Purpose of Review

Brain cholinergic denervation is a major feature of Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). We reviewed the topography assessed by a cholinergic molecular imaging study in these two major types of dementia. A small meta-analysis directly comparing vesicular acetylcholine transporter (VAChT) PET scans of AD vs. DLB patients is presented.

Recent Findings

VAChT PET studies showed evidence of extensive cortical cholinergic denervation in both forms of dementia, while multiple subcortical structures were also in DLB. Novel analysis revealed evidence of metathalamic denervation in AD, and epithalamus, premotor/sensorimotor cortical, and striatal losses in DLB.

Summary

Topographically distinct cortical and subcortical cholinergic lesions can distinguish AD and DLB, and new structures have been highlighted here. Differential vulnerability of specific cholinergic projections is likely associated with specific clinical features of these disorders. Improved understanding of the mechanisms and roles of cholinergic neurotransmission in regions with cholinergic deficits may lead to symptomatic therapies.

中文翻译：

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阿尔茨海默病和路易体痴呆中胆碱能系统的分子成像：扩大视野

审查目的

脑胆碱能去神经支配是阿尔茨海默病 (AD) 和路易体痴呆 (DLB) 的主要特征。我们回顾了胆碱能分子成像研究在这两种主要类型的痴呆中评估的地形。提出了一项直接比较 AD 与 DLB 患者的囊泡乙酰胆碱转运蛋白 (VAChT) PET 扫描的小型荟萃分析。

最近的发现

VAChT PET 研究显示，两种形式的痴呆都存在广泛的皮质胆碱能去神经支配，而 DLB 中也存在多个皮质下结构。新的分析揭示了 AD 中后丘脑去神经支配的证据，以及 DLB 中的上丘脑、运动前/感觉运动皮质和纹状体损失的证据。

概括

地形上不同的皮质和皮质下胆碱能病变可以区分 AD 和 DLB，这里强调了新的结构。特定胆碱能预测的差异易感性可能与这些疾病的特定临床特征有关。提高对胆碱能缺陷区域胆碱能神经传递机制和作用的理解可能会导致对症治疗。