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. 2024;100(1):127-137.
doi: 10.3233/JAD-231395.

Diagnostic Sensitivity and Symptomatic Relevance of Dopamine Transporter Imaging and Myocardial Sympathetic Scintigraphy in Patients with Dementia with Lewy Bodies

Zhihui Tang  1 , Shigeki Hirano  1 , Yume Koizumi  1 , Michiko Izumi  1 , Yoshihisa Kitayama  1 , Kosuke Yamagishi  1 , Mitsuyoshi Tamura  1 , Ai Ishikawa  1 , Kouichi Kashiwado  1 , Takashi Iimori  2 , Hiroki Mukai  3 , Hajime Yokota  3 , Takuro Horikoshi  3 , Takashi Uno  3 , Satoshi Kuwabara  1
Affiliations

Diagnostic Sensitivity and Symptomatic Relevance of Dopamine Transporter Imaging and Myocardial Sympathetic Scintigraphy in Patients with Dementia with Lewy Bodies

Zhihui Tang et al. J Alzheimers Dis. 2024.

Abstract

Background: Dementia with Lewy bodies (DLB) presents with various symptoms, posing challenges for early diagnosis challenging. Dopamine transporter (123I-FP-CIT) single-photon emission tomography (SPECT) and 123I-meta-iodobenzylguanidine (123I-MIBG) imaging are crucial diagnostic biomarkers. Hypothesis about body- and brain-first subtypes of DLB indicate that some DLB may show normal 123I-FP-CIT or 123I-MIBG results; but the characteristic expression of these two subtypes remains unclear.

Objective: This study aimed to evaluate the diagnostic sensitivity of 123I-FP-CIT and 123I-MIBG imaging alone, combined in patients with DLB and explore symptoms associated with the abnormal imaging results.

Methods: Demographic data, clinical status, and imaging results were retrospectively collected from patients diagnosed with possible DLB. Both images were quantified using semi-automated software, and the sensitivity of each imaging modality and their combination was calculated. Demographic data, cognition, and motor and non-motor symptoms were compared among the subgroups based on the imaging results. Symptoms related to each imaging abnormality were examined using binomial logistic regression analyses.

Results: Among 114 patients with DLB, 80 underwent 123I-FP-CIT SPECT (sensitivity: 80.3%), 83 underwent 123I-MIBG imaging (68.2%), and 66 both (sensitivity of either abnormal result: 93.9%). Visual hallucinations differed among the four subgroups based on imaging results. Additionally, nocturia and orthostatic hypotension differed between abnormal and normal 123I-MIBG images.

Conclusions: Overall, 123I-FP-CIT SPECT was slightly higher sensitivity than 123I-MIBG imaging, with combined imaging increasing diagnostic sensitivity. Normal results of a single imaging test may not refute DLB. Autonomic symptoms may lead to abnormal 123I-MIBG scintigraphy findings indicating body-first subtype of patients with DLB.

Keywords: 123I-meta-iodobenzylguanidine myocardial scintigraphy; Alzheimer’s disease; SPECT; dementia with Lewy bodies; dopamine transporter imaging; sensitivity.

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Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Imaging assessments and their results: disposition of patients with dementia with Lewy bodies.
See this image and copyright information in PMC

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References

    1. Vann Jones SA, O’Brien JT (2014) The prevalence and incidence of dementia with Lewy bodies: A systematic review of population and clinical studies. Psychol Med 44, 673–683. - PubMed
    1. Pasha T, Zatorska A, Sharipov D, Rogelj B, Hortobágyi T, Hirth F (2021) Karyopherin abnormalities in neurodegenerative proteinopathies. Brain 144, 2915–2932. - PMC - PubMed
    1. Hershey LA, Coleman-Jackson R (2019) Pharmacological management of dementia with Lewy bodies. Drugs Aging 36, 309–319. - PMC - PubMed
    1. McKeith IG, Ferman TJ, Thomas AJ, Blanc F, Boeve BF, Fujishiro H, Kantarci K, Muscio C, O’Brien JT, Postuma RB, Aarsland D, Ballard C, Bonanni L, Donaghy P, Emre M, Galvin JE, Galasko D, Goldman JG, Gomperts SN, Honig LS, Ikeda M, Leverenz JB, Lewis SJG, Marder KS, Masellis M, Salmon DP, Taylor JP, Tsuang DW, Walker Z, Tiraboschi P; prodromal DLB Diagnostic Study Group (2020) Research criteria for the diagnosis of prodromal dementia with Lewy bodies. Neurology 94, 743–755. - PMC - PubMed
    1. Kane JPM, Surendranathan A, Bentley A, Barker SAH, Taylor JP, Thomas AJ, Allan LM, McNally RJ, James PW, McKeith IG, Burn DJ, O’Brien JT (2018) Clinical prevalence of Lewy body dementia. Alzheimers Res Ther 10, 19. - PMC - PubMed

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