Changes in dementia diagnostic category and diagnostic confidence following dopamine transporter SPECT imaging (DaTscanTM - Ioflupane 123I) in people with an uncertain diagnosis of dementia with Lewy bodies (possible DLB)

Abstract

AD stages or a predisposition to the disease:Preclinical AD stage TDR0: 9 (11.11%) direct relatives of patients with primary involutive changes in the brain; MMSE 26-28 points; Early AD stage TDR-1: 24 (29.63%) patients with mild dementia, mild cognitive impairment, had previously been diagnosed with AD; MMSE 20-25 points; Middle AD stage TDR-2: 31 (38.27%)patients with moderate dementia, sufficiently resistant cognitive impairment, had previously been diagnosed with AD; MMSE 12-19 points;Late AD stage TDR-3: 17 (20.99%) patients with a fairly severe dementia, gross cognitive impairment, had previously been diagnosed with AD; MMSE 7-11 points. Control Group: 59 patients with the most common brain lesions accompanied by neurodegenerative changes and development of dementia and cognitive impairment, but not suffering from AD. Results: Patients with different AD stages revealed the following changes in angioarchitectonics and microcirculation:Absence of marked atherosclerotic lesions of intracranial vessels;Degeneration of the capillary bed in the temporal and fronto-parietal regions;Development of multiple arteriovenous shunts in the same regions;Early venous dumping;Abnormal extension of venous trunks that receive blood from arteriovenous shunts in the temporal and fronto-parietal regions;Stagnation of venous blood on the border of the frontal and parietal regions;Increased looping of intracranial arteries. Control Group patients had no combination of such changes. Conclusions: These vascular changes are specific for AD and form the vascular factor of the disease which plays an important role in AD etiology and pathogenesis. Patients suffering from other diseases associated with neurodegenerative changes in the brain do not have similar lesions.