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

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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.

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References

  1. Amino T, Orimo S, Ihoh Y, Takahashi A, Uchihara T, Mizusawa H (2005) Profound cardiac sympathetic denervation occurs in Parkinson disease. Brain Pathol 15:29–34

    Article  PubMed  Google Scholar 

  2. Bloch A, Probst A, Bissig H, Adams H, Tolnay M (2006) α-Synuclein pathology of the spinal and peripheral autonomic nervous system in neurologically unimpaired elderly subjects. Neuropathol Appl Neurobiol 32:284–295

    Article  PubMed  CAS  Google Scholar 

  3. Braune S, Reinhardt M, Schnitzer R, Riedel A, Lücking CH (1999) Cardiac uptake of [123I]MIBG separates Parkinson's disease from multiple system atrophy. Neurology 53:1020–1025

    PubMed  CAS  Google Scholar 

  4. Druschky A, Hilz MJ, Platsch G, Radespiel-Tröger M, Druschky K, Kuwert T, Neundörfer B (2000) Differentiation of Parkinson's disease and multiple system atrophy in early disease by means of I-123-MIBG-SPECTJ Neurol Sci 175:3–12

    Article  CAS  Google Scholar 

  5. Goldstein DS, Holmes C, Cannon RO III, Eisenhofer G, Kopin IJ (1997) Sympathetic cardioneuropathy in dysautonomias. N Engl J Med 336:696–702

    Article  PubMed  CAS  Google Scholar 

  6. Goldstein DS, Holmes C, Li S-T, Bruce S, Metman LV, Cannon RO III (2000) Cardiac sympathetic denervation in Parkinson disease. Ann Intern Med 133:338–347

    PubMed  CAS  Google Scholar 

  7. Hakusui S, Yasuda T, Yanagi T, Tohyama J, Hasegawa Y, Koike Y, Hirayama M, Takahashi A (1994) A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure. J Auton Nerv Syst 49:81–84

    Article  PubMed  CAS  Google Scholar 

  8. Hamada K, Hirayama M, Watanabe H, Kobayashi R, Ito H, Ieda T, Koike Y, Sobue G (2003) Onset age and severity of motor impairment are associated with reduction of myocardial 123IMIBG uptake in Parkinson's disease. J Neurol Neurosurg Psychiatry 74:423–426

    Article  PubMed  CAS  Google Scholar 

  9. Iwanaga K, Wakabayashi K, Yoshimoto M, Tomita I, Satoh H, Takashima H, Satoh A, Seto M, Tsujihata M, Takahashi H (1999) Lewy body-type degeneration in cardiac plexus in Parkinson's and incidental Lewy body diseases. Neurology 52:1269–1271

    PubMed  CAS  Google Scholar 

  10. Kawano H, Okada R,Yano K (2003) Histological study on the distribution of autonomic nerves in the human heart. Heart Vessels 18:32–39

    Article  PubMed  Google Scholar 

  11. Merlet P, Valette H, Dubobis-Randé J-L, Moyse D, Duboc D, Dove P, Bourguignon MH, Benvenuti C, Duval AM, Agnosti D, Loisance D, Castaigne A, Syrota A (1992) Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure. J Nucl Med 33:471–477

    PubMed  CAS  Google Scholar 

  12. Nakajima K, Taki J, Tonami N, Hisada K (1994) Decreased 123I-MIBG uptake and increased clearance in various cardiac diseases. Nucl Med Commun 15:317–323

    Article  PubMed  CAS  Google Scholar 

  13. Orimo S (2006) Parkinson's disease. Laboratory findings. SAISHIN IGAKU (in Japanese) Suppl. 72–80

  14. Orimo S (2006) Degeneration of cardiac sympathetic nerve in Parkinson's disease. Clin Neuroscience (in Japanese) 24:502–503

    Google Scholar 

  15. Orimo S, Amino T, Ito Y, Takahashi A, Kojo T, Uchihara T, Tsuchiya K, Mori F, Wakabayashi K, Takahashi H (2005) Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease. Acta Neuropathol (Berl) 109:583–588

    Article  Google Scholar 

  16. Orimo S, Takahashi A, Uchihara T, Mori F, Kakita A, Wakabayashi K, Takahashi H (2007) Degeneration of cardiac sympathetic nerve begins in the early disease process of Parkinson's disease. Brain Pathol 17:24–30

    Article  PubMed  CAS  Google Scholar 

  17. Orimo S, Amino T, Yokochi M, Kojo T, Uchihara T, Takahashi A, Wakabayashi K, Takahashi H, Hattori N, Mizuno Y (2005) Preserved cardiac sympathetic nerve accounts for normal cardiac uptake of MIBG in PARK2. Mov Disord 20:1350–1353

    Article  PubMed  Google Scholar 

  18. Orimo S, Kanazawa T, Amino T, Takahashi A, Kojo T, Uchihara T, Kakita A, Wakabayashi K, Takahashi H (2006) Difference of degenerating process between myelinated and unmyelinated fibers of cardiac nerve in Parkinson's disease. Neuropathology 26:A4

    Google Scholar 

  19. Orimo S, Kanazawa T, Nakamura A, Uchihara T, Mori F, Kakita A, Wakabayashi K, Takahashi H (2007) Degeneration of cardiac sympathetic nerve can occur in multiple system atrophy. Acta Neuropathol (Berl) 113:81–86

    Article  Google Scholar 

  20. Orimo S, Oka T, Miura H, Tsuchiya K, Mori F, Wakabayashi K, Nagao T, Yokochi M (2002) Sympathetic cardiac denervation in Parkinson's disease and pure autonomic failure but not in multiple system atrophy. J Neurol Neurosurg Psychiatry 73:776–777

    Article  PubMed  CAS  Google Scholar 

  21. Orimo S, Ozawa E, Nakade S, Hattori H, Tsuchiya K, Taki K, Takahashi A (2003) [123I]meta-iodobenzylguanidine myocardial scintigraphy differentiates corticobasal degeneration from Parkinson's disease. Intern Med 42:127–128

    PubMed  Google Scholar 

  22. Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H (1999) 123I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson's disease. J Neurol Neurosurg Psychiatry 67:189–194

    PubMed  CAS  Google Scholar 

  23. Orimo S, Ozawa E, Oka T, Nakade S, Tsuchiya K, Yoshimoto M, Wakabayashi K, Takahashi H (2001) Different histopathology accounting for a decrease in myocardial MIBG uptake in PD and MSA. Neurology 57:1140–1141

    PubMed  CAS  Google Scholar 

  24. Owman C (1988) Autonomic innervation of the cardiovascular system. In: Bjorklund A, Hokfelt T, Owman C (eds) Handbook of chemical neuroanatomy. Elsevier, Amsterdam, pp 327–389

  25. Rabinovitch MA, Rose CP, Schwab AJ, Fitchett DH, Honos GN, Stewart JA, Chen LF, Castilla EP, Gomez AA, Abrahamowicz M (1993) A method of dynamic analysis of iodine-123-metaiodobenzylguanidine scintigrams in cardiac mechanical overload hypertrophy and failure. J Nucl Med 34:589–600

    PubMed  CAS  Google Scholar 

  26. Satoh A, Serita T, Seto M, Tomita I, Satoh H, Iwanaga K, Takashima H, Tsujihata M (1999) Loss of 123I-MIBG uptake by the heart in Parkinson's disease: assessment of cardiac sympathetic denervation and diagnostic value. J Nucl Med 40:371–375

    PubMed  CAS  Google Scholar 

  27. Schofer J, Spielmann R, Schuchert A, Weber K, Schlüter M (1988) Iodine-123 meta-iodobenzylguanidine scintigraphy: A noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol 12:1252–1258

    Article  PubMed  CAS  Google Scholar 

  28. Stanton MS, Tuli MM, Radtke NL, Heger JJ, Miles WM, Mock BH, Burt RW, Wellman HN, Zipes DP (1989) Regional sympathetic denervation after myocardial infarction in humans detected noninvasively using I-123 metaiodobenzylguanidine. J Am Coll Cardiol 14:1519–1526

