{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:30:24Z","timestamp":1753893024955,"version":"3.41.2"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:sec><jats:title>Background and aim<\/jats:title><jats:p>Lewy body diseases (LBD) include neurodegenerative diseases such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD). Because DLB and Alzheimer's disease (AD) share similar neurological symptoms, DLB is frequently underdiagnosed. White Matter Hyperintensities (WMH) are associated with dementia risk and changes in both DLB and AD. In order to examine WMH discrepancies in DLB and AD patients and gain insight into their diagnostic utility and pathophysiological significance, this systematic review and meta-analysis is conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Databases such as PubMed, Scopus, Google Scholar, and Web of Science were searched for studies reporting WMH in DLB and AD patients based on Preferred Reporting Items for Systematic Review (PRISMA) guideline. Stata version 15 US is used to analyze the extracted data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies with 906 AD and 499 DLB patients were considered in this analysis. Although not statistically significant, the WMH was 0.03\u2005ml larger in AD patients than in DLB patients. The prevalence of hypertension varied, ranging from 21% to 56% in DLB patients and from 30% to 52% in AD patients. Different findings were found on the prevalence of diabetes; some research suggested that DLB patients had greater rates (18.7%\u201337%) than AD patients (9%\u201317.5%). The imaging modalities FLAIR, T2-weighted, and T1-weighted sequences were employed. Compared to DLB patients, AD patients had higher cortical and infratentorial infarcts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Those with AD have greater WMH volumes than cases with DLB, suggesting that WMH can be a biomarker to help better differentiation between these neurodegenerative diseases; however, this difference is not significant. To better understand the therapeutic implications and options for reducing WMH-related cognitive loss in various patient populations, more research is necessary.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fradi.2025.1554345","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T15:43:26Z","timestamp":1743781406000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of white matter signal alterations in dementia with Lewy bodies and Alzheimer's disease: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"5","author":[{"given":"Asad","family":"Abdi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milad","family":"Alipour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milad","family":"Ghanikolahloo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin","family":"Magsudy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"HojjatiPour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Gholamrezanezhad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehran","family":"Ilaghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehran","family":"Anjomrooz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Sayehmiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramtin","family":"Hajibeygi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mobina","family":"Fathi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Assadsangabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13024-019-0306-8","article-title":"Dementia with Lewy bodies: an update and outlook","volume":"14","author":"Outeiro","year":"2019","journal-title":"Mol Neurodegener"},{"key":"B2","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1212\/CON.0000000000000309","article-title":"Lewy Body dementias: dementia with Lewy bodies and Parkinson disease dementia","volume":"22","author":"Gomperts","year":"2016","journal-title":"Continuum (Minneap Minn)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1038\/s41572-021-00269-y","article-title":"Alzheimer Disease","volume":"7","author":"Knopman","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"B4","doi-asserted-by":"publisher","first-page":"6371","DOI":"10.3390\/ijms23126371","article-title":"Biomarkers of dementia with Lewy bodies: differential diagnostic with Alzheimer\u2019s disease","volume":"23","author":"Bousiges","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1007\/s00415-021-10402-2","article-title":"Differentiating dementia with Lewy bodies from Alzheimer\u2019s disease and Parkinson\u2019s disease dementia: an update on imaging modalities","volume":"269","author":"Orad","year":"2022","journal-title":"J Neurol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1002\/gps.2277","article-title":"Practical suggestions on how to differentiate dementia with Lewy bodies from Alzheimer\u2019s disease with common cognitive tests","volume":"24","author":"Palmqvist","year":"2009","journal-title":"Int J Geriatr Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/cns.13775","article-title":"Neuroimaging alterations in dementia with Lewy bodies and neuroimaging differences between dementia with Lewy bodies and Alzheimer\u2019s disease: an activation likelihood estimation meta-analysis","volume":"28","author":"Ma","year":"2022","journal-title":"CNS Neurosci Ther"},{"key":"B8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s13195-019-0575-z","article-title":"Changes