A new study from Karolinska Institutet and Mayo Clinic has revealed important insights into brain degeneration in dementia with Lewy bodies (DLB). This research, published in JAMA Neurology, could help doctors better monitor and treat this serious brain disease.
DLB is a common cause of dementia. It starts by the abnormal accumulation of the protein alpha-synuclein in the brain. This produces degeneration of the brain and causes problems with thinking, movement, and behavior. Eventually, the disease leads to dementia and death. Doctors use a imaging technique called FDG-PET to assess how the brain is affected in DLB. However, until now, there was no information on how these brain changes develop over time.
The study, led by Dr. Daniel Ferreira at the Department of Neurobiology, Care Sciences and Society , followed 35 patients with DLB, 37 patients with early-stage DLB (called prodromal DLB), and 100 healthy people from Mayo Clinic (USA), for an average of 3.8 years. The researchers found that brain degeneration starts early in prodromal DLB and worsens as the disease progresses.
"We discovered that people with prodromal DLB had faster degeneration in certain brain areas compared to healthy individuals," said Dr. Ferreira. "This information is crucial for monitoring disease progression from early stages and planning clinical trials for new treatments."
The study also showed that the brain changes seen on FDG-PET scans go in hand with worsening of clinical symptoms of DLB. This means that FDG-PET could be a valuable tool for tracking how the disease progresses over time and evaluate how well treatments are working.
This research is part of an international collaboration led by Dr. Daniel Ferreira from Karolinska Institutet with Dr. Kejal Kantarci at Mayo Clinic (USA).
The study received support from the Swedish Research Council, CIMED, ALF Medicine, Alzheimerfonden, Hjärnfonden, and NIH, as well as contributions from private bequests and foundations.
Publication
Longitudinal FDG-PET Metabolic Change Along the Lewy Body Continuum . Daniel Ferreira, Scott A. Przybelski, Timothy G. Lesnick, Patricia Diaz-Galvan, Christopher G. Schwarz, Melissa M. Murray, Dennis W. Dickson, Aivi Nguyen, Ross R. Reichard, Matthew L. Senjem, Jeffrey L. Gunter, Clifford R. Jack Jr., Paul H Min, Manoj K. Jain, Toji Miyagawa, Leah K. Forsberg, Julie A. Fields, Rodolfo Savica, Jonathan Graff-Radford, Vijay K. Ramanan, David T. Jones, Hugo Botha, Erik K. St. Louis, David S. Knopman, Neill R Graff-Radford, Gregory S. Day, Tanis J. Ferman, Walter K. Kremers, Ronald C. Petersen, Bradley F. Boeve, Val J. Lowe, and Kejal Kantarci. JAMA Neurology, online January 13, 2025, doi: 10.1001/jamaneurol.2024.4643.
