A clinical role for [123I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer's-type and dementia with Lewy bodies

Abstract

Results-In all patients with DLB, the heart to mediastinum (H/M) ratio of MIBG uptake was pathologically impaired in both early and delayed images, independently of the duration of disease and autonomic failure. All patients with DAT had successful MIBG uptake in the heart regardless of duration of disease and autonomic failure. Orthostatic hypotension was seen in four patients with DAT and 13 patients with DLB. Conclusions-[123 I]MIBG myocardial scintigraphy might detect early disturbances of the sympathetic nervous system in DLB and might provide useful diagnostic information to discriminate DLB from DAT. The distinction between DLB and DAT may be improved by greater emphasis on cardiac sympathetic disturbances. (J Neurol Neurosurg Psychiatry 2001;71:583-588)

The period of hypotension following orthostatic challenge is prolonged in dementia with Lewy bodies

“…(Watanabe et al, 2001;Yoshita et al, 2001) The results further underscore the postganglionic pattern of involvement of the autonomic nervous system in DLB.…”

P2‐198: The Diagnostic Value of Mibg Cardiac Scintigraphy for Differential Dementia Diagnosis

“…Previous research has shown promising results for the use of MIBG cardiac scintigraphy as a diagnostic tool to distinguish DLB from AD (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003, Hanyu et al, 2006, Wada-Isoe et al, 2007 with sensitivity and specificity values of 100% (Yoshita et al, 2006). However, most studies included limited study populations, and studies in Caucasian populations are sparse.…”

“…The decreased cardiac uptake of MIBG in DLB reflects the postganglionic cardiac sympathetic denervation (Orimo et al, 2005). Promising results have been published, but these studies have been conducted under very strict exclusion criteria (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003, Hanyu et al, 2006, Wada-Isoe et al, 2007. Indeed, patients with ischemic heart disease, heart failure, thyroid disease, or diabetes mellitus were excluded (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003.…”

“…Promising results have been published, but these studies have been conducted under very strict exclusion criteria (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003, Hanyu et al, 2006, Wada-Isoe et al, 2007. Indeed, patients with ischemic heart disease, heart failure, thyroid disease, or diabetes mellitus were excluded (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003. Moreover, patients with arterial hypertension or hyperlipidemia (Yoshita et al, 2001, Yoshita et al, 2006 and patients on antidepressant medication like trazodone or on antipsychotics like haloperidol were excluded from these studies (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003.…”

“…Indeed, patients with ischemic heart disease, heart failure, thyroid disease, or diabetes mellitus were excluded (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003. Moreover, patients with arterial hypertension or hyperlipidemia (Yoshita et al, 2001, Yoshita et al, 2006 and patients on antidepressant medication like trazodone or on antipsychotics like haloperidol were excluded from these studies (Yoshita et al, 2001, Yoshita et al, 2006, Watanabe et al, 2001, Oide et al, 2003. As most patients with a cognitive deterioration are older people having comorbidities like arterial hypertension, diabetes mellitus, cardiovascular disease, thyroid disease, or hyperlipidemia, these studies do not reflect clinical practice.…”