Iodine-123-MIBG sympathetic imaging in Lewy-body diseases and related movement disorders.

Iodine-123-labeled metaiodobenzylguanidine (MIBG) has a history of over 20 years as a marker of myocardial sympathetic activity in Japan and has been used for various cardiac diseases. Aside from conventional utilities in patients with cardiac diseases, including ischemic heart diseases, cardiomyopathy, heart failure and diabetes, neurological disorders have recently been drawing special attention. The [(123)I]MIBG study showed markedly decreased myocardial uptake in Parkinson's disease, dementia with Lewy bodies and pure autonomic failure, which is a common feature of Lewy-body diseases. The MIBG study can be used for differentiating patients with extrapyramidal signs and dementia. The unique application of MIBG in movement disorders and related neurological diseases is one of its most common uses in Japan, and further studies are expected worldwide.