{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:45:16Z","timestamp":1791049516739,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","issue":"11","funder":[{"name":"Japan Foundation for Neuroscience and Mental Health"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>We previously reported the usefulness of iodine-123 metaiodobenzylguanidine (<jats:sup>123<\/jats:sup>I-MIBG) myocardial scintigraphy for differentiation of dementia with Lewy bodies (DLB) from Alzheimer\u2019s disease (AD) in a cross-sectional multicentre study. The aim of this study was, by using reassessed diagnosis after 3-year follow-up, to evaluate the diagnostic accuracy of <jats:sup>123<\/jats:sup>I-MIBG scintigraphy in differentiation of probable DLB from probable AD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook 3-year follow-up of 133 patients with probable or possible DLB or probable AD who had undergone <jats:sup>123<\/jats:sup>I-MIBG myocardial scintigraphy at baseline. An independent consensus panel made final diagnosis at 3-year follow-up. Based on the final diagnosis, we re-evaluated the diagnostic accuracy of <jats:sup>123<\/jats:sup>I-MIBG scintigraphy performed at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-five patients completed 3-year follow-up assessment. The final diagnoses were probable DLB (n=30), possible DLB (n=3) and probably AD (n=31), and depression (n=1). With a receiver operating characteristic curve analysis of heart-to-mediastinum (H\/M) ratios for differentiating probable DLB from probable AD, the sensitivity\/specificity were 0.77\/0.94 for early images using 2.51 as the threshold of early H\/M ratio, and 0.77\/0.97 for delayed images using 2.20 as the threshold of delayed H\/M ratio. Five of six patients who were diagnosed with possible DLB at baseline and with probable DLB at follow-up had low H\/M ratio at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our follow-up study confirmed high correlation between abnormal cardiac sympathetic activity evaluated with <jats:sup>123<\/jats:sup>I-MIBG myocardial scintigraphy at baseline and the clinical diagnosis of probable DLB at 3-year follow-up. Its diagnostic usefulness in early stage of DLB was suggested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>UMIN00003419.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2017-317398","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T16:34:07Z","timestamp":1527784447000},"page":"1167-1173","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":61,"title":["<sup>123<\/sup>I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up 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