Objective: The purpose of the study is to analyze ¹²³I-metaiodobenzhylguanidine (MIBG) uptakes in the submandibular and parotid glands in patient with Lewy body disease (LBD) using semi-automated quantitative method, compared with non-parkinsonism controls (NPC), and to compare the MIBG uptakes between the major salivary glands and the heart.

Background: MIBG cardiac scintigraphy is a clinically useful tool for the diagnosis of LBD. MIBG is a physiological analogue of noradrenaline and is uptaken in the sympathetic nerve terminals. Recent neuroradiological study showed that MIBG uptakes in the major salivary glands may be reduced in Parkinson’s disease. However, the sympathetic innervation in the major salivary glands among LBD remained unclear and scanning methods have not been established yet.

Method: Sixty-one patients with LBD and age-matched 40 patients with NPC were recruited at Department of Neurology, Toho University. MIBG scintigraphy was scanned in 20 minutes for the early phase and in 4 hours for the delayed phase, respectively. Regions of interests were semi-automatically set in the heart and parotid/submandibular glands adjusting the location between chest and head planar images. We also evaluated clinical features like age, duration of illness, cognitive function, olfactory disturbance, autonomic dysfunction and motor disabilities with Hoehn-Yahr stages and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale. We compared MIBG uptakes in the heart and major salivary glands between LBD and NPC. Furthermore, we evaluated relations between clinical features and MIBG uptakes in the heart and major salivary glands.

Results: MIBG uptake in the submandibular glands was significantly reduced (early: p = 0.011, delayed: p = 0.038) in LBD compared with NPC. Additionally, MIBG cardiac uptake was significantly reduced in LBD. (both early and delayed: p < 0.001). However, no statistical difference was found between LBD and NPC for the parotid glands. There were neither correlations between motor disabilities and MIBG uptakes in the heart and major salivary glands, nor correlations in MIBG uptakes between the heart and major salivary glands.

Conclusion: Motor disabilities in LBD might independently progress from sympathetic denervation. Furthermore, sympathetic denervation might progress separately between the heart and major salivary glands.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mibg-uptakes-in-the-major-salivary-glands-among-lewy-body-disease-using-a-semi-automatic-quantitative-method/