Chronological changes of 123I-MIBG myocardial scintigraphy and clinical features of Parkinson's disease.
OBJECTIVE
The aim of this study was to investigate chronological changes of (123)I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy and its relation to clinical features in patients with Parkinson's disease (PD), and to characterise patients with PD with normal or mildly low MIBG uptakes at their early stages.


METHODS
The participants were 70 patients with PD who underwent (123)I-MIBG myocardial scintigraphy twice or more. A cluster analysis was performed using parameters calculated from heart to mediastinum (H/M) ratio and washout ratio (WR).


RESULTS
At baseline, the mean early H/M ratio (H/M(E)), delayed H/M ratio (H/M(D)) and WR were 1.83, 1.69 and 41.7%, respectively. After a mean interval of 3.0 years, follow-up studies showed significantly declined H/M(E) (1.69, p<0.001), declined H/M(D) (1.47, p<0.001) and enhanced WR (43.8%, p=0.007). Our longitudinal observations revealed that there existed heterogeneous changes in MIBG uptakes among patients. The cluster analysis classified the patients into two subgroups: 42 patients with markedly low MIBG uptakes at baseline (group A) and 28 patients with normal or mildly low MIBG uptakes at baseline (group B). Group B showed a significantly higher ratio of females, younger age at onset, lower Hoehn and Yahr stage and less demented, compared with group A.


CONCLUSIONS
Follow-up studies of MIBG divided the patients with PD into two major subgroups. A subgroup of patients with PD with normal or mildly low MIBG uptakes at the early stages of illness was characterised by female-dominant, young onset, slow progression in motor dysfunctions and preserved cognitive function.


BACKGROUND
1033.
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Koyo
K
Tsujikawa
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Yasuhiro
Y
Hasegawa
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Satoshi
S
Yokoi
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Keizo
K
Yasui
Department of Radiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Ichiro
I
Nanbu
Obu Dementia Care Research and Training Center, Aichi, Japan.
Tsutomu
T
Yanagi
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Akira
A
Takahashi
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010300:Parkinson Disease / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D063189:Symptom Assessment
NEURORADIOLOGY; PARKINSON'S DISEASE