Decreased cardiac uptake of MIBG is a potential biomarker for the presence of Lewy bodies

Abstract

Decreased cardiac uptake of meta-iodobenzylguanidine (MIBG) has been reported in patients with Parkinson's disease (PD), dementia with Lewy bodies (DLB) and pure autonomic failure (PAF). This imaging approach is a sensitive diagnostic tool that possibly differentiates PD and DLB from other movement disorders and Alzheimer's disease (AD). We recently reported cardiac sympathetic denervation in PD, DLB and PAF, which accounts for the decreased cardiac uptake of MIBG in these disorders. Patients with PD, DLB and PAF have Lewy bodies (LBs) in the nervous system, whereas patients with multiple system atrophy (MSA), progressive supranuclear palsy, corticobasal degeneration, AD and parkin-associated PD have no LBs in the nervous system. Even in patients with MSA, cardiac sympathetic denervation was associated with the presence of LBs. Therefore, cardiac sympathetic denervation is closely related to the presence of LBs in a wide range of neurodegenerative processes. Taken together, we conclude that the decreased cardiac uptake of MIBG is a potential biomarker for the presence of LBs. We infer that MIBG myocardial scintigraphy is a non-invasive tool that allows us to detect LBs during life.