title: Relationship between (123)I-MIBG scintigrams and REM sleep behavior disorder in Parkinson's disease.
abstract: BACKGROUND
  Uptake of (123)I-labeled meta-iodobenzylguanidine (MIBG) in myocardial scintigrams has been shown to be as low in patients with idiopathic RBD as in Parkinson's disease (PD) patients. AIM FOR STUDY: To clarify whether the existence of RBD accelerates autonomic dysfunction in PD, we investigated the association between MIBG scintigraphic findings and RBD measures among non-dementia PD patients.
  
  
  METHODS
  We conducted clinical interviews to assess REM sleep behavior disorder (RBD) symptoms, and performed polysomnograms (PSG) recordings and MIBG scintigrams on 49 PD patients. The patients were divided into three groups (PD with clinical RBD, PD with subclinical RBD, and PD with normal REM sleep).
  
  
  RESULTS
  PD patients with clinical RBD had reduced MIBG uptake as determined by heart-to-mediastinum ratios of the delayed image compared to those with subclinical RBD and those with normal REM sleep. Multiple linear regression analysis revealed that only the existence of RBD symptoms was significantly associated with reduced MIBG uptake among PD patients without dementia after adjusting for demographic and PD symptom-related variables.
  
  
  CONCLUSIONS
  PD patients with clinical RBD might suffer from a wider α-synuclein pathology, including reduced cardiac sympathetic ganglia function as reflected by a lowered MIBG uptake.
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan. ntnomura@med.tottori-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Uemura
authors.forename: Michio
authors.initials: M
authors.lastname: Kitayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.forename: Hidenao
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000000981:diagnostic imaging* / Q000209:etiology*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine