Although α-synuclein seed amplification assays (α-syn SAA) are promising, its sensitivity may be affected by heterogeneity among patients with Lewy body disease (LBD). We evaluated whether α-syn SAA sensitivity is affected by patient heterogeneity, using ¹²³I-meta-iodobenzylguanidine (MIBG) cardiac scintigraphy in early drug-naïve patients. Thirty-four patients with clinically established or probable Parkinson’s disease (PD) and seven with dementia with Lewy bodies (DLB) or prodromal DLB were included. While 85.2% of patients with abnormal cardiac MIBG were α-syn SAA positive, only 14.3% were positive among those with normal scans. Logistic regression analysis showed that MIBG positivity was the only significant variable associated with α-syn SAA positivity (odds ratio 74.2 [95% confidence interval 6.1–909]). Although α-syn SAA is sensitive for LBD in patients with abnormal MIBG, the sensitivity may be lower in those with normal MIBG. Further studies are necessary to evaluate the association between patient heterogeneity and α-syn SAA sensitivity.

尽管 α-突触核蛋白种子扩增测定 （α-syn SAA） 很有前景，但其敏感性可能受到路易体病 （LBD） 患者异质性的影响。我们在早期未接受过药物治疗的患者中使用 ¹²³I-间碘苄基胍 （MIBG） 心脏闪烁显像评估了 α-syn SAA 敏感性是否受患者异质性的影响。纳入 34 例临床确诊或疑似帕金森病 （PD） 患者和 7 例路易体痴呆 （DLB） 或前驱 DLB 患者。虽然 85.2% 的心脏 MIBG 异常患者为 α-syn SAA 阳性，但在扫描正常的患者中只有 14.3% 为阳性。Logistic 回归分析显示，MIBG 阳性是与 α-syn SAA 阳性相关的唯一显著变量 （比值比 74.2 [95% 置信区间 6.1-909]）。尽管 α-syn SAA 对 MIBG 异常患者的 LBD 敏感，但 MIBG 正常的患者的敏感性可能较低。需要进一步的研究来评估患者异质性与 α-syn SAA 敏感性之间的关联。