PMC9198785_01
Representations of both CSA and 18F-FDG-PET/CT patterns. a) Patient CSA patterns from occipital derivation at both admission and 6-month follow-up visit (left), compared to a CSA 1 pattern of a normal control (right). b) Axial 18F-FDG-PET/CT images and semiquantitative data (Cortex ID software) at 6 months from the hospitalization. Brain 18F-FDG PET study showed a moderate reduction in radiopharmaceutical uptake in the parietal, occipital, and lateral temporal bilaterally, more evident in the left hemisphere. A mild hypometabolism was also evident in the prefrontal regions bilaterally, although not reaching the statistically significant threshold at semiquantitative analyses. The uptake was also reduced at the level of the precuneus, especially on the right side, and a normal uptake at the level of the cingulate was present, describing the Cingulate Island Sign. This hypometabolic pattern was suggestive of DLB diagnosis. CSA, Compressed Spectral Array; 18F-FDG-PET/CT, 18F-fluorodeoxyglucose positron emission tomography; R, right; L, left.
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A spectral analysis electroencephalogram (QEEG) was performed (Fig. 1a), which showed a dominant frequency (DF) in the pre-alpha band (7.5 Hz) with a dominant frequency variability (DFV) of 2 Hz, typical of the early stages of DLB. QEEG recording confirmed the presence of a DLB-typical pattern (DF = 7.5 Hz, DFV = 2.5 Hz) (Fig. 1a). This pattern was suggestive of DLB diagnosis (Fig. 1b).