BACKGROUND Dementia with Lewy bodies (DLB) commonly exhibits a complex neuropathology, sharing characteristics with Alzheimer's disease (AD), including tau aggregates. However, studies using the 18F-AV-1451 tau tracer have shown inconsistent findings regarding both the extent and topographical distribution of tau pathology in DLB. OBJECTIVES Our aim was to elucidate the topographical patterns of tau deposition in DLB and to investigate the in vivo pathological distinction between DLB and AD in virtue of the 18F-Florzolotau positron emission tomography (PET) imaging. METHODS This cross-sectional study enrolled patients with DLB (n = 24), AD (n = 43), and cognitively healthy controls (n = 18). Clinical assessments and 18F-Florzolotau PET imaging were performed. 18F-Florzolotau binding was quantitatively assessed on PET images using standardized uptake value ratios and voxel-wise analysis. RESULTS 18F-Florzolotau PET imaging revealed widespread tau deposition across various cortical regions in DLB, uncovering heterogeneous topographical patterns. Among patients, 54.17% showed patterns similar to AD, whereas 16.67% exhibited distinct patterns. Compared to AD, DLB exhibited a unique in vivo neuropathological profile, characterized by a lower tau protein burden, heterogeneous topographical distributions, and a specific role of the medial temporal lobe in tau pathology. CONCLUSIONS 18F-Florzolotau PET imaging elucidated tau pathology patterns in DLB, providing valuable insights for future in vivo pathological differentiation and potential disease-modifying therapies. © 2024 International Parkinson and Movement Disorder Society.

中文翻译：

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18F-Florzolotau PET 成像揭示了路易体痴呆症的 Tau 病理学。


背景路易体痴呆 （DLB） 通常表现出复杂的神经病理学，与阿尔茨海默病 （AD） 具有共同特征，包括 tau 聚集体。然而，使用 18F-AV-1451 tau 示踪剂的研究显示，关于 DLB 中 tau 病理的范围和地形分布的研究结果不一致。目的 我们的目的是阐明 DLB 中 tau 沉积的地形模式，并凭借 18F-Florzolotau 正电子发射断层扫描 （PET） 成像研究 DLB 和 AD 之间的体内病理区分。方法 这项横断面研究招募了 DLB （n = 24） 、 AD （n = 43） 和认知健康对照 （n = 18） 患者。进行临床评估和 18F-Florzolotau PET 成像。使用标准化摄取值比和体素分析在 PET 图像上定量评估 18F-Florzolotau 结合。结果 18F-Florzolotau PET 成像显示 DLB 各个皮质区域的广泛 tau 沉积，揭示了异质性地形模式。在患者中，54.17% 的患者表现出与 AD 相似的模式，而 16.67% 的患者表现出不同的模式。与 AD 相比，DLB 表现出独特的体内神经病理学特征，其特征是较低的 tau 蛋白负荷、异质性地形分布以及内侧颞叶在 tau 病理学中的特定作用。结论 18F-Florzolotau PET 成像阐明了 DLB 中的 tau 病理模式，为未来的体内病理鉴别和潜在的疾病修饰疗法提供了有价值的见解。© 2024 年国际帕金森和运动障碍协会。