Abstract
123I-metaiodobenzylguanidine (MIBG) has a history of over 20 years as a marker of myocardial sympathetic activity and has been used for assessment of various cardiac diseases. Reduced cardiac MIBG uptake in myocardial scintigraphy has been reported in patients with Parkinson’s disease (PD), dementia with Lewy bodies (DLB), pure autonomic failure (PAF), rapid eye movement sleep behavior disorder (RBD), and familial PD linked to SNCA duplication. In 2005, the Dementia with Lewy Bodies Consortium considered 123I-MIBG myocardial scintigraphy a “supportive” diagnostic tool. Recently, reliable and clear evidence for the usefulness of 123I-MIBG scintigraphy in the diagnosis of Lewy body disorders has been accumulated, and it has become increasingly popular, whereas reduction of cardiac MIBG accumulation was reported in some cases of atypical parkinsonian syndromes such as progressive supranuclear palsy and multiple system atrophy. In 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropan (FP-CIT) SPECT-supplemented MIBG scintigraphy of PD and DLB, FP-CIT binding in basal ganglia is closely related to cardiac MIBG uptake. Reduced 123I-MIBG cardiac uptake might be a “suggestive” feature for Lewy body diseases.
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Abbreviations
- 123I-IMP:
-
N-isopropyl-p-[123I]-iodoamphetamine
- AD:
-
Alzheimer’s-type dementia
- CBD:
-
Corticobasal degeneration
- DLB:
-
Dementia with Lewy bodies
- DOPS:
-
Dihydroxyphenylserine
- ECD:
- FDG:
-
Fluorodeoxyglucose
- FP-CIT:
-
N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropan
- HMPAO:
-
Hexamethyl-propylene-amine-oxine
- LBD:
-
Lewy body disease
- MAO:
-
Monoamine oxidase
- MIBG:
-
Metaiodobenzylguanidine
- PAF:
-
Pure autonomic failure
- PD:
-
Parkinson’s disease
- PSP:
-
Progressive supranuclear palsy
References
Braune S (2001) The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of Parkinsonian syndromes. Clin Auton Res 11:351–355
Braune S, Reinhardt M, Bathmann J et al (1998) Impaired cardiac uptake of meta-[123I]iodobenzylguanidine in Parkinson’s disease with autonomic failure. Acta Neurol Scand 97:307–314
Braune S, Reinhardt M, Schnitzer R et al (1999) Cardiac uptake of [123I]MIBG separates Parkinson’s disease from multiple system atrophy. Neurology 53:1020–1025
Druschky A, Hilz MJ, Platsch G et al (2000) Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of I-123-MIBG- SPECT. J Neurol Sci 175:3–12
Glowniak JV, Turner FE, Gray LL et al (1989) Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants. J Nucl Med 30:1182–1191
Goldstein DS, Holmes C, Li ST, Bruce S et al (2000) Cardiac sympathetic denervation in Parkinson disease. Ann Intern Med 133:338–347
Hakusui S, Yasuda T, Yanagi T et al (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
Hanyu H, Shimizu S, Hirao K et al (2006) Comparative value of brain perfusion SPECT and [123I]MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer’s disease. Eur J Nucl Med Mol Imaging 33:248–253
Hirayama M, Hakusui S, Koike Y et al (1995) A scintigraphical qualitative analysis of peripheral vascular sympathetic function with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure. J Auton Nerv Syst 53:230–234
Iwanaga K, Wakabayashi K, Yoshimoto M et al (1999) Lewy body type degeneration in cardiac plexus in Parkinson’s and incidental Lewy body diseases. Neurology 52:1269–1271
Iwasa K, Nakajima K, Yoshikawa H (1998) Decreased myocardial 123I-MIBG uptake in Parkinson’s disease. Acta Neurol Scand 97:303–306
Kajimoto Y, Miwa H, Okawa-Izawa M et al (2009) Transcranial sonography of the substantia nigra and MIBG myocardial scintigraphy: complementary role in the diagnosis of Parkinson’s disease. Parkinsonism Relat Disord 15:270–272
Kashihara K, Ohno M, Kawada S et al (2006) 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 47:1099–1101
Kollensperger M, Seppi K, Liener C et al (2007) Diffusion weighted imaging best discriminates PD from MSA-P: a comparison with tilt table testing and heart MIBG scintigraphy. Mov Disord 22:1771–1776
