Nicotinic alpha4beta2 receptor binding in dementia with Lewy bodies using 123I-5IA-85380 SPECT demonstrates a link between occipital changes and visual hallucinations

Neuroimage. 2008 Apr 15;40(3):1056-63. doi: 10.1016/j.neuroimage.2008.01.010. Epub 2008 Jan 19.


Introduction: To investigate in vivo differences in the distribution of alpha4beta2 subtypes of nAChR using the ligand (123)I-5-Iodo-3-[2(S)-2-azetidinylmethoxy] pyridine (5IA-85380) and single photon emission computed tomography (SPECT) in DLB and similarly aged controls.

Methods: Thirty-one subjects (15 DLB and 16 controls) underwent (123)I-5IA-85380 and perfusion ((99m)Tc-exametazime) SPECT scanning. Patient scans were compared to scans of control subjects on a voxel-by-voxel basis using SPM2.

Results: Compared to controls, significant reductions in relative (123)I-5IA-85380 uptake were identified in frontal, striatal, temporal and cingulate regions in DLB. Elevation of scaled (123)I-5IA-85380 uptake in occipital cortex was observed in DLB relative to controls, as well as being associated with DLB subjects with a recent history of visual hallucinations. Changes in (123)I-5IA-85380 SPECT in DLB were different from perfusion.

Conclusion: Reductions in normalised (123)I-5IA-85380 uptake in DLB were distinct from their perfusion deficits. Significant increase in occipital lobe uptake was present in DLB, a change most pronounced in subjects with a recent history of visual hallucinations. The findings directly link cholinergic changes in occipital lobe to visual hallucinations in DLB.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Azetidines
  • Butanones
  • Female
  • Hallucinations / diagnostic imaging*
  • Hallucinations / metabolism
  • Hallucinations / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Lewy Body Disease / diagnostic imaging*
  • Lewy Body Disease / metabolism*
  • Male
  • Neuropsychological Tests
  • Occipital Lobe / diagnostic imaging*
  • Occipital Lobe / metabolism
  • Occipital Lobe / physiopathology*
  • Pyridines
  • Radiopharmaceuticals
  • Receptors, Nicotinic / metabolism*
  • Tomography, Emission-Computed, Single-Photon


  • 5-iodo-3-(2-azetidinylmethoxy)pyridine
  • Azetidines
  • Butanones
  • Pyridines
  • Radiopharmaceuticals
  • Receptors, Nicotinic
  • nicotinic receptor alpha4beta2
  • exametazime