Altered resting state brain metabolic connectivity in dementia with Lewy bodies

Euna Choi; Ji Won Han; Seung Wan Suh; Jong Bin Bae; Ji Hyun Han; Subin Lee; Sang Eun Kim; Ki Woong Kim

doi:10.3389/fneur.2022.847935

Altered resting state brain metabolic connectivity in dementia with Lewy bodies

Front Neurol. 2022 Aug 8:13:847935. doi: 10.3389/fneur.2022.847935. eCollection 2022.

Authors

Euna Choi¹, Ji Won Han², Seung Wan Suh³, Jong Bin Bae², Ji Hyun Han², Subin Lee¹, Sang Eun Kim^{4

5

6}, Ki Woong Kim^{1

2

7}

Affiliations

¹ Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea.
² Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
³ Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
⁴ Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
⁵ Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea.
⁶ Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology, Suwon, South Korea.
⁷ Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.

Abstract

Although dementia with Lewy bodies (DLB) have Parkinsonism in common with Parkinson's disease (PD) or PD dementia (PDD), they have different neuropathologies that underlie Parkinsonism. Altered brain functional connectivity that may correspond to neuropathology has been reported in PD while never been studied in DLB. To identify the characteristic brain connectivity of Parkinsonism in DLB, we compared the resting state metabolic connectivity in striato-thalamo-cortical (STC) circuit, nigrostriatal pathway, and cerebello-thalamo-cortical motor (CTC) circuit in 27 patients with drug-naïve DLB and 27 age- and sex-matched normal controls using 18F-fluoro-2-deoxyglucose PET. We derived 118 regions of interest using the Automated Anatomical Labeling templates and the Wake Forest University Pick-Atlas. We applied the sparse inverse covariance estimation method to construct the metabolic connectivity matrix. Patients with DLB, with or without Parkinsonism, showed lower inter-regional connectivity between the areas included in the STC circuit (motor cortex-striatum, midbrain-striatum, striatum-globus pallidus, and globus pallidus-thalamus) than the controls. DLB patients with Parkinsonism showed less reduced inter-regional connectivity between the midbrain and the striatum than those without Parkinsonism, and higher inter-regional connectivity between the areas included in the CTC circuit (motor cortex-pons, pons-cerebellum, and cerebellum-thalamus) than those without Parkinsonism and the controls. The resting state metabolic connectivity in the STC circuit may be reduced in DLB. In DLB with Parkinsonism, the CTC circuit and the nigrostriatal pathway may be activated to mitigate Parkinsonism. This difference in the brain connectivity may be a candidate biomarker for differentiating DLB from PD or PDD.

Keywords: Parkinsonism; dementia with Lewy bodies; metabolic connectivity; neurodegenerative disease; positron emission tomography.