Right prefrontal hypometabolism predicts delusions in dementia with Lewy bodies

Perneczky, Robert; Drzezga, Alexander; Boecker, Henning; Wagenpfeil, Stefan; Förstl, Hans; Kurz, Alexander; Häussermann, Peter

doi:10.1016/j.neurobiolaging.2007.12.001

« Previous Next »Neurobiology of Aging
Volume 30, Issue 9 , Pages 1420-1429, September 2009

Right prefrontal hypometabolism predicts delusions in dementia with Lewy bodies

Robert Perneczky
- Department of Psychiatry and Psychotherapy, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
- Corresponding author at: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany. Tel.: +49 89 4140 4279; fax: +49 89 4140 4923.
Alexander Drzezga
- Department of Nuclear Medicine, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
Henning Boecker
- Department of Nuclear Medicine, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
- Department of Radiology, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
Stefan Wagenpfeil
- Institute of Medical Statistics and Epidemiology, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
Hans Förstl
- Department of Psychiatry and Psychotherapy, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
Alexander Kurz
- Department of Psychiatry and Psychotherapy, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
Peter Häussermann
- Department of Neurology, Technical University Munich, Ismaninger Str. 22, 81675 München, Germany
- Centre for Integrative Psychiatry, Niemannsweg 147, 24105 Kiel, Germany

Received 10 August 2007; received in revised form 26 November 2007; accepted 3 December 2007. published online 13 February 2008.

Abstract

Delusions (DEL) are frequent in dementia with Lewy bodies (DLB); however, the neural equivalent is poorly understood. The present study therefore aimed to identify the cerebral metabolic pattern of glucose of a DLB group suffering from DEL (DLB+DEL) as compared to a non-delusional group (DLB−DEL) and a control group (NL); and to determine the predictive value of the regional metabolic deficit for DEL symptomatology in comparison to other clinical variables significantly associated with DEL. Voxel-wise comparisons were conducted between the patient and control groups in SPM2. The most significant regional metabolic deficit of the DLB+DEL group was used a predictor for DEL symptomatology in a logistic regression analysis along with other variables significantly associated with DEL, such as visual hallucinations (VH), and overall cognitive impairment. A significant relative hypometabolism of the right prefrontal cortex was found in the DLB+DEL group, which predicted DEL symptomatology in the regression analysis. VH and overall cognitive dysfunction were no significant predictors. These results underline the significance of right prefrontal damage for DEL in DLB.