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CharacteristicMale / FemaleAge (mean±SD)MMSE score (mean±SD)MCI (n=14)11 / 358.4±6.327.4±2.3AD (n=16)DLB (n=16)11 / 558.3±5.720.4±6.16 / 1061.6±3.816.7±6.6506advances in cerebral function measurement tech-nology have made it practicable to employ brain imaging analysis as an auxiliary measure for more accurate diagnosis. Technologies that are typically utilized for brain imaging include magnetic reso-nance imaging (MRI) and single photon emission computed tomography (SPECT). Clinically, detecting minute brain atrophy, a characteristic symptom of early-stage AD, requires high skill and long time. With the aim of easily and quantifiably identifying atrophied lesions in the hippocampus and parahip-pocampal gyrus in MR imagery, the Voxel-Based Specific Analysis System for Alzheimer’s Disease (VSRAD)3) has been recently developed and is now being used in medical practice. However, patients with early-onset dementia often have hippocampus/parahippocampal gyrus atrophies that are fairly inconspicuous, and it is not uncommon for VSRAD-based indices to fall within the normal range. At the stage of mild cognitive impairment (MCI), which is considered to be the prodromal phase of AD, known cerebral blood flow findings include a decrease in blood flow in the parietal lobe, precuneus, and posterior cingulate gyrus. Since even AD patients tend to display high blood circu-lation in the precuneus and posterior cingulate gyrus, it is difficult to macroscopically detect a decrease from early stages. An easy Z-score imaging system (eZIS) was developed to compare the normal blood flow of healthy people with that of AD patients4-6) and is now being used for aiding AD diagnosis.Depressiveness, hallucinations, and delusions are frequently observed symptoms of DLB7). However, presenile DLB patients are often falsely diagnosed with depression and/or schizophrenia due to these diseases sharing similar symptoms8). Impaired cognitive functions and psychiatric symptoms derived from DLB can be effectively treated with donepezil9). Therefore, early diagnosis is more crucial for DLB than for AD because it can signifi-cantly affect the prognosis. Moreover, predisposi-Table 1 Demographic datations of DLB patients, such as high sensitivity of antipsychotics, mean that differential diagnosis is critical. In DLB, sugar metabolism and blood flow decrease in the occipital lobe. Additionally, 18F- FDG PET imaging reveals a cingulate island sign (CIS), a finding that sugar metabolism is relatively retained in the posterior cingulate gyrus in DLB as opposed to AD10). According to the Clinical Diag-nostic Criteria for DLB (2017 Revised Edition), the CIS is regarded as one of the major biomarkers11). Furthermore, a recent study has reported that DLB patients exhibit CIS findings are in cerebral blood flow SPECT using 99mTc-ECD, as compared with AD patients12). Another study has demon-strated the high effectiveness of CIScore (a refer-ence index using CIS in eZIS) in differentiating AD from DLB13).In the present study, we retrospectively evalu-ated the usefulness of various numerical indices calculated by eZIS (cerebral blood flow SPECT analysis software) in differentiating types of early-onset dementia.The present study was approved by the Ethics Committee of Juntendo University Hospital (No. JHS 17-0017) and was conducted with the informed consent of the subjects and their families in writing.The study involved patients with early-onset and mild dementia who were receiving ambulatory care at our outpatient department specializing in Alzheimer’s disease. The patient characteristics are summarized in Table 1. The subjects comprised 14 MCI patients (11 men and 3 women), 16 AD patients (11 men and 5 women), and 16 probable/possible DLB patients (6 men and 10 women). The MCI patients were diagnosed in accordance with Petersen’s Criteria 2004, were 51 to 69 years old (mean: 58.4; standard deviation 6.3), and their MMSE score ranged from 22 to 30 (mean: 27.4; standard deviation: 2.3). The AD patients were diagnosed in accordance with DSM-IV-TR, were Materials and Methods

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