    Article  PubMed  CAS  Google Scholar 

  29. Suzuki M, Hattori N, Orimo S, Fukumitsu N, Abo M, Kono Y, Sengoku R, Kurita A, Honda H, Inoue K (2005) Preserved myocardial 123I-metaiodobenzylguanidine uptake in autosomal recessive juvenile parkinsonism: first case report. Mov Disord 20:634–636

    Article  PubMed  Google Scholar 

  30. Taki J, Nakajima K, Hwang E-H, Matsunari I, Komai K, Yoshita M, Sakajiri K, Tonami N (2000) Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med 27:566–573

    Article  PubMed  CAS  Google Scholar 

  31. Taki J, Yoshita M, Yamada M, Tonami N (2004) 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 18:453–461

    Article  PubMed  Google Scholar 

  32. Wakabayashi K, Takahashi H, Ohama E, Takeda S, Ikuta F (1993) Lewy bodies in the visceral autonomic nervous system in Parkinson's disease. In: Narabayashi H, Nagatsu N, Yanagisawa N, Mizuno Y (eds) Advances in neurology. Lippincott-Raven, New York, pp 609–612

  33. Watanabe H, Ieda T, Katayama T, Takeda A, Aiba I, Doyu M, Hirayama M, Sobue G (2001) Cardiac 123I-metaiodobenzylguanidine (MIBG) uptake in dementia with Lewy bodies: comparison with Alzheimer's disease. J Neurol Neurosurg Psychiatry 70:781–783

    Article  PubMed  CAS  Google Scholar 

  34. Wieland DM, Wu J-I, Brown LE, Mangner TJ, Swanson DP, Beierwaltes WH (1980) Radiolabeled adrenergic neuron-blocking agents: adrenomedullary imaging with [131I]iodobenzylguanidine. J Nucl Med 21:349–353

    PubMed  CAS  Google Scholar 

  35. Yoshida M, Fukumoto Y, Kuroda Y, Ohkoshi N (1997) Sympathetic denervation of myocardium demonstrated by 123I-MIBG scintigraphy in pure progressive autonomic failure. Eur Neurol 38:291–296

    PubMed  CAS  Google Scholar 

  36. Yoshita M (1998) Differentiation of idiopathic Parkinson's disease from striatonigral degeneration and progressive supranuclear palsy using iodine-123 meta-iodobenzylguanidine myocardial scintigraphy. J Neurol Sci 155:60–67

    Article  PubMed  CAS  Google Scholar 

  37. Yoshita M, Taki J, Yamada M (2001) A clinical role for [123I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer' stype and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 71:583–588

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Dept. of Neurology, Kanto Central Hospital, 6-25-1 Kami-Yoga, Setagaya-ku, 158-8531 Tokyo, Japan

    Satoshi Orimo

  2. Dept. of Neurology, Tokyo Medical and Dental University, Tokyo, Japan

    Takeshi Amino

  3. Dept. of Neuropathology, Tokyo Metropolitan Institute for Neuroscience, Tokyo, Japan

    Satoshi Orimo & Toshiki Uchihara

  4. Dept. of Neuropathology, Institute of Brain Science, Hirosaki University School of Medicine, Hirosaki, Japan

    Fumiaki Mori & Koichi Wakabayashi

  5. Dept. of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan

    Akiyoshi Kakita & Hitoshi Takahashi

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  1. Satoshi Orimo
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  2. Takeshi Amino
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  3. Toshiki Uchihara
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  4. Fumiaki Mori
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  7. Hitoshi Takahashi
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Correspondence to Satoshi Orimo.

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Orimo, S., Amino, T., Uchihara, T. et al. Decreased cardiac uptake of MIBG is a potential biomarker for the presence of Lewy bodies. J Neurol 254 (Suppl 4), IV21–IV28 (2007). https://doi.org/10.1007/s00415-007-4005-y

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  • DOI: https://doi.org/10.1007/s00415-007-4005-y

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