Lewy小体病の概念を変えたMIBG心筋シンチグラフィ

抄録

In Lewy body disease including Parkinson's disease and dementia with Lewy bodies (DLB), dopamine neurons in the substantia nigra and various neurons in the brain degenerate, resulting in the appearance of motor and various non–motor symptoms. Lewy bodies are observed in the remaining neurons of the brain, which play an important role in neuronal degeneration. After that, there has been accumulating evidence that Lewy bodies are found in neurons of the peripheral autonomic system, resulting in the appearance of various autonomic symptoms. Cardiac meta–iodobenzylguanidine (MIBG) uptake on ¹²³I–MIBG myocardial scintigraphy is reduced in patients with Lewy body disease, suggesting disturbance of the postganglionic sympathetic nerve in Lewy body disease. Postmortem studies have shown that the number of tyrosine hydroxylase–immunoreactive nerve fibers of the heart was decreased in pathologically–confirmed Lewy body disease, supporting the findings of the reduced cardiac MIBG uptake in Lewy body diseases. These clinical and pathological evidence have confirmed the involvement of the peripheral autonomic nervous system in Lewy body disease. Thus, the concept of “Lewy body disease is a systemic disease” has been established.