Objective: To examine the relation among degeneration of the cardiac sympathetic nerve (CSN), clinical features and neuropathological findings in dementia with Lewy bodies (DLB).

Background: Reduced cardiac meta-iodobenzylguanidine (MIBG) uptake and loss of cardiac sympathetic axons, as its anatomical substrate, were both recognized in DLB, and reduced cardiac MIBG uptake is a useful diagnostic biomarker to DLB from other dementia. However, cardiac MIBG uptake is occasionally preserved in patients with DLB.

Methods: We collected cardiac tissue samples from 58 autopsy-confirmed DLB patients (limbic and neocortical type). Samples of the left ventricular anterior wall were immunostained with anti-tyrosine hydroxylase antibody as cathecholaminergic nerve axons. We quantified immunolabeled areas and examined the relationship among degeneration of the CSN, clinical features and neuropathological findings.

Results: Almost all the subjects showed degeneration of the CSN. However, 4 subjects showed relatively preserved CSN. Their clinical diagnoses were Alzheimer disease (AD)(n=2), Parkinson’s disease with dementia (n=1) and DLB (n=1). The characteristics of 3 out of 4 subjects, whose CSN were relatively preserved, are psychological symptoms as presenting symptoms, limbic type Lewy body pathology, strong concomitant AD pathology, and short duration of the illness. However, one subject showed neocortical type Lewy body pathology and weak concomitant AD pathology.

Conclusions: These findings suggest presenting symptom, disease duration, Lewy body pathology and AD pathology are related to degeneration of the CSN in DLB. However, other factors may make an influence on degeneration of the CSN in DLB.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-affecting-the-cardiac-sympathetic-denervation-in-autopsy-confirmed-dementia-with-lewy-bodies/