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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.09.2008 | Original Article

Cardiac ¹²³I-metaiodobenzylguanidine imaging allows early identification of dementia with Lewy bodies during life

verfasst von: Montserrat Estorch, Valle Camacho, Pilar Paredes, Elisabet Rivera, Ato Rodríguez-Revuelto, Albert Flotats, Jaume Kulisevsky, Ignasi Carrio

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 9/2008

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Abstract

Purpose

Differential diagnosis between dementia with Lewy bodies (DLB) and other neurodegenerative diseases with cognitive impairment represents a clinical challenge. Due to the overlapping of symptoms, the clinical diagnosis can be modified during the prolonged follow-up of these diseases. The purpose of this study was to assess the ability of cardiac metaiodobenzylguanidine (MIBG) imaging for early identification of DLB.

Materials and methods

Since January 2003, all patients with neurodegenerative diseases with cognitive impairment at their first visit at the Memory Unit and clinical criteria of DLB were consecutively recruited and underwent a cardiac ¹²³I-MIBG study. The heart-to-mediastinum ratio (HMR) and the washout rate (WR) of cardiac MIBG uptake were obtained.

Results

Sixty-five patients were included. After a clinical follow-up of 4 years, the progress of the disease procured a definite diagnosis in 44 (68%) patients: 19 DLB, 12 Alzheimer disease (AD), and 13 other neurodegenerative diseases with cognitive impairment. HMR was significantly decreased in DLB with respect to the other neurodegenerative diseases. WR was only significantly different between DLB and AD. The HMR cut off point of 1.36 differentiated DLB from the other dementias with a sensitivity of 94% and a specificity of 96% with an accuracy of 95%.

Conclusions

Cardiac MIBG imaging performed at the time of the first clinical diagnosis of DLB can help early clinical identification or exclusion of this disease.

McKeith IG, Mintzer J, Aarsland D, et al. Dementia with Lewy bodies. Lancet Neurol 2004;3:19–28.PubMedCrossRef

Rahkonen T, Eloniemi-Sulkava U, Rissanen S, Vatanen A, Viramo P, Sulkava R. Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older. J Neurol Neurosurg Psychiatry 2003;74:720–4.PubMedCrossRef

McKeith IG, Galasko D, Kosaka K, et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47:1113–24.PubMed

Luis CA, Barker WW, Gajaraj K, et al. Sensitivity and specificity of three clinical criteria for dementia with Lewy bodies in an autopsy-verified sample. Int J Geriatr Psychiatry 1999;14:526–33.PubMedCrossRef

McKeith IG, Ballard CG, Perry RH, et al. Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology 2000;54:1050–8.PubMed

McKeith IG, Fairbairn A, Perry RH, Thomson P, Perry E. Neuroleptic sensitivity in patients with senile dementia with Lewy body type. BMJ 1992;305:673–8.PubMedCrossRef

McKeith IG, Del Ser T, Spano P, et al. Efficacy of rivastigmin in dementia with Lewy bodies: a randomized, double-blind, placebo-controlled international study. Lancet 2000;356:2031–6.PubMedCrossRef

McKeith IG, Dickson DW, Lowe J, et al. Diagnosis and management of dementia with Lewy bodies. Third report of the DLB consortium. Neurology 2005;65:1863–72.PubMedCrossRef

Bombardieri E, Aktolun C, Baum RP, et al. ¹³¹I/¹²³I-Metaiodobenzylguanidine (MIBG) scintigraphy: procedure guidelines for tumour Imaging. Eur J Nucl Med Mol Imaging 2003;30:BP132–9.PubMed

10.

Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.PubMedCrossRef

11.

Estorch M, Carrio I, Berna L, Lopez-Pousa J, Torres G. Myocardial iodine-labeled metaiodobenzylguanidine 123 uptake relates to age. J Nucl Cardio 1995;2:126–32.

12.

Orimo S, Amino T, Itoh Y, et al. Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease. Acta Neuropathol 2005;109:583–8.PubMedCrossRef

13.

Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H. (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999;67:189–94.PubMed

14.

Braune S, Reinhardt M, Schnitzer R, Riedel A, Lucking CH. Cardiac uptake of [123I]MIBG separates Parkinson’s disease from multiple system atrophy. Neurology 1999;53:1020–5.PubMed

15.

Taki J, Nakajima K, Hwang EH, et al. Peripheral sympathetic dysfunction in patients with Parkinson’s disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med 2000;27:566–73.PubMedCrossRef

16.

Courbon F, Brefel-Courbon C, Thalamas C, et al. Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson’s disease. Mov Disord 2003;18:890–7.PubMedCrossRef

17.

Saiki S, Hirose G, Sakai K, et al. Cardiac 123I-MIBG scintigraphy can assess the disease severity and phenotype of PD. J Neurol Sci 2004;220:105–11.PubMedCrossRef

18.

Taki J, Yoshita M, Yamada M, Tonami N. Significance of 123I-MIBG scintigraphy as a pathophysiological indicator in the assessment of Parkinson’s disease and related disorders: it can be a specific marker for Lewy body disease. Ann Nucl Med 2004;18:453–61.PubMed

19.

Nagayama H, Hamamoto M, Ueda M, Nagashima J, Katayama Y. Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson’s disease. J Neurol Neurosurg Psychiatry 2005;76:249–51.PubMedCrossRef

20.

