Is dopamine transporter invariably impaired at the time of diagnosis in dementia with Lewy bodies?

Excerpt

Assessment of the integrity of the nigrostriatal dopaminergic pathway with ¹²³I-ioflupane SPECT has been approved by the Food and Drug Administration and the European Medicines Agency for the differential diagnosis between dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD). This has fulfilled a previously unmet need, i.e. to support the clinical diagnosis of DLB that is usually difficult because of overlapping symptoms with AD and also with frontotemporal lobe degeneration and vascular cognitive impairment. Indeed, by pooling the results from nine clinicopathological studies including 135 DLB patients and 350 non-DLB patients, the average sensitivity of clinical diagnosis was 49 % (range 0 – 83 %) and the average specificity (proportion of non-DLB patients correctly diagnosed clinically) was 92 % (range 79 – 100 %) [1]. This specificity was considered good but the sensitivity was considered unacceptably low. …