用于诊断路易体痴呆的诊断标志物：脑脊液和MIBG心肌闪烁显像研究

Diagnostic markers for diagnosing dementia with Lewy bodies: CSF and MIBG cardiac scintigraphy study.

作者信息

Wada-Isoe Kenji, Kitayama Michio, Nakaso Kazuhiro, Nakashima Kenji

机构信息

Department of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan.

出版信息

J Neurol Sci. 2007 Sep 15;260(1-2):33-7. doi: 10.1016/j.jns.2007.03.016. Epub 2007 Apr 24.

DOI:10.1016/j.jns.2007.03.016

PMID:17459416

Abstract

OBJECTIVE

This study examined the diagnostic value of cerebrospinal fluid (CSF) markers and iodine-123 metaiodobenzylguanidine ((123)I-MIBG) cardiac scintigraphy in distinguishing dementia with Lewy bodies (DLB) from Alzheimer's disease (AD).

METHODS

CSF levels of amyloid beta1-42 (Abeta42) and 181-Thr phosphorylated tau (p-tau) were measured using enzyme linked immunosorbent assay (ELISA) kits. (123)I-MIBG cardiac scintigraphy was performed in patients with AD and DLB, and control (CTL) subjects.

RESULTS

Increased CSF levels of p-tau in AD were found compared to DLB patients and CTL subjects (P<0.01), but there was no significant difference in CSF levels of Abeta42 between AD and DLB patients. The early and delayed heart to mediastinum (H/M) ratios of (123)I-MIBG cardiac scintigraphy were significantly decreased in patients with DLB compared to AD patients and CTL subjects (P<0.01). The receiver operating characteristic (ROC) analysis revealed that the diagnostic value of (123)I-MIBG cardiac scintigraphy was superior to that of CSF markers.

CONCLUSIONS

(123)I-MIBG cardiac scintigraphy may be useful for discriminating between DLB and AD.

摘要

目的

本研究探讨脑脊液（CSF）标志物和碘-123间碘苄胍（（123）I-MIBG）心肌显像在区分路易体痴呆（DLB）和阿尔茨海默病（AD）中的诊断价值。

方法

使用酶联免疫吸附测定（ELISA）试剂盒检测脑脊液中β淀粉样蛋白1-42（Aβ42）和181-苏氨酸磷酸化tau蛋白（p-tau）的水平。对AD和DLB患者以及对照（CTL）受试者进行（123）I-MIBG心肌显像。

结果

与DLB患者和CTL受试者相比，AD患者脑脊液中p-tau水平升高（P<0.01），但AD和DLB患者脑脊液中Aβ42水平无显著差异。与AD患者和CTL受试者相比，DLB患者（123）I-MIBG心肌显像的早期和延迟心/纵隔（H/M）比值显著降低（P<0.01）。受试者操作特征（ROC）分析显示，（123）I-MIBG心肌显像的诊断价值优于脑脊液标志物。