Usefulness of MIBG scintigraphy in idiopathic REM sleep behavior disorder: a systematic review
Giorgio Treglia1, Fabrizio Cocciolillo1, Antonella Stefanelli1, Ernesto Cason2, Alessandro Giordano1
1Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy; 2Unit of Nuclear Medicine, Maggiore Hospital, Bologna, Italy
Background and purpose: It has been widely demonstrated that Parkinson's disease (PD) and dementia with Lewy bodies (DLB) share one clinicopathological entity; Lewy body disease (LBD) has thus become a general term for these diseases. LBD presents an impairment of adrenergic function and consequently an abnormal myocardial metaiodobenzylguanidine (MIBG) innervation imaging. Like PD and DLB, other Lewy body disorders, including pure autonomic failure and idiopathic rapid eye movement sleep behavior disorder (RBD), have been reported to develop cardiac sympathetic denervation. This study is designed to systematically review whether iodine-123-MIBG scintigraphy in patients with RBD demonstrates reduced myocardial uptake thereby suggesting cardiac sympathetic denervation, a typical finding of LBD, in these patients.
Methods: A comprehensive computer literature search of studies published through December 2010 regarding MIBG scintigraphy in patients with RBD was performed in PubMed/Medline and EMBASE databases. Only studies in which MIBG scintigraphy was performed in more than two patients with RBD were selected.
Results: Ultimately, six studies comprising a total of 139 patients with RBD were identified and discussed.
Conclusions: RBD usually show a markedly reduced cardiac MIBG uptake, consistent with a sympathetic denervation, a typical finding of a LBD.
Keywords: metaiodobenzylguanidine, REM sleep behavior disorder, Lewy body disease
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