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Differentiation of Dementia with Lewy Bodies, Alzheimer’s Disease and Vascular Dementia by Cardiac 131I-meta-iodobenzylguanidine (MIBG) Uptake (Preliminary Report)


Panitha Jindahra MD*, Athasit Vejjajiva MD, FRCP*,
Rawiphan Witoonpanich MD, FRCP*, Rojana Sirisriro MD**,
Chanika Sritara MD**, Teeratorn Pulkes MD*

* Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
** Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University


Objective : Differentiation of dementia with Lewy bodies (DLB), vascular dementia (VAD), and Alzheimer’s disease (AD) is difficult in clinical practice. Several new techniques have been used for differentiation of various types of dementia. Among these techniques 123I-meta-iodobenzylguanidine (MIBG) uptake was reported to have benefit in distinguishing DLB from AD. The authors study the role of MIBG as a tool for differentiation of DLB, AD and VAD.
Method : Patients with dementia were recruited to the study by DSMIIIR criteria. Diagnosis of each dementia type was made by standard clinical criteria. Brain imagings and 131I-MIBG uptake were performed in all the studied patients.
Results : Five DLB, 3 AD and 3 VAD patients were clinically diagnosed. The heart/mediastinum (H/M) ratio in 4 out of 5 in DLB was significantly lower than H/M ratio in patients with AD and VAD. AD patients had the highest uptake of MIBG. MIBG uptake of VAD patients was in the range between AD and DLB but the values were close to the AD group.
Conclusions : 131I -MIBG is helpful in differentiating DLB from AD.

Keyword : Dementia with Lewy bodies, Alzheimer’s disease, Vascular dementia

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