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Cholinesterase inhibitor use does not significantly influence the ability of I-123-FP-CIT imaging to distinguish Alzheimer's disease from dementia with Lewy bodies

Lookup NU author(s): Dr John-Paul Taylor, Dr Sean Colloby, Professor Ian McKeith, Professor David Burn, Dr David Williams, Professor John O'Brien

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Abstract

Background: I-123- labelled 2 beta- carbomethoxy- 3 beta-( 4- iodophenyl)- N-( 3- fluoropropyl) nortropane ( I-123- FP- CIT) imaging is a diagnostic tool to help differentiate dementia with Lewy bodies ( DLB) from Alzheimer's disease ( AD). However, in animals, cholinesterase inhibitors ( ChEi) have been reported to reduce radioligand binding to the striatal dopamine transporter. As ChEi are frequently used in people with dementia, it is important to determine whether their use affects I-123- FP- CIT uptake in the striatum. Objective: To clarify whether chronic ChEi therapy modulates striatal dopamine transporter binding measured by I-123- FP- CIT in patients with AD, DLB and Parkinson's disease with dementia ( PDD). Design: Cross sectional study in 99 patients with AD ( nine on ChEi, 25 not on ChEi), DLB ( nine on ChEi, 19 not on ChEi) and PDD ( six on ChEi, 31 not on ChEi) comparing I-123- FP- CIT striatal binding ( caudate, anterior and posterior putamen) in patients receiving compared with those not receiving ChEi, correcting for key clinical variables including diagnosis, age, sex, Mini- Mental State Examination score, severity of parkinsonism and concurrent antidepressant use. Results: As previously described, I-123- FP- CIT striatal uptake was lower in DLB and PDD subjects compared with those with AD. Median duration of ChEi use was 180 days. I-123- FP- CIT uptake was not significantly reduced in subjects receiving ChEi compared those not receiving ChEi ( mean percentage reduction: AD 4.3%; DLB 0.7%; PDD 6.1%; p = 0.40). ChEi use did not differentially affect striatal (FP)-F-123- CIT uptake between patient groups ( p = 0.83). Conclusions: Use of ChEi does not significantly influence the ability of 123I- FP- CIT imaging to distinguish AD from DLB.


Publication metadata

Author(s): Taylor JP, Colloby SJ, McKeith IG, Burn DJ, Williams D, Patterson J, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Journal of Neurology, Neurosurgery and Psychiatry

Year: 2007

Volume: 78

Issue: 10

Pages: 1069-1071

ISSN (print): 0022-3050

ISSN (electronic): 1468-330X

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/jnnp.2006.111666

DOI: 10.1136/jnnp.2006.111666


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