title: Comparison of Dopamine Transporter SPECT and 123I-MIBG Myocardial Scintigraphy to Assess Clinical Severity in Patients With Parkinson Disease.
abstract: OBJECTIVE
  The aim of our study was to evaluate the use of dopamine transporter (DAT) SPECT and I-MIBG myocardial scintigraphy to determine the clinical severity of Parkinson disease (PD), with a focus on motor impairments affecting activities of daily living (ADLs).
  
  
  METHODS
  Data for 65 consecutive PD patients who underwent both DAT and MIBG imaging were reviewed. Associations between imaging variables and Hoehn and Yahr (H&Y) staging or self-supportive care ratings were investigated. Univariate and multivariate regression analyses were performed to determine the factors associated with ADLs.
  
  
  RESULTS
  After applying the exclusion criteria, 45 patients were analyzed (age, 73.1 ± 9.3 years; 23 males; H&Y stage 1: n = 12, stage 2: n = 14, stage 3: n = 10, stage 4: n = 5, and stage 5: n = 4; self-supportive care rating-dependent ADLs: n = 29). Dopamine transporter variables were significantly associated with the clinical severity of PD as assessed by H&Y staging, whereas MIBG variables were not. Dopamine transporter variables gradually decreased throughout progressive stages, whereas the MIBG variables changed only in the advanced stages. In a multivariate analysis including clinical and imaging variables, both lower DAT and MIBG uptakes were significantly associated with dependent ADL status (P = 0.028 and 0.034, respectively).
  
  
  CONCLUSIONS
  In patients with PD, DAT SPECT and MIBG myocardial scintigraphy were associated with ADL status; DAT SPECT was a stronger indicator of severity than MIBG myocardial scintigraphy in the early and middle stages.
authors: From the *Department of Radiology, Saitama Medical University Hospital, Saitama; †Department of Neurology, International Medical Center, Saitama Medical University, Saitama; ‡Department of Neurology, Saitama Medical University Hospital, Saitama; §Department of Cardiology, International Medical Center, Saitama Medical University, Saitama; and ∥Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, Saitama, Japan.
authors: Nanami
authors: N
authors: Okano
authors: Mamoru
authors: M
authors: Niitsu
authors: Junji
authors: J
authors: Tanaka
authors: Takahiro
authors: T
authors: Sasaki
authors: Kazushi
authors: K
authors: Takahashi
authors: Nobuo
authors: N
authors: Araki
authors: Toshimasa
authors: T
authors: Yamamoto
authors: Shintaro
authors: S
authors: Nakano
authors: Shigeyuki
authors: S
authors: Nishimura
authors: Takaaki
authors: T
authors: Senbonmatsu
authors: Ichiro
authors: I
authors: Matsunari
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D050483:Dopamine Plasma Membrane Transport Proteins; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine