DAT imaging and myocardial MIBG scintigraphy for Lewy body diseases: A clinical‐neuroimaging study

Abstract

AbstractObjectivesNeuroimaging markers for Lewy body diseases (LBDs) include dopamine transporter (DAT) scanning and metaiodobenzylguanidine (MIBG) myocardial scintigraphy. It is unknown which marker is more useful for identifying the three major LBD subtypes: Parkinson's disease (PD), dementia with Lewy bodies (DLB), and the autonomic‐sleep variant. To answer this question, we analyzed clinical‐neuroimaging data of 450 LBD patients.MethodsThis study was a prospective cohort study with a recruiting period of 3.0 years, prospective follow‐up period of 2.0 ± 1.8 years, and visits at least once a year. We recruited 745 referred subjects who had undergone both DAT and MIBG tests, and the inclusion criteria accorded with published criteria of PD, DLB, and the autonomic/sleep variant (at least one of PD/DLB's known early features: orthostatic hypotension, constipation, overactive bladder, and REM sleep behavior disorder [RBD]).ResultsA total of 450 patients fulfilled the criteria. Among the LBD subtypes, the most common was PD (49.3%), followed by DLB (46.4%) and the autonomic/sleep variant (4.2%). DAT and MIBG tests were almost equally abnormal in PD (98.2%, 79.3%, respectively); however, between the two measures, DAT was more frequently abnormal in DLB (82.3%, 56.9%, respectively) and MIBG in the autonomic/sleep variant (57.9%, 94.7%, respectively). Still, these differences did not reach statistical significance.ConclusionBetween the two neuroimaging tests, the DAT scan tended to parallel brain disease (PD/DLB), while the MIBG test tended to parallel peripheral disease (autonomic/sleep variant).