title: Depletion or preservation of cardiac sympathetic nerve - an autopsy-verified contrast in two cases of Alzheimer's disease with or without Lewy bodies.
abstract: We report autopsy findings of 2 patients with the clinical diagnosis of dementia with Lewy bodies (DLB) both with Alzheimer disease (AD) pathology. Lewy bodies and cardiac sympathetic nerve depletion were found in case 1, while these pathological changes were both absent in case 2 with pure AD pathology. This autopsy-verified contrast was detectable through reduced uptake of (123)I-metaiodobenzylguanidine cardiac scintigraphy as in case 1. Conversely, its preserved uptake, indicating preserved cardiac sympathetic nerve, may point to the absence of Lewy bodies, as in case 2, even though other clinical pictures are indistinguishable from DLB. (123)I-metaiodobenzylguanidine cardiac scintigraphy may be useful to distinguish clinically between pure AD and DLB.
authors.affiliation: Department of Neurology, Nakano General Hospital, Tokyo, Japan. toru@nakanogo.or.jp
authors.forename: Shuta
authors.initials: S
authors.lastname: Toru
authors.forename: Toshiki
authors.initials: T
authors.lastname: Uchihara
authors.forename: Makoto
authors.initials: M
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Ichihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Endo
authors.forename: Morito
authors.initials: M
authors.lastname: Kurata
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kitagawa
authors.forename: Katsuiku
authors.initials: K
authors.lastname: Hirokawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D019797:3-Iodobenzylguanidine; D000320:Adrenergic Fibers / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000473:pathology*; D001344:Autopsy / Q000379:methods; D005260:Female; D006624:Hippocampus / Q000378:metabolism / Q000473:pathology; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology*; D020961:Lewy Body Disease / Q000150:complications / Q000473:pathology*; D008297:Male; D009206:Myocardium / Q000473:pathology*; D016900:Neurofilament Proteins / Q000378:metabolism; D019275:Radiopharmaceuticals; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism; D016875:tau Proteins / Q000378:metabolism
chemical_list: D016900:Neurofilament Proteins; D019275:Radiopharmaceuticals; D016875:tau Proteins; C051774:neurofilament protein H; D019797:3-Iodobenzylguanidine; D014446:Tyrosine 3-Monooxygenase