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Abstract Details

A Pilot Myocardial MIBG Scintigraphy Study in Prodromal and Overt Dementia with Lewy Bodies
Aging, Dementia, and Behavioral Neurology
P11 - Poster Session 11 (11:45 AM-12:45 PM)
13-003

To establish the basis for a myocardial 123I-metaiodobenzylguanidine scintigraphy (MIBG-scintigraphy) study in the US and to assess its potential utility in prodromal dementia with Lewy bodies (DLB) clinical trials.
MIBG-scintigraphy noninvasively assesses postganglionic cardiac sympathetic denervation. Despite the internationally recognized importance of MIBG-scintigraphy in LBD, its use in LBD is not FDA approved and has rarely been used in the US for neurological research. We launched a pilot MIBG scintigraphy study in isolated REM sleep behavior disorder (iRBD) and mild cognitive impairment with Lewy bodies (MCI-LB) individuals, who are regarded as representing evolving LBD.
MIBG-scintigraphy was conducted in individuals with iRBD, MCI-LB, overt DLB, and healthy controls (HC). Heart-to-mediastinum (H/M) ratio of the MIBG uptake on delayed image (3-4 hours after Adreview® injection; late-HMR) was calculated with MIM workflow. Cutoff value of 2.2 was used for determining abnormal late-HMR. All participants were followed clinically and longitudinal scans were performed in selected participants.
MIBG-scintigraphy was conducted in 20 individuals (100% white, 80% male, mean age (yrs (SD) 69.9(7.9)). Eleven had iRBD (82% male, 68.7(7.3) yrs), three had MCI-LB (33% male, 70.0(8.5) yrs), three had DLB (100% male, 79.3(4.6) yrs), and three were HC (100% male, 64.7(2.4) yrs). Late-HMR (SD) and %abnormal late-HMR were 1.20(0.12) (100%) in DLB, 1.63(0.03) (67%) in MCI-LB, 2.45(0.19) (18%) in iRBD, and 2.77(0.14) (0%) in HC. No iRBD or MCI-LB participant developed DLB to date at follow-up visits. Three MCI-LB, three iRBD, and one HC had 2nd MIBG-scintigraphy. One MCI-LB participant became abnormal in the 2nd scan and the other participants had relatively unchanged findings.
Our preliminary data suggest relatively lower abnormal MIBG-scintigraphy rate in iRBD participants which might be contributed to our iRBD cohort in earlier stage without apparent cognitive or motor impairment compared to the previously published reports.
Authors/Disclosures
Toji Miyagawa, MD, PhD (Mayo Clinic)
PRESENTER 		Dr. Miyagawa has nothing to disclose.
Cynthia Vernon (Mayo Clinic) Cynthia Vernon has nothing to disclose.
Scott Przybelski Scott Przybelski has nothing to disclose.
Paul Min (Mayo Clinic) No disclosure on file
Julie A. Fields, PhD (Mayo Clinic) The institution of Dr. Fields has received research support from National Institutes of Health. The institution of Dr. Fields has received research support from Patient-Centered Outcomes Research Institute.
Leah K. Forsberg, PhD (Mayo Clinic) Ms. Forsberg has nothing to disclose.
Erik K. St. Louis, MD (Mayo Clinic) The institution of Dr. St. Louis has received research support from NIH. Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. St. Louis has received publishing royalties from a publication relating to health care.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF. The institution of Dr. Kantarci has received research support from Eisai. The institution of Dr. Kantarci has received research support from BioArctic.
Val J. Lowe, MD (Mayo Clinic) Dr. Lowe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AVID Radiopharmaceutical. Dr. Lowe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Inc. The institution of Dr. Lowe has received research support from AVID Radiopharmaceuticals.
Bradley F. Boeve, MD, FAAN (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.