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Amnestic mild cognitive impairment with low myocardial metaiodobenzylguanidine uptake

Ryuji Sakakibara1, Takeshi Ogata, Masayuki Haruta

  • 1Neurology, Internal Medicine, Sakura Medical Center, Toho University Sakura, Japan.

American Journal of Neurodegenerative Disease
|February 6, 2013
PubMed
Abstract

Insights

Amnestic mild cognitive impairment (MCI) patients with low MIBG uptake may have early dementia with Lewy bodies (DLB). These patients often show impaired frontal function and may experience visual hallucinations or sleep disorders.

Area of Science:

  • Neurology
  • Nuclear Medicine
  • Geriatrics

Background:

  • Dementia with Lewy bodies (DLB) is characterized by dementia and parkinsonism.
  • Mild cognitive impairment (MCI) can be a prodromal stage for dementia.
  • Myocardial scintigraphy with (123)I-metaiodobenzylguanidine (MIBG) assesses cardiac sympathetic denervation, often impaired in DLB.

Purpose of the Study:

  • To investigate amnestic MCI patients without core DLB clinical features.
  • To determine the prevalence of low MIBG uptake in this MCI cohort.
  • To identify clinical and imaging features associated with low MIBG uptake in MCI.

Main Methods:

  • Retrospective analysis of 254 patients with memory complaints over 3 years.
  • Neurological examination, cognitive tests (MMSE, ADAScog, FAB, WMS-R), and imaging (MRI, SPECT, MIBG scintigraphy).
  • Focus on 44 patients meeting amnestic MCI criteria.

Main Results:

  • 30% (13/44) of amnestic MCI patients exhibited low MIBG uptake.
  • These patients were elderly, with preserved general cognition (MMSE 24.8/30) but impaired frontal function (FAB 12.5/18).
  • Associated symptoms included visual hallucinations, autonomic dysfunction, REM sleep behavior disorder, and occipital hypoperfusion on SPECT.

Conclusions:

  • Low MIBG uptake in amnestic MCI suggests a potential early-stage DLB presentation.
  • Clinical features include impaired frontal executive function (low FAB), visual hallucinations, and sleep disturbances.
  • This highlights the utility of MIBG scintigraphy in identifying MCI patients at risk for DLB.
Keywords:
amnestic mild cognitive impairmentdementia with Lewy bodiesmemory disordermetaiodobenzylguanidine (MIBG) myocardial scintigraphy

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