Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system

Annelies Heylen; Yannick Vermeiren; Sebastiaan Engelborghs; Frank Van Acker; Peter Paul De Deyn; Debby Van Dam

doi:10.1016/j.prdoa.2025.100346

Clinical Parkinsonism & Related Disorders (Jan 2025)

Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system

Annelies Heylen,
Yannick Vermeiren,
Sebastiaan Engelborghs,
Frank Van Acker,
Peter Paul De Deyn,
Debby Van Dam

Affiliations

Annelies Heylen: Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
Yannick Vermeiren: Division of Human Nutrition and Health, Chair Group of Nutritional Biology, Wageningen University & Research (WUR), Wageningen, the Netherlands; Faculty of Medicine & Health Sciences, Translational Neurosciences, University of Antwerp, Antwerp, Belgium
Sebastiaan Engelborghs: Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
Frank Van Acker: Department of Nuclear Medicine, Ziekenhuis Aan de Stroom (ZAS) Middelheim, Antwerp, Belgium
Peter Paul De Deyn: Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
Debby Van Dam: Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands; Corresponding author at: Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands, and Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.

DOI: https://doi.org/10.1016/j.prdoa.2025.100346
Journal volume & issue: Vol. 12
p. 100346

Abstract

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Setting: Dementia with Lewy bodies (DLB) remains poorly understood and frequently misdiagnosed, complicated by co-pathology with other dementia forms. DLB patients often present with autonomic dysfunction and peripheral Lewy body pathology alongside central lesions. Monoaminergic neurotransmitter systems seem an early target for DLB pathology, especially the noradrenergic system. Noradrenaline analogue 123I-metaiodobenzylguanidine (MIBG) is considered an indicative biomarker for peripheral noradrenergic sympathetic denervation. Objectives: Our aim was to measure paired monoaminergic levels and MIBG scintigraphy values in DLB patients, exploring a possible link between noradrenergic neurotransmission and peripheral denervation. Design: 44 patients with a possible DLB diagnosis entered the study. Peripheral uptake of 123I-MIBG was determined by the heart-to-mediastinum (H/M) ratio, as a measure for noradrenergic sympathetic denervation. In cerebrospinal fluid (CSF), serum and plasma samples, monoamines ((nor)adrenaline ((N)A), 5-hydroxytryptamin (5-HT, serotonin), dopamine (DA)) and respective metabolites (3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC)), were measured by means of reversed-phase ultrahigh-performance liquid chromatography with electrochemical detection. Results: We found significant correlations between the H/M ratio and serum 5-HIAA, plasma 5-HT, plasma 5-HIAA/5-HT and plasma HVA/5-HIAA, but no further correlations with the noradrenergic system. CSF-serum MHPG, CSF-serum DOPAC, CSF-serum HVA, CSF-plasma MHPG, CSF plasma NA, CSF-plasma DOPAC, CSF-plasma MHPG/NA and CSF-plasma DOPAC/DA were significantly correlated. Conclusions: These results show an association between the H/M ratio and serotonergic system, but not between peripheral noradrenergic denervation and circulating noradrenergic levels.

Published in Clinical Parkinsonism & Related Disorders

ISSN: 2590-1125 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/clinical-parkinsonism-and-related-disorders

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