Hattori Makoto, Hiraga Keita, Satake Yuki, Tsuboi Takashi, Tamakoshi Daigo, Sato Maki, Yokoi Katsunori, Suzuki Keisuke, Arahata Yutaka, Hori Akihiro, Kawashima Motoshi, Shimizu Hideaki, Matsuda Hiroshi, Kato Katsuhiko, Washimi Yukihiko, Katsuno Masahisa
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Neurology and Center for Comprehensive Care and Research Center on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
NPJ Parkinsons Dis. 2023 Apr 26;9(1):67. doi: 10.1038/s41531-023-00507-y.
Individuals with prodromal symptoms of Lewy body disease (LBD), such as rapid eye movement sleep behavior disorder (RBD), often showed imaging defects similar to patients with Parkinson's disease and dementia with Lewy bodies. We examined dopamine transporter (DaT) single-photon-emission computed tomography (SPECT) and metaiodobenzylguanidine (MIBG) scintigraphy in 69 high-risk subjects with ≥2 prodromal symptoms (dysautonomia, hyposmia, and probable RBD) and 32 low-risk subjects without prodromal symptoms, whom were identified through a questionnaire survey of health checkup examinees. The high-risk subjects had significantly worse scores on Stroop test, line orientation test, and the Odor Stick Identification Test for Japanese than the low-risk subjects. The prevalence of abnormalities on DaT-SPECT was higher in the high-risk group than in the low-risk group (24.6% vs. 6.3%, p = 0.030). A decreased uptake on DaT-SPECT was associated with motor impairment, and MIBG scintigraphy defects were associated with hyposmia. The simultaneous evaluation of DaT-SPECT and MIBG scintigraphy may capture a wide range of individuals with prodromal LBD.
路易体病（LBD）前驱症状患者，如快速眼动睡眠行为障碍（RBD），其影像学缺陷常与帕金森病和路易体痴呆患者相似。我们对69名有≥2种前驱症状（自主神经功能障碍、嗅觉减退和可能的RBD）的高危受试者和32名无前驱症状的低危受试者进行了多巴胺转运体（DaT）单光子发射计算机断层扫描（SPECT）和间碘苄胍（MIBG）闪烁扫描，这些受试者是通过对健康体检者的问卷调查确定的。高危受试者在Stroop测试、直线定向测试和日本嗅觉棒识别测试中的得分明显低于低危受试者。高危组DaT-SPECT异常的患病率高于低危组（24.6%对6.3%，p = 0.030）。DaT-SPECT摄取减少与运动障碍有关，MIBG闪烁扫描缺陷与嗅觉减退有关。同时评估DaT-SPECT和MIBG闪烁扫描可能发现广泛的LBD前驱个体。
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