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Commentary: Autopsy Validation of 123I-FP-CIT Dopaminergic Neuroimaging for the Diagnosis of DLB

Dementia with Lewy bodies is the second most common cause of dementia after Alzheimer’s disease. One of the key features of the disease is the loss of dopaminergic neurons in the nigrostriatal pathway. Their loss is associated with the presence of a-synuclein aggregates, which is one of the hallmarks of Lewy Body Disease (LBD)1. Currently the gold standard for diagnosis of alpha synucleinopathies, including DLB, is autopsy. However, neuroimaging provides in-vivo evidence of underlying neuropathological features of DLB, in line with the recent NIA-AA Framework for AD2. This paper focuses on a study by Thomas et al., 2017 which validates 123I-FP-CIT neuroimaging against autopsy. This paper will highlight the importance of combining clinical acumen and neuroimaging in DLB diagnosis to improve clinical confidence in DLB diagnosis3.