[(123)I-MIBG myocardial scintigraphy in the diagnosis of Lewy body dementia].
BACKGROUND
Lewy body dementia (LBD) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). A cardiac post-ganglionic sympathetic denervation has been described in this condition which can be quantified by MIBG (metaiodobenzylguanidine) myocardial scintigraphy. The aim of our work was to retrospectively evaluate cardiac MIBG uptake (expressed as the heart-to-mediastinum ratio at 4h (HMR) in patients with suspected LBD, and to examine its relationship with clinical and para-clinical data.


METHODS
A total of 77 patients with clinical suspicion of LBD evaluated at our centre between September 2005 and June 2008 to whom a MIBG myocardial scintigraphy has been performed were retrospectively reviewed. International Consensus Criteria of LBD were applied to divide the sample into probable LBD, possible LBD and non-LBD. HMR values and their relationships with clinical and neuropsychological data were analysed. A subgroup of patients had FP-CIT (fluoropropyl-carbomethoxy-3β-4-iodophenyltropane) SPECT as a part of the evaluation.


RESULTS
Mean HMR values were significantly lower in probable LBD group than in possible LBD and non-LBD groups. Low HMR values were associated only with reduced FP-CIT uptake in the striatum, but not with any clinical or neuropsychological item.


CONCLUSIONS
Low MIBG myocardial scintigraphy uptake is a robust measure in LBD, and it is not largely affected by medical conditions, or by the stage of the disease. In LBD reduced MIBG myocardial uptake is associated with nigrostriatal degeneration.
Unidad de Memoria, Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. martamarquie@hotmail.com
M
M
Marquié Sayagués
L
L
Da Silva Alves
L
L
Molina-Porcel
D
D
Alcolea Rodríguez
I
I
Sala Matavera
M B
MB
Sánchez-Saudinós
V
V
Camacho Martí
M
M
Estorch Cabrera
R
R
Blesa González
R
R
Blesa González
T
T
Gómez-Isla
T
T
Gómez-Isla
A
A
Lleó Bisa
A
A
Lleó Bisa
D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D020961:Lewy Body Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D019275:Radiopharmaceuticals
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine