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000285739 0247_ $$2doi$$a10.1136/jnnp-2025-336935
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000285739 0247_ $$2ISSN$$a0368-329X
000285739 0247_ $$2ISSN$$a1468-330X
000285739 0247_ $$2ISSN$$a2753-0477
000285739 0247_ $$2ISSN$$a2753-0485
000285739 037__ $$aDZNE-2026-00296
000285739 041__ $$aEnglish
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000285739 1001_ $$00000-0001-8595-7773$$aPerovnik, Matej$$b0
000285739 245__ $$aMetabolic brain networks in dementia with Lewy bodies: from prodromal to manifest disease stages.
000285739 260__ $$aLondon$$bBMJ Publishing Group$$c2026
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000285739 520__ $$aDementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia, yet it remains under-recognised and misdiagnosed, which delays treatment, causes inaccurate prognosis and limits research opportunities. Imaging with 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) is a supportive DLB biomarker. We evaluated a multivariate, quantifiable metabolic network biomarker, termed DLB-related pattern (DLBRP), for its further clinical translation across centres and disease stages.We analysed demographic, clinical and FDG PET imaging data of 1180 participants from 14 tertiary centres and two multicentre datasets. We included 379 DLB, 28 mild cognitive impairment-LB (MCI-LB), 195 dementia due to Alzheimer's disease (ADD), 172 MCI-AD without α-synuclein co-pathology (MCI-AD-S-), and 73 MCI-AD with α-synuclein co-pathology (S+) patients, along with a comparative group of 333 normal controls (NCs). From the scans, we calculated the expression of DLBRP, AD-related pattern (ADRP) and Parkinson's disease-related pattern (PDRP) and compared them across groups. DLBRP scores were correlated with clinical measurements.Across independent cohorts, DLBRP robustly distinguished DLB from NCs (sensitivity >89%, specificity >90%), and scores correlated with Unified Parkinson's Disease Rating Scale Part III and independently predicted Mini-Mental State Examination. DLBRP was elevated already in MCI-LB. In a small longitudinal dataset, we observed steady increases in DLBRP expression with scores exceeding the diagnostic threshold prior to dementia onset. DLBRP and PDRP discriminated DLB from ADD (sensitivity, 74%-90%; specificity, 80%). In MCI-AD groups, ADRP was expressed, whereas DLBRP and PDRP were increased only in MCI-AD-S+, although comparatively less than in MCI-LB.This study demonstrates the value of DLBRP in diagnosing prodromal and manifest DLB and distinguishing them from their AD counterparts. While overlap between patterns may reflect actual co-pathology, this possibility cannot be accepted without thorough pathological confirmation. The current findings support the use of DLBRP in patient evaluation and in future trial design.
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000285739 650_7 $$2Other$$aALZHEIMER'S DISEASE
000285739 650_7 $$2Other$$aLEWY BODY DEMENTIA
000285739 650_7 $$2Other$$aPET, FUNCTIONAL IMAGING
000285739 650_7 $$00Z5B2CJX4D$$2NLM Chemicals$$aFluorodeoxyglucose F18
000285739 650_7 $$2NLM Chemicals$$aBiomarkers
000285739 650_2 $$2MeSH$$aHumans
000285739 650_2 $$2MeSH$$aLewy Body Disease: metabolism
000285739 650_2 $$2MeSH$$aLewy Body Disease: diagnostic imaging
000285739 650_2 $$2MeSH$$aMale
000285739 650_2 $$2MeSH$$aFemale
000285739 650_2 $$2MeSH$$aAged
000285739 650_2 $$2MeSH$$aPositron-Emission Tomography
000285739 650_2 $$2MeSH$$aCognitive Dysfunction: metabolism
000285739 650_2 $$2MeSH$$aCognitive Dysfunction: diagnostic imaging
000285739 650_2 $$2MeSH$$aBrain: metabolism
000285739 650_2 $$2MeSH$$aBrain: diagnostic imaging
000285739 650_2 $$2MeSH$$aFluorodeoxyglucose F18
000285739 650_2 $$2MeSH$$aAlzheimer Disease: metabolism
000285739 650_2 $$2MeSH$$aAlzheimer Disease: diagnostic imaging
000285739 650_2 $$2MeSH$$aAged, 80 and over
000285739 650_2 $$2MeSH$$aDisease Progression
000285739 650_2 $$2MeSH$$aBiomarkers: metabolism
000285739 650_2 $$2MeSH$$aProdromal Symptoms
000285739 650_2 $$2MeSH$$aMiddle Aged
000285739 7001_ $$aSimončič, Urban$$b1
000285739 7001_ $$aJamšek, Jan$$b2
000285739 7001_ $$aGregorič Kramberger, Milica$$b3
000285739 7001_ $$00000-0003-0959-4776$$aBrumberg, Joachim$$b4
000285739 7001_ $$aMeyer, Philipp Tobias$$b5
000285739 7001_ $$aPerani, Daniela$$b6
000285739 7001_ $$aCaminiti, Silvia Paola$$b7
000285739 7001_ $$0P:(DE-2719)9001539$$aBrendel, Matthias$$b8$$udzne
000285739 7001_ $$0P:(DE-2719)9002610$$aStockbauer, Anna$$b9$$udzne
000285739 7001_ $$00000-0003-0748-0847$$aCamacho, Valle$$b10
000285739 7001_ $$00000-0002-3819-3245$$aAlcolea, Daniel$$b11
000285739 7001_ $$00000-0001-6237-2502$$aVandenberghe, Rik$$b12
000285739 7001_ $$aVan Laere, Koen$$b13
000285739 7001_ $$aKo, Ji Hyun$$b14
000285739 7001_ $$aLee, Chong Sik$$b15
000285739 7001_ $$aPardini, Matteo$$b16
000285739 7001_ $$aLombardo, Lorenzo$$b17
000285739 7001_ $$aPadovani, Alessandro$$b18
000285739 7001_ $$0P:(DE-2719)9000943$$aPilotto, Andrea$$b19
000285739 7001_ $$aOchoa-Figueroa, Miguel A$$b20
000285739 7001_ $$aDavidsson, Anette$$b21
000285739 7001_ $$aCháfer-Pericás, Consuelo$$b22
000285739 7001_ $$aÁlvarez-Sánchez, Lourdes$$b23
000285739 7001_ $$00000-0003-2422-698X$$aGaribotto, Valentina$$b24
000285739 7001_ $$aLemstra, Afina W$$b25
000285739 7001_ $$aFerreira, Daniel$$b26
000285739 7001_ $$aMorbelli, Silvia Daniela$$b27
000285739 7001_ $$aTang, Chris C$$b28
000285739 7001_ $$aEidelberg, David$$b29
000285739 7001_ $$aTrošt, Maja$$b30
000285739 7001_ $$aInitiative, Alzheimer’s Disease Neuroimaging$$b31$$eCollaboration Author
000285739 773__ $$0PERI:(DE-600)1480429-3$$a10.1136/jnnp-2025-336935$$gVol. 97, no. 4, p. 316 - 324$$n4$$p316 - 324$$tJournal of neurology, neurosurgery, and psychiatry$$v97$$x0022-3050$$y2026
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