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Front Syst Neurosci. 2015 Jul 1;9:99. doi: 10.3389/fnsys.2015.00099. eCollection 2015.

(123)I-FP-CIT SPECT imaging in early diagnosis of dementia in patients with and without a vascular component.

Author information

1
Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain ; Psychiatric Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain.
2
Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain.
3
College of Applied Medical Sciences, Majmaah University Almajmaah Al Majmaah, Saudi Arabia.
4
Research Unit, Research Foundation Mútua Terrassa, Universitat de Barcelona Barcelona, Spain.
5
Cetir-Grup Medic, CTD, Hospital Universitari Mútua de Terrassa Terrassa, Spain.
6
School of Healthcare Science, Manchester Metropolitan University Manchester, UK.
7
Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain ; School of Healthcare Science, Manchester Metropolitan University Manchester, UK.

Abstract

Alzheimer's disease (AD) and vascular dementia (VaD) are the most common cause of dementia. Cerebral ischemia is a major risk factor for development of dementia. (123)I-FP-CIT SPECT (DaTScan) is a complementary tool in the differential diagnoses of patients with incomplete or uncertain Parkinsonism. Additional application of DaTScan enables the categorization of Parkinsonian disease with dementia (PDD), and its differentiation from pure AD, and may further contribute to change the therapeutic decision. The aim of this study was to analyze the vascular contribution towards dementia and mild cognitive impairment (MCI). We evaluated the utility of DaTScan for the early diagnosis of dementia in patients with and without a clinical vascular component, and the association between neuropsychological function, vascular component and dopaminergic function on DaTScan. One-hundred and five patients with MCI or the initial phases of dementia were studied prospectively. We developed an initial assessment using neurologic examination, blood tests, cognitive function tests, structural neuroimaging and DaTScan. The vascular component was later quantified in two ways: clinically, according to the Framingham Risk Score (FRS) and by structural neuroimaging using Wahlund Scale Total Score (WSTS). Early diagnosis of dementia was associated with an abnormal DaTScan. A significant association was found between a high WSTS and an abnormal DaTScan (p < 0.01). Mixed AD was the group with the highest vascular component, followed by the VaD group, while MCI and pure AD showed similar WSTS. No significant associations were found between neuropsychological impairment and DaTScan independently of associated vascular component. DaTScan seems to be a good tool to discriminate, in a first clinical assessment, patients with MCI from those with established dementia. There was bigger general vascular affectation observable in MRI or CT in patients with abnormal dopaminergic uptake seen on DaTScan.

KEYWORDS:

123I-FP-CIT SPECT; Framingham risk score; dementia; mild cognitive impairment

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