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2016 ; 43
(7
): 1376-86
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Cholinergic imaging in dementia spectrum disorders
#MMPMID26984612
Roy R
; Niccolini F
; Pagano G
; Politis M
Eur J Nucl Med Mol Imaging
2016[Jul]; 43
(7
): 1376-86
PMID26984612
show ga
The multifaceted nature of the pathology of dementia spectrum disorders has
complicated their management and the development of effective treatments. This is
despite the fact that they are far from uncommon, with Alzheimer's disease (AD)
alone affecting 35 million people worldwide. The cholinergic system has been
found to be crucially involved in cognitive function, with cholinergic
dysfunction playing a pivotal role in the pathophysiology of dementia. The use of
molecular imaging such as SPECT and PET for tagging targets within the
cholinergic system has shown promise for elucidating key aspects of underlying
pathology in dementia spectrum disorders, including AD or parkinsonian dementias.
SPECT and PET studies using selective radioligands for cholinergic markers, such
as [(11)C]MP4A and [(11)C]PMP PET for acetylcholinesterase (AChE), [(123)I]5IA
SPECT for the ?4?2 nicotinic acetylcholine receptor and [(123)I]IBVM SPECT for
the vesicular acetylcholine transporter, have been developed in an attempt to
clarify those aspects of the diseases that remain unclear. This has led to a
variety of findings, such as cortical AChE being significantly reduced in
Parkinson's disease (PD), PD with dementia (PDD) and AD, as well as correlating
with certain aspects of cognitive function such as attention and working memory.
Thalamic AChE is significantly reduced in progressive supranuclear palsy (PSP)
and multiple system atrophy, whilst it is not affected in PD. Some of these
findings have brought about suggestions for the improvement of clinical practice,
such as the use of a thalamic/cortical AChE ratio to differentiate between PD and
PSP, two diseases that could overlap in terms of initial clinical presentation.
Here, we review the findings from molecular imaging studies that have
investigated the role of the cholinergic system in dementia spectrum disorders.
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