123I-MIBG Scintigraphy Utility as a biomarker for Prodromal DEmentia with Lewy Bodies (SUPErB)
Alzheimer's Research UK
Alzheimer's disease & other dementias
Early and accurate identification of dementia is a major priority and will require diagnosis during the mild cognitive impairment (MCI) stage preceding dementia, also known as the prodromal phase. Biological markers of disease (biomarkers) will be needed to make these early diagnoses accurately but, unlike Alzheimers disease, we know little about the prodromal stage of dementia with Lewy bodies (DLB). DLB, like Alzheimers disease, has excellent biomarkers but they have not been investigated in the prodromal stage. Our pilot study has however demonstrated the feasibility of identifying people with pDLB. We have found that people with prodromal DLB have abnormal dopaminergic imaging consistent with underlying Lewy body pathology. However, pathological studies have shown that an early change in DLB is outside the brain, involving loss of nerve projections to the heart at very early stages. Myocardial tracer (123I-MIBG) imaging assesses these nerve projections and so there is good reason to believe that it may be a better early biomarker of pDLB than dopaminergic brain imaging. This proposal is for a five year study examining the utility of MIBG imaging as a biomarker predictor of cognitive decline and conversion to dementia in people with MCI due to prodromal DLB.