Skip to main content
Log in

Utility of 123I-FP-CIT SPECT for dementia diagnoses and therapeutic strategies in elderly patients

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Evaluation of the influence of single photon emission computed tomography (SPECT) of the dopamine transporter (123I-FP-CIT) on diagnosis and treatment strategies in elderly patients with mild dementia.

Design

Retrospective study.

Setting

Geriatrics memory clinic.

Participants

Consecutive ambulatory patients who had 123I-FP-CIT SPECT for a suspicion of DLB.

Measurements

Clinical diagnoses before SPECT were compared with imaging results.

Results

46 patients were included. Pre imaging clinical hypotheses were probable DLB in 14, possible DLB in 21 and alternate diagnoses in 11. Rates of abnormal imaging in these groups were respectively 71%, 43% and 18%. Overall, diagnoses were revised in 37% of the cases. Four patients with probable DLB had normal imaging. Their number of core criteria did not differ from the remainder (2.75 ± 0.5 vs. 2.1 ± 0.6), but hallucinations in 2 patients were not well formed and detailed as usual in DLB. Among 38 patients free of antipsychotics, rates of abnormal scans were 36% in patients with questionable parkinsonism, 57% in definite parkinsonism, 67% in patients with no parkinsonism. Among 9 patients on Levodopa, 6 had normal scans and Levodopa was stopped.

Conclusion

We show a significant impact of 123I-FP-CIT SPECT on diagnoses, even in cases of definite parkinsonism or probable DLB. In the latter, scarcity of hallucinations, especially if there are not well formed and detailed, should prompt 123I-FP-CIT SPECT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. McKeith I, O’Brien J, Walker Z et al. (2007) Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 6: 305–313

    Article  PubMed  Google Scholar 

  2. Cummings JL, Henchcliffe C, Schaier S, Simuni T, Waxman A, Kemp P (2011) The role of dopaminergic imaging in patients with symptoms of dopaminergic system neurodegeneration. Brain 134: 3146–3166

    Article  PubMed  Google Scholar 

  3. Walker Z, Jaros E, Walker RWH, Lee L, Costa DC, Livingston G, Ince PG, Perry R, McKeith I, Katona CLE (2007) Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry 78: 1176–1181

    Article  PubMed  Google Scholar 

  4. Schneider JA, Arvanitakis Z, Bang W, Bennett DA (2007) Mixed brain pathologies account for most dementia cases in community-dwelling older patients. Neurology 69: 2197–2204

    Article  PubMed  Google Scholar 

  5. Walker RWH, Walker Z. (2009) Dopamine transporter single photon emission computerized tomography in the diagnosis of dementia with Lewy bodies. Mov Dis 24,sup 2: S754–S759

    Article  Google Scholar 

  6. Ceravolo R, Volterrani D, Gambaccini G, Rossi C, Logi C, Manca G, Berti C, Mariani G, Murri L, Bonuccelli U (2003) Dopaminergic degeneration and perfusional impairment in Lewy body dementia and Alzheimer’s disease. Neurol Sci 24: 162–163

    Article  CAS  PubMed  Google Scholar 

  7. O’Brien JT, Colloby S, Fenwick J, Williams D, Firbank M, Burn D, Aarsland D, McKeith IG (2004) Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies. Arch Neurol 61: 919–925

    Article  PubMed  Google Scholar 

  8. Colloby SJ, Firbank MJ, Pakrasi S, Lloyd JJ, Driver I, McKeith IG, Williams ED, O’Brien JT (2008) A comparison of 99mTc-exametazime and 123I-FP-CIT SPECT imaging in the differential diagnosis of Alzheimer’s disease and dementia with Lewy bodies. Int Psychoger 20: 1124–1140

    Article  Google Scholar 

  9. Mc Keith IG, Dickson DW, Lowe J et al. Consortium on DLB (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65: 1863–1872

    Article  CAS  Google Scholar 

  10. Benamer HTS, Patterson J, Grosset DG (2000) Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123]-FP-CIT SPECT Imaging: The [123]-FP-CIT Study Group. Mov Disord 15: 503–510

    Article  CAS  PubMed  Google Scholar 

  11. O’Brien JT, McKeith IG, Walker Z, Tatsch K, Booij J, Darcourt J, Marquardt M, Reininger C for the DLB study group (2009) Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. Brit J Psych 194: 34–39

    Article  Google Scholar 

  12. Colloby SJ, McParland S, O’Brien JT, Attems J (2012) Neuropathological correlates of dopaminergic in Alzheimer’s disease and Lewy body dementias. Brain 135: 2798–2808

    Article  PubMed  Google Scholar 

  13. Walker Z, Costa DC, Walker RWH, Shaw K, Gacinovic S, Stevens T, Livingston G, Ince P, McKeith IG, Katona CLE (2002) Differentiation of dementia with Lewy bodies from Alzheimer’s disease using a dopaminergic presynaptic ligand. J Neurol Neurosurg Psychiatry 73: 134–140

    Article  CAS  PubMed  Google Scholar 

  14. Bairactaris C, Demakopoulos N, Tripsianis G, Sioka C, Farmakiotis D, Vadikolias K, Heliopoulos I, Georgoulias P, Tsougos I, Papanastasiou I, Piperidou C (2009) Impact of dopamine transporter single photon emission computed tomography imaging using I-123 ioflupane on diagnoses of patients with parkinsonian syndromes. J Clin neurosci 16: 246–252

    Article  CAS  PubMed  Google Scholar 

  15. Booij J, Knol RJJ (2007) SPECT imaging of the dopaminergic system in (premotor) Parkinson’s disease. Park Rel Disord 13: S425–S428

    Article  Google Scholar 

  16. Darcourt J, Booij J, Tatsch K, Varrone A, Vander Borght T, Kapucu OL, Nagren K, Nobili F, Walker Z, Van Laere K (2010) EANM procedure guidelines for brain neurotransmission SPECT using 123I-labelled dopamine transporter ligands. Eur J Nucl Med Mol Imaging 37: 443–450

    Article  CAS  PubMed  Google Scholar 

  17. Diaz-Corrales FJ, Sanz-Viedma S, Garcia-Solis D, Escobar-Delgado T, Mir P (2010) Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson’s disease. Eur J Nucl Med Mol Imaging 37: 556–564

    Article  PubMed  Google Scholar 

  18. Booij J, Kemp P (2008) Dopamine transporter imaging with [123I]FP-CIT SPECT: potential effects of drugs. Eur J Nucl Med Mol Imaging 35: 424–438

    Article  CAS  PubMed  Google Scholar 

  19. Albin RL (2007) An advance in molecular imaging of dementias. Lancet Neurol 6: 288–289

    Article  PubMed  Google Scholar 

  20. Nelson PT, Jicha GA, Kryscio RJ, Abner EL, Schmitt FA, Cooper G, Xu LO, Smith CD, Markesbery WR (2010) Low sensitivity in clinical diagnoses of dementia with Lewy bodies. J Neurol 257: 359–366

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zina Barrou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barrou, Z., Boddaert, J., Faucounau, V. et al. Utility of 123I-FP-CIT SPECT for dementia diagnoses and therapeutic strategies in elderly patients. J Nutr Health Aging 18, 50–53 (2014). https://doi.org/10.1007/s12603-013-0346-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-013-0346-7

Key words

Navigation