Lee PH, Yeo SH, Yong SW et al (2007) Odour identification test and its relation to cardiac 123I-metaiodobenzylguanidine in patients with drug induced Parkinsonism. J Neurol Neurosurg Psychiatry 78:1250–1252
Lobotesis K, Fenwick JD, Phipps A et al (2001) Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD. Neurology 56:643–649
McKeith IG, Dickson DW, Lowe J et al (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium. Neurology 65:1863–1872
McKeith I, O’Brien J, Walker Z et al (2007) Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 6:305–313
Merlet P, Valette H, Dubois-Rande JL et al (1992) Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure. J Nucl Med 33:471–477
Mitsui J, Saito Y, Momose T et al (2006) Pathology of the sympathetic nervous system corresponding to the decreased cardiac uptake in 123I-metaiodobenzylguanidine (MIBG) scintigraphy in a patient with Parkinson’s disease. J Neurol Sci 243:101–104
Miyamoto T, Miyamoto M, Inoue Y et al (2006) Reduced cardiac 123I-MIBG scintigraphy in idiopathic REM sleep behavior disorder. Neurology 67:2236–2238
Mori H, Oda M, Komori T et al (2002) Lewy bodies in progressive supranuclear palsy. Acta Neuropathol 104:273–278
Mori K, Iwasaki Y, Ito M et al (2012) Decreased myocardial uptake of meta-iodobenzylguanidine in an autopsy-confirmed case of corticobasal degeneration with Lewy bodies restricted to the sympathetic ganglia. Clin Neurol 52:405–410
Movellino F, Bagnato A, Salsone M et al (2010) Myocardial 123I-MIBG scintigraphy for differentiation of Lewy bodies disease from FTD. Neurobiol Aging 31:1903–1933
Nagayama H, Hirayama M et al (2005) Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson’s disease. J Neurol Neurosurg Psychiatry 76:249–251
Nakajima K, Bunko H, Taki J et al (1990) Quantitative analysis of 123I-meta-iodobenzylguanidine (MIBG) uptake in hypertrophic cardiomyopathy. Am Heart J 119:1329–1337
Nakajima K, Yoshita M, Matsuo S et al (2008) Iodine-123-MIBG sympathetic imaging in Lewy-body diseases and related movement disorders. Q J Nucl Mol Imaging 52:378–387
Nakajima K, Okuda K, Matsuo S et al (2012) Standardization of metaiodobenzylguanidine heart to mediastinum ratio using a calibration phantom: effects of correction on normal databases and a multicentre study. Eur J Nucl Med Mol Imaging 39:113–119
Oka H, Toyoda C, Yogo M et al (2011) Reduced cardiac 123I-MIBG uptake reflects sympathetic dysfunction in de novo Parkinson’s disease. J Neural Transm 118:1323–1327
Orimo S, Ozawa E, Nakade S et al (1999) 123I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 67:189–194
Orimo S, Ozawa E, Nakade S et al (2003) [123I] meta-iodobenzylguanidine myocardial scintigraphy differentiates corticobasal degeneration from Parkinson’s disease. Intern Med 42:127–128
Orimo S, Amino T, Yokouchi M et al (2005) Preserved cardiac sympathetic nerve accounts for normal cardiac uptake of MIBG in PARK2. Mov Disord 20:1350–1353
Orimo S, Kanazawa T, Nakamura A et al (2007) Degeneration of cardiac sympathetic nerve can occur in multiple system atrophy. Acta Neuropathol 113:81–86
Orimo S, Suzuki M, Inaba A et al (2012) 123I-MIBG myocardial scintigraphy for differentiating Parkinson’s disease from other neurodegenerative Parkinsonism: a systematic review and meta-analysis. Parkinsonism Relat Disord 18:494–500
Quattrone A, Bangnato A, Annesi G et al (2008) Myocardial 123I-metaiodobenzylguanidine uptake in genetic Parkinson’s disease. Mov Disord 23:21–27
Rascol O, Schelosky L (2009) 123I-metaiodobezylguanidine scintigraphy in Parkinson’s disease and related disorders. Mov Disord 24(Suppl 2):S732–S741
Reinhardt MJ, Jungling FD, Krause TM et al (2000) Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake. Eur J Nucl Med 27:595–600
Saiki S, Hirose G, Sakai K et al (2004) Cardiac 123I-MIBG scintigraphy can assess the disease severity and phenotype of PD. J Neurol Sci 220:105–111
Solanki KK, Bomanji J, Moyes J et al (1992) A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun 13:513–521
