case_images: PMC9043811_01
case_images: PMC9043811_02
case_images: Timeline of relevant symptoms presented from psychiatric-onset prodromal dementia with Lewy bodies (DLB) to DLB in moderate dementia stage. Gradient-colored symptoms vary in severity. Darker colors indicate more severity while light colors indicate less severity. Solid-colored symptoms did not vary in severity. AD, Alzheimer's Disease; PD, Parkinson's Disease; DLB, Dementia with Lewy Bodies; ADL, Activities of daily living.
case_images: fneur-13-839539-g0001.jpg
case_images: PMC9043811_02_fneur-13-839539-g0001.jpg
case_images: F1
case_images: PMC9043811_03
case_images: Imaging and electrophysiological findings. (A)
  18F-dihydroxyphenylalanine 18F-DOPA PET showed reduced dopamine uptake in the nigrostriatal regions. (B) Axial (left) and coronal (right) MRI planes of hippocampal structures in T1 sequence, showing relative sparing of hippocampi. (C) Electroencephalogram (EEG):Compressed spectral arrays (CSA) showing stacked plots of the power spectral density for each 1-s epoch. Frequencies lower than theta were filtered as could be affected by artifacts. (C1) CSA from derivation O1 (left occipital) during the eyes-closed condition. (C2) Interpretation of CSA from derivation O1 (left occipital). Yellow dots illustrate the dominant frequency (frequency with a maximum power peak) in each 1-s epoch. The dotted yellow line depicts dominant frequency variability across epochs. Dominant frequency in each epoch variates from the alpha band (at 9 Hz) to the pre-alpha/fast-theta band (at 6-7 Hz). Dominant frequency variability of 3 Hz is represented.
case_images: fneur-13-839539-g0002.jpg
case_images: PMC9043811_03_fneur-13-839539-g0002.jpg
case_images: F2
case_images: The 18F-dihydroxyphenylalanine (DOPA) Positron Emitted Tomography (PET) demonstrated reduced uptake in the nigrostriatal pathway, but increased uptake in the pons and medulla oblongata (Figure 2A). Structural MRI revealed mild diffuse cortical atrophy, but relative sparing of hippocampi in the T1 sequence (Figure 2B) as defined by medial temporal lobe atrophy score, and minimal white matter vascular lesions in FLAIR and T2 sequences according to Fazekas scale. The latter defines a typical pattern of early DLB at the index admission (Figure 2C).