 43 patients with DLB and 63 patients with Alzheimer's disease (AD) were included in the study. The CIScore was determined based on the posterior cingulate area and the occipital cortex using the eZIS software. The CIScore was analyzed using receiver operating characteristic curve analysis. Statistical parametric mapping 8 was used for the voxel-by-voxel group analysis of single-photon emission computed tomography.

The mean CIScore was significantly lower in DLB patients than in Alzheimer's disease patients. The age at examination was higher in the normal CIScore subgroup than in the abnormal CIScore subgroup based on optimal cut-off value. Statistical parametric mapping 8 analysis showed Alzheimer's disease-specific hypoperfusion in the normal-CIScore subgroup. Furthermore, stratifying the patients by age before applying the optimal CIScore cut-off improved the largest area under the receiver operating characteristic curve in patients aged ≤78 years compared with patients aged >79 years.

The present findings suggest that older DLB patients might have a normal CIScore because of concomitant multiple pathology. Therefore, age should be considered when interpreting the CIScore. Geriatr Gerontol Int 2019; 19: 197-202.