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. 2021 Mar 28;11(4):433. doi: 10.3390/brainsci11040433

Figure 2.

Figure 2

Metabolic connectivity alterations in Lewy bodies disease spectrum. The figure represents the main metabolic connectivity findings in Parkinson’s disease (PD), dementia with Lewy bodies (DLB), and isolated rapid eye movement (REM) sleep behavior disorders (iRBD). The figure depicts the neurotransmission networks (A) and the large-scale resting-state network alterations (B). (A) DLB and PD share connectivity changes, mainly in noradrenergic and cholinergic (Ch)4 perisylvian (P) cholinergic networks. The iRBD and DLB groups show high similarity in noradrenergic and Ch5-Ch6 cholinergic networks. IRBD and PD show a high degree of similarity in the noradrenergic network. Finally, the dopaminergic network impairment is limited and localized in iRBD and moderate-to-severe in DLB and PD. (B) PD is characterized by alteration of the frontal component of anterior default mode network DMN, posterior DMN, and motor and executive networks (right), and DLB by alteration of the posterior component of PVN, pDMN, and limbic and attentional networks (left). All the evidence supports that alpha-synucleinopathies should be considered multisystem disorders since the prodromal stage. Panel A modified by Carli et al. (2020) [95] with the permission of Elsevier 2021. Abbreviations: RBD = REM sleep behavior disorder, PD = Parkinson’s disease; DLB = dementia with Lewy bodies; DMN: default mode network; Ch5-Ch6 = cholinergic Ch5-Ch6 divisions networks; Ch4 medial = cholinergic medial Ch4 division network; Ch4 perisylvian = cholinergic lateral perisylvian Ch4 division networks; Ch3 = cholinergic Ch3 division network; Ch1-Ch2 = cholinergic Ch1-Ch2 division network.