• Junji Komatsu, Miharu Samuraki, Kenichi Nakajima, Heii Arai, Hiroyuki Arai, Tetsuaki Arai, Takashi Asada, Hiroshige Fujishiro, Haruo Hanyu, Osamu Iizuka, Eizo Iseki, Kenichi Kashihara, Kenji Kosaka, Hirotaka Maruno, Katsuyoshi Mizukami, Yoshikuni Mizuno, Etsuro Mori, Hiroyuki Nakamura, Seigo Nakano, Kenji Nakashima, Yoshiyuki Nishio, Satoshi Orimo, Akira Takahashi, Junichi Taki, Takahiko Tokuda, Katsuya Urakami, Kumiko Utsumi, Kenji Wada, Yukihiko Washimi, Shouhei Yamashina, Junichi Yamasaki, Mitsuhiro Yoshita, and Masahito Yamada.
• Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
• J. Neurol. Neurosurg. Psychiatr. 2018 Nov 1; 89 (11): 1167-1173.

Background And PurposeWe previously reported the usefulness of iodine-123 metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy for differentiation of dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a cross-sectional multicentre study. The aim of this study was, by using reassessed diagnosis after 3-year follow-up, to evaluate the diagnostic accuracy of 123I-MIBG scintigraphy in differentiation of probable DLB from probable AD.MethodsWe undertook 3-year follow-up of 133 patients with probable or possible DLB or probable AD who had undergone 123I-MIBG myocardial scintigraphy at baseline. An independent consensus panel made final diagnosis at 3-year follow-up. Based on the final diagnosis, we re-evaluated the diagnostic accuracy of 123I-MIBG scintigraphy performed at baseline.ResultsSixty-five patients completed 3-year follow-up assessment. The final diagnoses were probable DLB (n=30), possible DLB (n=3) and probably AD (n=31), and depression (n=1). With a receiver operating characteristic curve analysis of heart-to-mediastinum (H/M) ratios for differentiating probable DLB from probable AD, the sensitivity/specificity were 0.77/0.94 for early images using 2.51 as the threshold of early H/M ratio, and 0.77/0.97 for delayed images using 2.20 as the threshold of delayed H/M ratio. Five of six patients who were diagnosed with possible DLB at baseline and with probable DLB at follow-up had low H/M ratio at baseline.ConclusionsOur follow-up study confirmed high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy at baseline and the clinical diagnosis of probable DLB at 3-year follow-up. Its diagnostic usefulness in early stage of DLB was suggested.Trial Registration NumberUMIN00003419.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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