Loss of the “swallow tail sign” on susceptibility-weighted imaging in the diagnosis of dementia with Lewy bodies: a systematic review and meta-analysis

Introduction Loss of dorsolateral nigral hyperintensity (DNH) on iron-sensitive brain MRI is useful for Parkinson’s disease detection. DNH loss could also be of diagnostic value in dementia with Lewy bodies (DLB), an a-synuclein-related pathology. We aim to quantitatively synthesize evidence, invest...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of neurology Vol. 271; no. 7; pp. 3754 - 3763
Main Authors:	Tseriotis, Vasilis-Spyridon, Mavridis, Theodoros, Eleftheriadou, Kyriaki, Konstantis, Georgios, Chlorogiannis, David-Dimitris, Pavlidis, Pavlos, Pourzitaki, Chryssa, Arnaoutoglou, Marianthi, Spyridon, Konitsiotis
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2024 Springer Nature B.V
Subjects:	Alzheimer's disease Biomarkers Dementia Dementia disorders Frontotemporal dementia Humans Lewy bodies Lewy Body Disease - diagnosis Lewy Body Disease - diagnostic imaging Magnetic resonance imaging Magnetic Resonance Imaging - standards Medicine Medicine & Public Health Meta-analysis Neurodegenerative diseases Neuroimaging Neurology Neuroradiology Neurosciences Parkinson's disease Population studies Quality control Review Sensitivity analysis Substantia nigra Substantia Nigra - diagnostic imaging Substantia Nigra - pathology Synuclein Susceptibility-weighted imaging Dorsolateral nigral hyperintensity Magnetic resonance imaging Swallow tail sign Dementia with Lewy bodies Dementia
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Introduction Loss of dorsolateral nigral hyperintensity (DNH) on iron-sensitive brain MRI is useful for Parkinson’s disease detection. DNH loss could also be of diagnostic value in dementia with Lewy bodies (DLB), an a-synuclein-related pathology. We aim to quantitatively synthesize evidence, investigating the role of MRI, a first-line imaging modality, in early DLB detection and differentiation from other dementias. Methods Our study was conducted according to the PRISMA statement. MEDLINE, Scopus, Web of Science, and Cochrane Library were searched using the terms like “dementia with Lewy bodies”, “dorsolateral nigral hyperintensity”, and “MRI”. Only English-written peer-reviewed diagnostic accuracy studies were included. We used QUADAS-2 for quality assessment. Results Our search yielded 363 search results. Three studies were eligible, all with satisfying, high quality. The total population of 227 patients included 63 with DLB and 164 with other diseases (Alzheimer disease, frontotemporal dementia, mild cognitive impairment). Using a univariate random-effects logistic regression model, our meta-analysis resulted in pooled sensitivity, specificity and DOR of 0.82 [0.62; 0.92], 0.79 [0.70; 0.86] and 16.26 ([3.3276; 79.4702], p = 0.0006), respectively, for scans with mixed field strength (1.5 and 3 T). Subgroup analysis of 3 T scans showed pooled sensitivity, specificity and DOR of 0.82 [0.61; 0.93], 0.82 [0.72; 0.89] and 18.36 ([4.24; 79.46], p < 0.0001), respectively. Discussion DNH loss on iron-sensitive MRI might comprise a supportive biomarker for DLB detection, that could augment the value of the DLB diagnostic criteria. Further evaluation using standardized protocols is needed, as well as direct comparison to other supportive and indicative biomarkers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3
ISSN:	0340-5354 1432-1459 1432-1459
DOI:	10.1007/s00415-024-12381-6