Meta-iodobenzylguanidine (
MIBG) myocardial scintigraphy can assess postganglionic presynaptic cardiac sympathetic nerve endings. Reduced cardiac
MIBG uptake on
MIBG myocardial scintigraphy has been reported in patients with
Parkinson disease (PD),
dementia with Lewy bodies (DLB),
pure autonomic failure (PAF), and familial PD linked to SNCA duplication. This imaging procedure is a sensitive diagnostic tool that might differentiate PD and DLB from other
movement disorders from
Alzheimer disease (AD). We recently reported cardiac
sympathetic denervation in PD, DLB, PAF, and familial PD linked to SNCA duplication which accounts for the reduced cardiac
MIBG uptake in these disorders. The patients with PD, DLB, PAF and familial PD linked to SNCA duplication have Lewy bodies in the nervous system, whereas patients with
multiple system atrophy (MSA),
progressive supranuclear palsy (PSP),
corticobasal degeneration, AD, and parkin-associated PD do not. However, in patients with MSA or PSP, cardiac
sympathetic denervation was associated with the presence of Lewy bodies in the nervous system. Therefore, cardiac
sympathetic denervation is closely related to the presence of Lewy bodies in the wide range of neurodegenerative processes. Thus, we conclude that reduced cardiac
MIBG uptake is a potential
biomarker for the presence of Lewy bodies in the nervous system. We infer that
MIBG myocardial scintigraphy is a noninvasive tool for detecting Lewy bodies during life.