APOE ε4 and GBA1 mutations shape distinct FDG-PET metabolic patterns in Lewy body dementia

In dementia with Lewy bodies, APOE ε4 carriers had less cingulate island sign preservation (p=0.03). GBA1 non-carriers showed higher Alzheimer disease-like metabolism (p=0.004), while GBA1 carriers had more homogenous Parkinson disease/DLB-like patterns (p=0.003). Genetic status…

• This cross-sectional study analyzed FDG-PET scans from 43 DLB patients and 35 healthy controls, stratified by GBA1 and APOE ε4 status.
• APOE ε4-negative patients showed greater preservation of the DLB-typical cingulate island sign compared to APOE ε4 carriers (p=0.03).
• GBA1 non-carriers had higher expression of an Alzheimer disease-related metabolic pattern (p=0.004), while GBA1 carriers showed a more homogeneous Parkinson disease/DLB-like pattern (p=0.003) on machine learning analysis.

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