MRI May Help Identify Lewy Body Dementia vs Alzheimer’s

HealthDay News — Magnetic resonance imaging (MRI) of the brain may aid diagnosis of dementia with Lewy bodies versus Alzheimer’s disease, according to a study published online Nov. 2 in Neurology.

Starting in 2005, Kejal Kantarci, MD, a radiologist at the Mayo Clinic in Rochester, Minnesota, and colleagues followed 160 patients with mild cognitive impairment. Participants had MRI brain scans to measure the size of the hippocampus. For an average of 2 years, study participants had annual evaluations. During the course of the study, 61 people developed Alzheimer’s disease. Twenty people progressed to probable dementia with Lewy bodies.

The researchers found that someone whose hippocampus stayed the same size was nearly 6 times more likely to develop Lewy body dementia than someone whose hippocampus shrunk in size (hazard ratio, 5.8). A total of 17 of the 20 patients who were identified with probable Lewy body disease (85%) maintained normal volume in the hippocampus. Of the 61 participants who developed Alzheimer’s, 37 (61%) had hippocampal atrophy.

“Identifying people with mild cognitive impairment at risk for dementia with Lewy bodies is critical for early interventions with the potential treatments emerging in the field,” Kantarci told HealthDay. “Early diagnosis also helps target appropriate treatments, including what medications not to give. For example, as many as 50% of people with Lewy body disease have severe reactions to antipsychotic medications.”

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Kantarci K, Lesnick T, Ferman TJ, et al. Hippocampal volumes predict risk of dementia with Lewy bodies in mild cognitive impairment. Neurology. 2016; doi:10.1212/WNL.0000000000003371.