MIBG scintigraphy for differentiating Parkinson's disease with autonomic dysfunction from Parkinsonism-predominant multiple system atrophy.
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.
Chung
Eun Joo
EJ
Department of Neurology, Inje University Pusan Baik Hospital, Pusan, Korea.
Lee
Won Yong
WY
Yoon
Won Tae
WT
Kim
Byeong Joon
BJ
Lee
Gyeong Han
GH
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
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D000241:Adenosine