in gray matter volume and functional connectivity in dementia with Lewy bodies compared to Alzheimer\u2019s disease and normal aging: implications for fluctuations","volume":"12","author":"Chabran","year":"2020","journal-title":"Alzheimers Res Ther"},{"key":"B9","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.clineuro.2017.10.024","article-title":"Potential diagnostic value of 131I-MIBG myocardial scintigraphy in discrimination between Alzheimer disease and dementia with Lewy bodies","volume":"163","author":"Abbasi","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.pscychresns.2015.12.007","article-title":"Early differential diagnosis between Alzheimer\u2019s disease and dementia with Lewy bodies: comparison between (18)F-FDG PET and (123)I-IMP SPECT","volume":"249","author":"Chiba","year":"2016","journal-title":"Psychiatry Res Neuroimaging"},{"key":"B11","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.neurobiolaging.2020.12.009","article-title":"The value of multimodal imaging with 123I-FP-CIT SPECT in differential diagnosis of dementia with Lewy bodies and Alzheimer\u2019s disease dementia","volume":"99","author":"Miyagawa","year":"2021","journal-title":"Neurobiol Aging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jpsychires.2016.03.010","article-title":"Multimodal EEG-MRI in the differential diagnosis of Alzheimer\u2019s disease and dementia with Lewy bodies","volume":"78","author":"Colloby","year":"2016","journal-title":"J Psychiatr Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.neubiorev.2020.11.007","article-title":"White matter hyperintensities and risks of cognitive impairment and dementia: a systematic review and meta-analysis of 36 prospective studies","volume":"120","author":"Hu","year":"2021","journal-title":"Neurosci Biobehav Rev"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e001140","DOI":"10.1161\/JAHA.114.001140","article-title":"What are white matter hyperintensities made of? Relevance to vascular cognitive impairment","volume":"4","author":"Wardlaw","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"B15","doi-asserted-by":"publisher","first-page":"W65","DOI":"10.7326\/0003-4819-151-4-200908180-00136","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann Intern Med"},{"article-title":"The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","year":"2000","author":"Wells","key":"B16"},{"key":"B17","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"Br Med J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1097\/01.JGP.0000236596.56982.1c","article-title":"Progression of white matter hyperintensities in Alzheimer disease, dementia with Lewy bodies, and Parkinson disease dementia: a comparison with normal aging","volume":"14","author":"Burton","year":"2006","journal-title":"Am J Geriatr Psychiatry"},{"key":"B19","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1159\/000351423","article-title":"Prevalence and clinical implication of microbleeds in dementia with Lewy bodies in comparison with microbleeds in Alzheimer\u2019s disease","volume":"3","author":"Fukui","year":"2013","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e12306","DOI":"10.1002\/dad2.12306","article-title":"Effects of white matter hyperintensities, neuropsychiatric symptoms, and cognition on activities of daily living: differences between Alzheimer\u2019s disease and dementia with Lewy bodies. Alzheimer\u2019s & dementia: diagnosis","volume":"14","author":"Mirza","year":"2022","journal-title":"Alzheimers Dement (Amst)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.jalz.2016.07.003","article-title":"An investigation of cerebrovascular lesions in dementia with Lewy bodies compared to Alzheimer\u2019s disease","volume":"13","author":"Sarro","year":"2017","journal-title":"Alzheimers Dement"},{"key":"B22","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.parkreldis.2021.09.025","article-title":"A multiparametric MRI study of structural brain damage in dementia with Lewy bodies: a comparison with Alzheimer\u2019s disease","volume":"91","author":"Caso","year":"2021","journal-title":"Parkinsonism Relat Disord"},{"key":"B23","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1002\/gps.5485","article-title":"Association of cerebral microbleeds with cerebrospinal fluid Alzheimer-biomarkers and clinical symptoms in early dementia with Lewy bodies","volume":"36","author":"Mendes","year":"2021","journal-title":"Int J Geriatr Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jns.2017.12.018","article-title":"White matter hyperintensities on MRI in dementia with Lewy bodies, Parkinson\u2019s disease with dementia, and Alzheimer\u2019s disease","volume":"385","author":"Joki","year":"2018","journal-title":"J Neurol Sci"},{"key":"B25","doi-asserted-by":"publisher","first-page":"545","DOI":"10.3233\/JAD-210669","article-title":"Implication of small vessel disease MRI markers in Alzheimer\u2019s disease and Lewy body disease","volume":"83","author":"Park","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"103204","DOI":"10.1016\/j.nicl.2022.103204","article-title":"White matter hyperintensity distribution differences in aging and neurodegenerative disease cohorts","volume":"36","author":"Dadar","year":"2022","journal-title":"Neuroimage Clin"},{"key":"B27","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1136\/jnnp.67.1.66","article-title":"White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer\u2019s