Depletion or preservation of cardiac sympathetic nerve - an autopsy-verified contrast in two cases of Alzheimer's disease with or without Lewy bodies.
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.
Toru
Shuta
S
Department of Neurology, Nakano General Hospital, Tokyo, Japan. toru@nakanogo.or.jp
Uchihara
Toshiki
T
Takahashi
Makoto
M
Ichihara
Kazuaki
K
Endo
Takashi
T
Kurata
Morito
M
Kitagawa
Masanobu
M
Hirokawa
Katsuiku
K
Kobayashi
Takayoshi
T
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
D016900:Neurofilament Proteins; D019275:Radiopharmaceuticals; D016875:tau Proteins; C051774:neurofilament protein H; D019797:3-Iodobenzylguanidine; D014446:Tyrosine 3-Monooxygenase