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@ARTICLE{Perovnik:285739,
      author       = {Perovnik, Matej and Simončič, Urban and Jamšek, Jan and
                      Gregorič Kramberger, Milica and Brumberg, Joachim and
                      Meyer, Philipp Tobias and Perani, Daniela and Caminiti,
                      Silvia Paola and Brendel, Matthias and Stockbauer, Anna and
                      Camacho, Valle and Alcolea, Daniel and Vandenberghe, Rik and
                      Van Laere, Koen and Ko, Ji Hyun and Lee, Chong Sik and
                      Pardini, Matteo and Lombardo, Lorenzo and Padovani,
                      Alessandro and Pilotto, Andrea and Ochoa-Figueroa, Miguel A
                      and Davidsson, Anette and Cháfer-Pericás, Consuelo and
                      Álvarez-Sánchez, Lourdes and Garibotto, Valentina and
                      Lemstra, Afina W and Ferreira, Daniel and Morbelli, Silvia
                      Daniela and Tang, Chris C and Eidelberg, David and Trošt,
                      Maja},
      collaboration = {Initiative, Alzheimer’s Disease Neuroimaging},
      title        = {{M}etabolic brain networks in dementia with {L}ewy bodies:
                      from prodromal to manifest disease stages.},
      journal      = {Journal of neurology, neurosurgery, and psychiatry},
      volume       = {97},
      number       = {4},
      issn         = {0022-3050},
      address      = {London},
      publisher    = {BMJ Publishing Group},
      reportid     = {DZNE-2026-00296},
      pages        = {316 - 324},
      year         = {2026},
      abstract     = {Dementia 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.},
      keywords     = {Humans / Lewy Body Disease: metabolism / Lewy Body Disease:
                      diagnostic imaging / Male / Female / Aged /
                      Positron-Emission Tomography / Cognitive Dysfunction:
                      metabolism / Cognitive Dysfunction: diagnostic imaging /
                      Brain: metabolism / Brain: diagnostic imaging /
                      Fluorodeoxyglucose F18 / Alzheimer Disease: metabolism /
                      Alzheimer Disease: diagnostic imaging / Aged, 80 and over /
                      Disease Progression / Biomarkers: metabolism / Prodromal
                      Symptoms / Middle Aged / ALZHEIMER'S DISEASE (Other) / LEWY
                      BODY DEMENTIA (Other) / PET, FUNCTIONAL IMAGING (Other) /
                      Fluorodeoxyglucose F18 (NLM Chemicals) / Biomarkers (NLM
                      Chemicals)},
      cin          = {AG Haass},
      ddc          = {610},
      cid          = {I:(DE-2719)1110007},
      pnm          = {352 - Disease Mechanisms (POF4-352)},
      pid          = {G:(DE-HGF)POF4-352},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41344886},
      doi          = {10.1136/jnnp-2025-336935},
      url          = {https://pub.dzne.de/record/285739},
}