disease, vascular dementia, and normal aging","volume":"67","author":"Barber","year":"1999","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e02112","DOI":"10.1002\/brb3.2112","article-title":"Structural connectivity networks in Alzheimer\u2019s disease and Lewy body disease","volume":"11","author":"Baik","year":"2021","journal-title":"Brain Behav"},{"journal-title":"Independent and Interaction Effects of Alzheimer's Disease and Lewy Body Disease on the Brain Networks: A Diffusion Tensor Imaging Study","year":"2023","author":"Kyung-won","key":"B29"},{"key":"B30","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jns.2010.09.031","article-title":"Prevalence of small cerebral bleeds in patients with a neurodegenerative dementia: a neuropathological study","volume":"300","author":"De Reuck","year":"2011","journal-title":"J Neurol Sci"},{"key":"B31","first-page":"1","article-title":"The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","volume":"2","author":"Peterson","year":"2011","journal-title":"Ottawa: Ottawa Hospital Research Institute"},{"key":"B32","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1038\/nrneurol.2015.10","article-title":"White matter hyperintensities, cognitive impairment and dementia: an update","volume":"11","author":"Prins","year":"2015","journal-title":"Nat Rev Neurol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1917","DOI":"10.1002\/acn3.51429","article-title":"The influence of white matter hyperintensity on cognitive impairment in Parkinson\u2019s disease","volume":"8","author":"Liu","year":"2021","journal-title":"Ann Clin Transl Neurol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"S89","DOI":"10.1002\/alz.13402","article-title":"White matter hyperintensities are higher among early-onset Alzheimer\u2019s disease participants than their cognitively normal and early-onset nonAD peers: longitudinal early-onset Alzheimer\u2019s disease study (LEADS)","volume":"19","author":"Eloyan","year":"2023","journal-title":"Alzheimers Dement"},{"key":"B35","doi-asserted-by":"publisher","first-page":"515","DOI":"10.3233\/JAD-170573","article-title":"White matter hyperintensities and cognition in mild cognitive impairment and Alzheimer\u2019s disease: a domain-specific meta-analysis","volume":"63","author":"van den Berg","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"B36","first-page":"c3666","article-title":"The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis","volume":"341","author":"Debette","year":"2010","journal-title":"MJ"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1001\/archneur.61.10.1531","article-title":"Cerebral white matter lesions and the risk of dementia","volume":"61","author":"Prins","year":"2004","journal-title":"Arch Neurol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"S393","DOI":"10.3233\/JAD-141473","article-title":"White matter hyperintensities as early and independent predictors of Alzheimer\u2019s disease risk","volume":"42","author":"Mortamais","year":"2014","journal-title":"J Alzheimers Dis"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e56972","DOI":"10.1371\/journal.pone.0056972","article-title":"Spatial distribution of cerebral white matter lesions predicts progression to mild cognitive impairment and dementia","volume":"8","author":"Mortamais","year":"2013","journal-title":"PLoS One"},{"key":"B40","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/ggi.12661","article-title":"White matter integrity and cognitive dysfunction: radiological and neuropsychological correlations","volume":"15","author":"Tomimoto","year":"2015","journal-title":"Geriatr Gerontol Int"},{"key":"B41","doi-asserted-by":"publisher","first-page":"686","DOI":"10.3109\/09540261.2013.838151","article-title":"Cerebral white matter hyperintensities in the prediction of cognitive decline and incident dementia","volume":"25","author":"Mortamais","year":"2013","journal-title":"Int Rev Psychiatry"},{"key":"B42","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1042\/CS20160452","article-title":"Lesion location and cognitive impact of cerebral small vessel disease","volume":"131","author":"Biesbroek","year":"2017","journal-title":"Clin Sci (Lond)"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1161\/01.STR.0000126041.99024.86","article-title":"White matter hyperintensities are associated with impairment of memory, attention, and global cognitive performance in older stroke patients","volume":"35","author":"Burton","year":"2004","journal-title":"Stroke"},{"key":"B44","doi-asserted-by":"crossref","DOI":"10.3233\/JAD-210669","article-title":"Implication of small vessel disease MRI markers in Alzheimer\u2019s and Lewy body disease","author":"Park","year":"2021"}],"container-title":["Frontiers in Radiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2025.1554345\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T15:43:36Z","timestamp":1743781416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2025.1554345\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":44,"alternative-id":["10.3389\/fradi.2025.1554345"],"URL":"https:\/\/doi.org\/10.3389\/fradi.2025.1554345","relation":{},"ISSN":["2673-8740"],"issn-type":[{"type":"electronic","value":"2673-8740"}],"subject":[],"published":{"date-parts":[[2025,4,4]]},"article-number":"1554345"}}