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

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 sy...

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Main Authors: Annelies Heylen, Yannick Vermeiren, Sebastiaan Engelborghs, Frank Van Acker, Peter Paul De Deyn, Debby Van Dam
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Clinical Parkinsonism & Related Disorders
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590112525000507
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author Annelies Heylen
Yannick Vermeiren
Sebastiaan Engelborghs
Frank Van Acker
Peter Paul De Deyn
Debby Van Dam
author_facet Annelies Heylen
Yannick Vermeiren
Sebastiaan Engelborghs
Frank Van Acker
Peter Paul De Deyn
Debby Van Dam
author_sort Annelies Heylen
collection DOAJ
description 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.
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spelling doaj-art-e522de991850444fbe474b0b0af69cde2025-08-20T03:09:42ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011210034610.1016/j.prdoa.2025.100346Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic systemAnnelies Heylen0Yannick Vermeiren1Sebastiaan Engelborghs2Frank Van Acker3Peter Paul De Deyn4 Debby Van Dam5Laboratory of Neurochemistry and Behaviour, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, BelgiumDivision 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, BelgiumLaboratory 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, BelgiumDepartment of Nuclear Medicine, Ziekenhuis Aan de Stroom (ZAS) Middelheim, Antwerp, BelgiumLaboratory 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 NetherlandsLaboratory 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.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.http://www.sciencedirect.com/science/article/pii/S2590112525000507DLBUPLCBiogenic aminesSerotoninDopamineNoradrenaline
spellingShingle Annelies Heylen
Yannick Vermeiren
Sebastiaan Engelborghs
Frank Van Acker
Peter Paul De Deyn
Debby Van Dam
Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
Clinical Parkinsonism & Related Disorders
DLB
UPLC
Biogenic amines
Serotonin
Dopamine
Noradrenaline
title Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
title_full Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
title_fullStr Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
title_full_unstemmed Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
title_short Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system
title_sort correlation analyses between mibg myocardial scintigraphy and monoamine levels in dementia with lewy bodies show potential link with the serotonergic system
topic DLB
UPLC
Biogenic amines
Serotonin
Dopamine
Noradrenaline
url http://www.sciencedirect.com/science/article/pii/S2590112525000507
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