Spiegel J, Hellwig D, Farmakis G et al (2007) Myocardial sympathetic degeneration correlates with clinical phenotype of Parkinson’s disease. Mov Disord 22:1004–1008
Suchowersky O, Reich S, Perlmutter J et al (2006) Practice parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 66:968–975
Südmeyer M, Antke C, Zizek T et al (2011) Diagnostic accuracy of combined FP-CIT, IBZM, and MIBG scintigraphy in the differential diagnosis of degenerative Parkinsonism: a multidimensional statistical approach. J Nucl Med 52:733–740
Takatsu H, Nagashima K, Murase M et al (2000a) Differentiating Parkinson disease from multiple-system atrophy by measuring cardiac iodine-123 metaiodobenzylguanidine accumulation. JAMA 284:44–45
Takatsu H, Nishida H, Matsuo H et al (2000b) Cardiac sympathetic denervation from the early stage of Parkinson’s disease: clinical and experimental studies with radio-labeled MIBG. J Nucl Med 41:71–77
Taki J, Nakajima K, Hwang EH et al (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
Taki J, Yoshita M, Yamada M et al (2004) Significance of 123IMIBG 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
Tijero B, Gomez-Esteban JC, Llorens V et al (2010) Cardiac sympathetic denervation precedes nigrostrial loss in the E46K mutation of the alpha-synuclein gene (SNCA). Clin Auton Res 20:267–269
Treglia G, Gason E (2012) Diagnostic performance of myocardial innervation imaging using MIBG scintigraphy in differential diagnosis between dementia with Lewy bodies and other dementias: a systematic review and a meta-analysis. J Neuroimaging 22:111–117
Treglia G, Stefanelli A, Gason E et al (2011) Diagnostic performance of iodine-123-metaiodobenzylguanidine scintigraphy in differential diagnosis between Parkinson’s disease and multiple-system atrophy: a systematic review and a meta-analysis. Clin Neurol Neurosurg 113:823–829
Treglia G, Cason E, Stefanelli A et al (2012) MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis. Clin Auton Res 22:43–55
Valldeoriola F, Gaig C, Muxi A et al (2011) 123I-MIBG cardiac uptake and smell identification in Parkinsonian patients with LRRK2 mutations. J Neurol 258:1126–1132
Wakabayashi K, Takahashi H (1997) Neuropathology of autonomic nervous system in Parkinson’s disease. Eur Neurol 38(Suppl 2):2–7
Watanabe H, Ieda T, Katayama T et al (2001) Cardiac 123I-meta-iodobenzylguanidine (MIBG) uptake in dementia with Lewy bodies: comparison with Alzheimer’s disease. J Neurol Neurosurg Psychiatr 70:781–783
Yoshida M, Fukumoto Y, Kuroda Y et al (1997) Sympathetic denervation of myocardium demonstrated by 123I-MIBG scintigraphy in pure autonomic failure. Eur Neurol 38:291–296
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
Yoshita M (2000) Cardiac uptake of [123I]MIBG separates PD from multiple system atrophy. Neurology 54:1877–1878
Yoshita M, Yamada M (2003) Occipital cerebral hypoperfusion and cardiac sympathetic dysfunction in dementia with Lewy bodies and MIBG scintigraphy in patients with dementia of the Alzheimer’s type. Neurology 60(Suppl 1):A208
Yoshita M, Matsubara S, Tada A (1996) Decreased accumulation of 123I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. Neurol Med 45:221–225
Yoshita M, Hayashi M, Hirai S (1998) Decreased myocardial accumulation of 123I-meta-iodobenzyl guanidine in Parkinson’s disease. Nucl Med Commun 19:137–142
Yoshita M, Taki J, Yamada M. (2001) 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 71:583–588
Yoshita M, Taki J, Yokoyama K et al (2006) Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD. Neurology 66:1850–1854
Yoshita M, Noto D, Takahashi K et al (2008) 123I-MIBG scintigraphy in PSP, CBD and IPD. Clin Auton Res 18:281
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Yoshita, M. (2014). Value of MIBG in the Differential Diagnosis of Neurodegenerative Disorders. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., Leenders, K. (eds) PET and SPECT in Neurology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54307-4_19
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