title: MIBG scintigraphy for differentiating Parkinson's disease with autonomic dysfunction from Parkinsonism-predominant multiple system atrophy.
abstract: Parkinson's disease (PD) with autonomic dysfunction is difficult to differentiate from Parkinsonism-predominant multiple system atrophy (MSA-p). This study aimed to analyze the validity of MIBG scintigraphy for PD with autonomic dysfunction and MSA-p. Thirty-nine patients (PD: 27 patients, MSA-p type: 12) and 12 age-matched controls were prospectively enrolled and underwent MIBG scintigraphy and autonomic function test (AFT). We separately calculated early and delayed heart-to-mediastinal (H/M) ratio and washout rates (WRs). AFT was composed of sympathetic skin reflex and parasympathetic tests based on heart rate variability. Abnormal AFT was observed in 17 (63%) of PD and 10 (83%) of MSA-p. On comparing PD with abnormal AFT with MSA-p, either the early or delayed H/M ratio in PD was not different from that in MSA-p (P > 0.05). Only the WR could differentiate PD with abnormal AFT from MSA-p (47.07 +/- 57.48 vs. 31.39 +/- 31.52, respectively) (P = 0.026). According to the results, WR may be more useful than the early and delayed H/M ratio to distinguish MSA-p from PD with abnormal AFT. Furthermore, the MIBG uptake did not reflect the disease duration or severity.
authors.affiliation: Department of Neurology, Inje University Pusan Baik Hospital, Pusan, Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Chung
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: Won Tae
authors.initials: WT
authors.lastname: Yoon
authors.forename: Byeong Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Gyeong Han
authors.initials: GH
authors.lastname: Lee
mesh_terms: D019797:3-Iodobenzylguanidine; D000241:Adenosine; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D005712:Galvanic Skin Response; D006321:Heart / Q000000981:diagnostic imaging; D006339:Heart Rate; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012119:Respiration; D012680:Sensitivity and Specificity; D017779:Sympathetic Fibers, Postganglionic / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon; D014636:Valsalva Maneuver
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D000241:Adenosine