Role of myocardial ¹²³I-mIBG innervation imaging in the diagnosis of neurodegenerative diseases

Neurodegenerative diseases occur when neurons in the central and/or peripheral nervous systems lose function over time and ultimately die. They are characterized by common cellular and molecular mechanisms including protein aggregation and inclusion body formation, categorising each type of disease. Therefore, the definitive diagnosis is at post-mortem, based on pathology. However, the development of various molecular imaging techniques has enabled pathological changes to be inferred in vivo. Decreased myocardial ¹²³I-mIBG uptake has been reported in some patients with neurodegenerative diseases. This review is aimed to synthesise the basis, methodology and clinical role of myocardial ¹²³I-mIBG imaging in the diagnosis of certain neurodegenerative diseases, focusing on its utility to differentiate some neurodegenerative Parkinsonisms between them, and to differentiate dementia with Lewy bodies from Alzheimer's disease and other dementias.