123 I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study.

Autor:	Komatsu J; Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan., Samuraki M; Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan., Nakajima K; Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan., Arai H; Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan., Arai H; Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan., Arai T; Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan., Asada T; Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan., Fujishiro H; PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan., Hanyu H; Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan., Iizuka O; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan., Iseki E; PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan., Kashihara K; Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan., Kosaka K; Department of Neurology, Medical Care Court Clinic, Yokohama, Japan., Maruno H; Department of Radiology, Toranomon Hospital, Tokyo, Japan., Mizukami K; Faculty of Health and Sport Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan., Mizuno Y; Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan., Mori E; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan., Nakamura H; Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan., Nakano S; Center for Treatment, Care and Research of Dementia, Medical Co. LTA, Tokyo, Japan., Nakashima K; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan., Nishio Y; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan., Orimo S; Department of Neurology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan., Takahashi A; Tokai Central Hospital, Kakamigahara, Japan., Taki J; Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan., Tokuda T; Department of Molecular Pathobiology of Brain Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan., Urakami K; Department of Biological Regulation, Faculty of Medicine, School of Health Science, Tottori University, Tottori, Japan., Utsumi K; Department of Neuropsychiatry, Sunagawa City Medical Center, Sunagawa, Japan., Wada K; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan., Washimi Y; Department for Cognitive Disorders, Hospital of National Center for Geriatrics and Gerontology, Toyota, Japan., Yamashina S; Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Toho University School of Medicine, Tokyo, Japan., Yamasaki J; Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Toho University School of Medicine, Tokyo, Japan., Yoshita M; Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.; Department of Neurology, Hokuriku National Hospital, Toyama, Japan., Yamada M; Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Jazyk:	angličtina
Zdroj:	Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2018 Nov; Vol. 89 (11), pp. 1167-1173. Date of Electronic Publication: 2018 May 31.
DOI:	10.1136/jnnp-2017-317398
Abstrakt:	Background and Purpose: We previously reported the usefulness of iodine-123 metaiodobenzylguanidine ( 123 I-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 123 I-MIBG scintigraphy in differentiation of probable DLB from probable AD. Methods: We undertook 3-year follow-up of 133 patients with probable or possible DLB or probable AD who had undergone 123 I-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 123 I-MIBG scintigraphy performed at baseline. Results: Sixty-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. Conclusions: Our follow-up study confirmed high correlation between abnormal cardiac sympathetic activity evaluated with 123 I-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 Number: UMIN00003419. Competing Interests: Competing interests: HeA, TAr and KW received honoraria for sponsored lectures from Fujifilm RI Pharma. TAs and SY received honoraria for sponsored lectures and research grant from Fujifilm RI Pharma Co and Nihon Medi-Physics. HF, SN, SO, JT and MYo received honoraria for sponsored lectures from Fujifilm RI Pharma and Nihon Medi-Physics. HH and KUt received honoraria for sponsored lectures from Nihon Medi-Physics. EI received honoraria for consultancies, sponsored lectures and presiding at lecture meetings from Nihon Medi-Physics. OI received honoraria for sponsored lectures and travel costs from Nihon Medi-Physics. KKo received honoraria for sponsored lectures, writing and editing from Fujifilm RI Pharma, and honoraria for sponsored lectures from Nihon Medi-Physics. HM received honoraria for sponsored lectures and travel costs from Fujifilm RI Pharma and Nihon Medi-Physics. KNakaj has collaborative research works with Fujifilm RI Pharma and received research funds for joint research and honoraria for lectures and writing. KNakas received sponsored scholarship and honoraria for presiding at meetings from Fujifilm RI Pharma and honoraria for presiding at lecture meetings from Nihon Medi-Physics. EM received research grant from Fujifilm RI Pharma and honoraria for sponsored lectures from Nihon Medi-Physics and Fujifilm RI Pharma. TT received honoraria for sponsored lectures and presiding at lecture meetings from Nihon Medi-Physics. KUr received research grant from Fujifilm RI Pharma and honoraria for sponsored lectures from Nihon Medi-Physics. MYa received honoraria for sponsored lectures and research grant from Fujifilm RI Pharma. JY received sponsored scholarship, honoraria for sponsored lectures and travel costs from Fujifilm RI Pharma, and honoraria for sponsored lectures and research grant from Nihon Medi-Physics. JK, HiA, EI, KKa, KM, YM, HN, YN, MS, AT and YW declare that they have no conflicts of interest. (© 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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