Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease
Identifieur interne : 006069 ( Main/Merge ); précédent : 006068; suivant : 006070Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease
Auteurs : Frédéric Courbon [France] ; Christine Brefel-Courbon [France] ; Claire Thalamas [France] ; Marie Jeanne Alibelli [France] ; Isabelle Berry [France] ; Jean-Louis Montastruc [France] ; Olivier Rascol [France] ; Jean-Michel Senard [France]Source :
- Movement disorders [ 0885-3185 ] ; 2003.
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Abstract
[123I]Metaiodobenzylguanidine ([123I]MIBG) cardiac scintigraphy could be helpful to differentiate Parkinson's disease (PD) from multiple system atrophy (MSA), demonstrating that, in PD with autonomic failure but not in MSA, there is a myocardial postganglionic sympathetic dysfunction. To investigate whether this method is more sensitive than standard autonomic testing to detect early involvement of sympathetic cardiac efferent, we analyse MIBG myocardial uptake in 8 PD patients with normal autonomic testing (nondysautonomia PD group, NDPD) in comparison with 10 PD patients with abnormal autonomic testing (dysautonomia PD group, DPD) and 10 MSA patients. Global MIBG uptake was assessed using the ratio of [123I]MIBG uptake in the heart to the upper mediastinum (H/M) on planar scintigraphic data. Regional MIBG uptake was determined on two single photon emission tomography scans in regions of the left ventricle. The mean H/M ratios were significantly different among the three groups (P < 0.0001). H/M ratios of both NDPD and DPD patients groups (H/M = 1.83 ± 0.50 and 1.24 ± 0.40, respectively) were significantly lower than in MSA patients (H/M = 2.52 ± 0.60). However, in NDPD patients, H/M was significantly higher than in DPD patients. When compared to MSA patients, NDPD patients showed a regional reduction in MIBG uptake in all left ventricle regions markedly in the apex and the inferior wall. Our results suggest that MIBG myocardial scintigraphy (analysis of both H/M ratio and regional MIBG uptake) may be more sensitive than standard autonomic testing for the early detection of silent autonomic dysfunction in PD.
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wicri:level="1"><inist:fA14 i1="02"><s1>Service de Pharmacologie Clinique, University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Thalamas, Claire" sort="Thalamas, Claire" uniqKey="Thalamas C" first="Claire" last="Thalamas">Claire Thalamas</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Centre d'Investigation Clinique, Purpan Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Alibelli, Marie Jeanne" sort="Alibelli, Marie Jeanne" uniqKey="Alibelli M" first="Marie Jeanne" last="Alibelli">Marie Jeanne Alibelli</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Service de Médecine Nucléaire, University Rangueil Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Berry, Isabelle" sort="Berry, Isabelle" uniqKey="Berry I" first="Isabelle" last="Berry">Isabelle Berry</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Service de Médecine Nucléaire, University Rangueil Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Service de Pharmacologie Clinique, University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Institut National de la Santé et de la Recherche Médicale U317</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Service de Pharmacologie Clinique, University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Midi-Pyrénées</region></placeName><orgName type="university" n="3">Université Toulouse III - Paul Sabatier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Toulouse</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Centre d'Investigation Clinique, Purpan Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Midi-Pyrénées</region></placeName><orgName type="university" n="3">Université Toulouse III - Paul Sabatier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Toulouse</orgName></affiliation></author><author><name sortKey="Senard, Jean Michel" sort="Senard, Jean Michel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Service de Pharmacologie Clinique, University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Institut National de la Santé et de la Recherche Médicale U317</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Complication</term><term>Denervation</term><term>Differential diagnostic</term><term>Diseases of the autonomic nervous system</term><term>Heart</term><term>Iobenguane(131I)</term><term>Multiple system atrophy</term><term>Parkinson disease</term><term>Scintigraphy</term><term>Sympathetic nervous system</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Scintigraphie</term><term>Iobenguane(131I)</term><term>Système nerveux autonome pathologie</term><term>Coeur</term><term>Atrophie multisystématisée</term><term>Enervation</term><term>Système nerveux sympathique</term><term>Diagnostic différentiel</term><term>Complication</term><term>Adulte</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">[<sup>123</sup>I]Metaiodobenzylguanidine ([<sup>123</sup>I]MIBG) cardiac scintigraphy could be helpful to differentiate Parkinson's disease (PD) from multiple system atrophy (MSA), demonstrating that, in PD with autonomic failure but not in MSA, there is a myocardial postganglionic sympathetic dysfunction. To investigate whether this method is more sensitive than standard autonomic testing to detect early involvement of sympathetic cardiac efferent, we analyse MIBG myocardial uptake in 8 PD patients with normal autonomic testing (nondysautonomia PD group, NDPD) in comparison with 10 PD patients with abnormal autonomic testing (dysautonomia PD group, DPD) and 10 MSA patients. Global MIBG uptake was assessed using the ratio of [<sup>123</sup>I]MIBG uptake in the heart to the upper mediastinum (H/M) on planar scintigraphic data. Regional MIBG uptake was determined on two single photon emission tomography scans in regions of the left ventricle. The mean H/M ratios were significantly different among the three groups (P < 0.0001). H/M ratios of both NDPD and DPD patients groups (H/M = 1.83 ± 0.50 and 1.24 ± 0.40, respectively) were significantly lower than in MSA patients (H/M = 2.52 ± 0.60). However, in NDPD patients, H/M was significantly higher than in DPD patients. When compared to MSA patients, NDPD patients showed a regional reduction in MIBG uptake in all left ventricle regions markedly in the apex and the inferior wall. Our results suggest that MIBG myocardial scintigraphy (analysis of both H/M ratio and regional MIBG uptake) may be more sensitive than standard autonomic testing for the early detection of silent autonomic dysfunction in PD.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li></region><settlement><li>Toulouse</li></settlement><orgName><li>Université Toulouse III - Paul Sabatier</li><li>Université de Toulouse</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Courbon, Frederic" sort="Courbon, Frederic" uniqKey="Courbon F" first="Frédéric" last="Courbon">Frédéric Courbon</name></noRegion><name sortKey="Alibelli, Marie Jeanne" sort="Alibelli, Marie Jeanne" uniqKey="Alibelli M" first="Marie Jeanne" last="Alibelli">Marie Jeanne Alibelli</name><name sortKey="Berry, Isabelle" sort="Berry, Isabelle" uniqKey="Berry I" first="Isabelle" last="Berry">Isabelle Berry</name><name sortKey="Brefel Courbon, Christine" sort="Brefel Courbon, Christine" uniqKey="Brefel Courbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><name sortKey="Senard, Jean Michel" sort="Senard, Jean Michel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name><name sortKey="Senard, Jean Michel" sort="Senard, Jean Michel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name><name sortKey="Thalamas, Claire" sort="Thalamas, Claire" uniqKey="Thalamas C" first="Claire" last="Thalamas">Claire Thalamas</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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