Oka H, Mochio S, Yoshioka M, Morita M, Onouchi K, Inoue K. Cardiovascular dysautonomia in Parkinson’s disease and multiple system atrophy. Acta Neurol Scand 2006;113:221–7.PubMedCrossRef

21.

Takatsu H, Nishida H, Matsuo H, et al. Cardiac Sympathetic denervation from the early stage of Parkinson’s disease: clinical and experimental studies with radiolabeled MIBG. J Nucl Med 2000;41:71–7.PubMed

22.

Watanabe H, Ieda T, Katayama T, et al. Cardiac (123)I-meta-iodobenzylguanidine (MIBG) uptake in dementia with Lewy bodies: comparison with Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2001;70:781–3.PubMedCrossRef

23.

Yoshita M, Taki J, Yamada M. A clinical role for [(123)I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer’s-type and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 2001;71:583–8.PubMedCrossRef

24.

Oide T, Tokuda T, Momose M, et al. Usefulness of [123I]metaiodobenzylguanidine ([123I]MIBG) myocardial scintigraphy in differentiating between Alzheimer’s disease and dementia with Lewy bodies. Intern Med 2003;42:686–90.PubMedCrossRef

25.

Hanyu H, Shimizu S, Hirao K, et al. Comparative value of brain perfusion SPECT and [(123)I]MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer’s disease. Eur J Nucl Med Mol Imaging 2006;33:248–53.PubMedCrossRef

26.

Yoshita M, Taki J, Yokoyama K, et al. Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD. Neurology 2006;66:1850–4.PubMedCrossRef

27.

Estorch M, Camacho V, Fuertes J, et al. Dementia with Lewy bodies and Alzheimer’s disease: differential diagnosis by cardiac sympathetic innervation MIBG imaging. Rev Esp Med Nucl 2006;25:229–35.PubMedCrossRef

28.

Hanyu H, Shimizu S, Hirao K, et al. The role of 123I-metaiodobenzylguanidine myocardial scintigraphy in the diagnosis of Lewy body disease in patients with dementia in a memory clinic. Dement Geriatr Cogn Disord 2006;22:379–84.PubMedCrossRef

29.

Kashihara K, Ohno M, Kawada S, Okumura Y. Reduced cardiac uptake and enhanced washout of ¹²³I-MIBG in pure autonomic failure occurs conjointly with Parkinson’s disease and dementia with Lewy bodies. J Nucl Med 2006;47:1099–101.PubMed

30.

Hanyu H, Shimizu S, Hirao K, et al. The role of ¹²³I-metaiodobenzylguanidine myocardial scintigraphy in the diagnosis of Lewy body disease in patients with dementia in a memory clinic. Dement Geriatr Cogn Disord 2006;22:379–84.PubMedCrossRef

31.

Lobotesis K, Fenwick JD, Phipps A, et al. Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD. Neurology 2001;56:643–9.PubMed

32.

Pasquier J, Michel B, Brenot-Rossi I, Hasse-Sebbag N, Sauvan R, Gastaut JL. Value of 99mTc-ECD SPET for diagnosis of dementia with Lewy bodies. Eur J Nucl Med 2002;29:1342–8.CrossRef

33.

Shimizu S, Hanyu H, Kanetaka H, Iwamoto T, Koizumi K, Abe K. Differentiation of dementia with Lewy bodies from Alzheimer’s disease using brain SPECT. Dement Geriatr Cogn Disord 2005;20:25–30.PubMedCrossRef

34.

Ishii K, Imamura T, Sasaki M, et al. Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer’s disease. Neurology 1998;51:125–30.PubMed

35.

Koeppe RA, Gilman S, Joshi A, et al. 11C-DTBZ and 18F-FDG PET measures in differentiating dementias. J Nucl Med 2005;46:936–44.PubMed

36.

Kemp PM, Hoffmann SA, Tossici-Bolt L, Fleming JS, Holmes C. Limitations of the HMPAO SPECT appearances of occipital lobe perfusion in the differential diagnosis of dementia with Lewy bodies. Nucl Med Commun 2007;28:451–6.PubMedCrossRef

37.

Walker Z, Costa DC, Walker RWH, et al. Differentiation of dementia with Lewy bodies from Alzheimer’s disease using a dopaminergic presynaptic ligand. J Neurol Neurosurg Psychiatry 2002;73:134–40.PubMedCrossRef

38.

McKeith I, O’Brien J, Walker Z, et al. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007;6:305–13.PubMedCrossRef

39.

Walker Z, Jaros E, Walker RW, et al. Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT SPECT imaging and autopsy. J Neurol Neurosurg Psychiatry 2007;78:1176–81.PubMedCrossRef

40.

Inui Y, Toyama H, Manabe Y, et al. Evaluation of probable or possible dementia with Lewy bodies using ¹²³I-IMP brain perfusion SPECT, ¹²³I-MIBG, and ^99mTc-MIBI myocardial SPECT. J Nucl Med 2007;48:1641–50.PubMedCrossRef

Titel: Cardiac 123I-metaiodobenzylguanidine imaging allows early identification of dementia with Lewy bodies during life
verfasst von: Montserrat Estorch
Valle Camacho
Pilar Paredes
Elisabet Rivera
Ato Rodríguez-Revuelto
Albert Flotats
Jaume Kulisevsky
Ignasi Carrio
Publikationsdatum: 01.09.2008
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 9/2008
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-0828-8

Springer Medizin

Abstract

Purpose

Materials and methods

Results

Conclusions

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