Cardiac MIBG scintigraphy in Primary Progressive Freezing Gait.
Freezing of gait (FOG) generally occurs as a late manifestation of Parkinson's Disease (PD). FOG, however, can present in isolation, constituting the so-called "Primary Progressive Freezing Gait"(PPFG). Myocardial (123)Metaiodiobenzylguanidine (MIBG) enables the assessment of postganglionic sympathetic cardiac nerve terminals. MIBG uptake reflects sympathetic system integrity, and reduced myocardial uptake of the tracer has been observed in nearly all patients with PD. We investigated MIBG uptake in 7 patients with PPFG, 14 patients with mild PD, and 6 patients with advanced PD and FOG (PD-FOG), and 18 control subjects. Our study shows that myocardial MIBG uptake was normal in all patients with PPFG (H/M ratio: mean+/-SD, 1.85+/-0.11 early; 1.71+/-0.15 delayed) and in the controls (H/M ratio: mean+/-SD, 1.94+/-0.18 early; 2.02+/-0.19 delayed) whereas it was markedly decreased in the patients with mild and advanced PD (H/M ratio: mean+/-SD, PD: 1.17+/-0.02 early; 1.16+/-0.02 delayed; PD-FOG: 1.22+/-0.10 early; 1.08+/-0.06 delayed). Our findings demonstrate that cardiac sympathetic denervation did not occur in patients with PPFG, confirming that PPFG and PD are distinct diseases.
Salsone
Maria
M
Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy.
Bagnato
Antonio
A
Novellino
Fabiana
F
Cascini
Giuseppe Lucio
GL
Paglionico
Sandra
S
Cipullo
Stefania
S
Morelli
Maurizio
M
Pugliese
Pierfrancesco
P
Nicoletti
Giuseppe
G
Messina
Demetrio
D
Condino
Francesca
F
Arabia
Gennarina
G
Morgante
Letterio
L
Quattrone
Aldo
A
D019797:3-Iodobenzylguanidine; D017668:Age of Onset; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005684:Gait; D020235:Gait Apraxia / Q000000981:diagnostic imaging* / Q000209:etiology; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007457:Iodine Radioisotopes; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012016:Reference Values; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D007980:Levodopa