Value of 123 I-MIBG radioactivity in the differential diagnosis of DLB from AD
- 27 June 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 66 (12), 1850-1854
- https://doi.org/10.1212/01.wnl.0000219640.59984.a7
Abstract
Objective: To evaluate the diagnostic reliability of cardiac iodine-123 metaiodobenzylguanidine (123I-MIBG) radioactivity in discriminating dementia with Lewy bodies (DLB) from Alzheimer disease (AD) regardless of parkinsonism. Background: The diagnosis of DLB may be confounded by the absence of parkinsonism. This highlights the need to improve the accuracy of antemortem diagnosis of DLB without parkinsonism. Methods: Cardiac sympathetic denervation was examined using myocardial 123I-MIBG scintigraphy in 37 patients with DLB, 42 patients with AD, and 10 normal elderly controls. The DLB patients consisted of seven patients without parkinsonism (DLB/P−) and 30 patients with parkinsonism (DLB/P+) at the time of the study. Results: The heart-to-mediastinum uptake ratio (H/M ratio) of myocardial MIBG uptake was decreased in both the DLB groups vs the AD group (p < 0.0001) and control group (p < 0.0001). The washout rate (WR) was higher in the DLB group than in the control group (p < 0.0001) and AD group (p < 0.0001). No differences were found between the AD and control groups or between the DLB/P+ and DLB/P− groups in either the early or delayed H/M ratio or WR. In discriminating between DLB and AD, regardless of parkinsonism, the delayed H/M ratio had a sensitivity of 100%, a specificity of 100%, and a positive predictive value of 100% at a cutoff value of 1.68. Conclusions: Our results indicate that dementia with Lewy bodies results in cardiac sympathetic denervation and that iodine-123 metaiodobenzylguanidine myocardial scintigraphy is a sensitive tool for discriminating dementia with Lewy bodies from Alzheimer disease even in patients without parkinsonism.Keywords
This publication has 25 references indexed in Scilit:
- A clinical role for [123I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer's-type and dementia with Lewy bodiesJournal of Neurology, Neurosurgery & Psychiatry, 2001
- Cardiac 123I-meta-iodobenzylguanidine (MIBG) uptake in dementia with Lewy bodies: comparison with Alzheimer's diseaseJournal of Neurology, Neurosurgery & Psychiatry, 2001
- A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failureJournal of the Autonomic Nervous System, 1994
- Decreased 123I-MIBG uptake and increased clearance in various cardiac diseasesNuclear Medicine Communications, 1994
- Neuroleptic sensitivity in patients with senile dementia of Lewy body type.BMJ, 1992
- A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG)Nuclear Medicine Communications, 1992
- Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy.Circulation, 1988
- Clinical diagnosis of Alzheimer's diseaseNeurology, 1984
- A New Clinical Scale for the Staging of DementiaThe British Journal of Psychiatry, 1982
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975