The arginine growth hormone stimulation test in bradykinetic-rigid parkinsonisms.
Identifieur interne : 001F31 ( Ncbi/Curation ); précédent : 001F30; suivant : 001F32The arginine growth hormone stimulation test in bradykinetic-rigid parkinsonisms.
Auteurs : Maria Teresa Pellecchia [Italie] ; Katia Longo ; Michela Manfredi ; Claudio Lucetti ; Giovanni Cossu ; Alfredo Petrone ; Roberto Marconi ; Mariachiara Sensi ; Antonio Epifanio ; Roberto Eleopra ; Roberta Marchese ; Tomaso Scaravilli ; Letterio Morgante ; Giovanni Abbruzzese ; Ubaldo Bonuccelli ; Edoardo Donati ; Rosario Pivonello ; Annamaria Colao ; Paolo BaroneSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- MESH :
- chemical , blood : Human Growth Hormone.
- chemical , diagnostic use : Arginine.
- blood : Multiple System Atrophy, Parkinsonian Disorders.
- diagnosis : Multiple System Atrophy, Parkinson Disease, Parkinsonian Disorders.
- Aged, Analysis of Variance, Female, Humans, Male, Middle Aged, ROC Curve.
Abstract
The arginine growth hormone (GH) stimulation test differentiates the Parkinsonian variant of multiple system atrophy (MSA-P) from idiopathic Parkinson's disease (PD). Our aim was to evaluate the accuracy of the arginine GH stimulation test in distinguishing between PSP, MSA-P, and PD. We measured the GH response to arginine in serum samples of 26 MSA-P, 23 PSP, and 26 PD patients, and in 80 healthy controls. We used ANOVA followed by the Bonferroni test to compare GH values and peaks among groups. We used receiver operating characteristic curve analysis to establish the arginine cut-off level that best differentiated between MSA-P, PSP, and PD. The GH peak was significantly lower (P < 0.01) in MSA-P (1.46 +/- 0.29 microg/L) than in both PD (8.74 +/- 0.98 microg/L) and PSP (6.64 +/- 0.82 microg/L) patients, and controls (8.59 +/- 0.44 microg/L). Growth hormone peaked later in PSP patients than in PD patients and controls. At a cut-off level of 4 microg/L, arginine test distinguished MSA-P from PD with a sensitivity of 92% and a specificity of 96%, and MSA-P from PSP with a sensitivity of 78% and a specificity of 96%. The GH response to arginine differentiates MSA-P from PD and PSP with a good diagnostic accuracy. The neuroendocrine response to arginine of PSP patients differed from that of MSA-P patients, but was not identical to that of normal controls and PD patients. Our results suggest that the impairment of the central mechanisms modulating GH release differs between PSP and MSA-P.
DOI: 10.1002/mds.21700
PubMed: 18044703
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<author><name sortKey="Pellecchia, Maria Teresa" sort="Pellecchia, Maria Teresa" uniqKey="Pellecchia M" first="Maria Teresa" last="Pellecchia">Maria Teresa Pellecchia</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurological Sciences, University of Naples Federico II, Naples, Italy.</nlm:affiliation>
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<author><name sortKey="Longo, Katia" sort="Longo, Katia" uniqKey="Longo K" first="Katia" last="Longo">Katia Longo</name>
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<author><name sortKey="Manfredi, Michela" sort="Manfredi, Michela" uniqKey="Manfredi M" first="Michela" last="Manfredi">Michela Manfredi</name>
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<author><name sortKey="Donati, Edoardo" sort="Donati, Edoardo" uniqKey="Donati E" first="Edoardo" last="Donati">Edoardo Donati</name>
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<term>Human Growth Hormone (blood)</term>
<term>Humans</term>
<term>Male</term>
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<term>Multiple System Atrophy (blood)</term>
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<front><div type="abstract" xml:lang="en">The arginine growth hormone (GH) stimulation test differentiates the Parkinsonian variant of multiple system atrophy (MSA-P) from idiopathic Parkinson's disease (PD). Our aim was to evaluate the accuracy of the arginine GH stimulation test in distinguishing between PSP, MSA-P, and PD. We measured the GH response to arginine in serum samples of 26 MSA-P, 23 PSP, and 26 PD patients, and in 80 healthy controls. We used ANOVA followed by the Bonferroni test to compare GH values and peaks among groups. We used receiver operating characteristic curve analysis to establish the arginine cut-off level that best differentiated between MSA-P, PSP, and PD. The GH peak was significantly lower (P < 0.01) in MSA-P (1.46 +/- 0.29 microg/L) than in both PD (8.74 +/- 0.98 microg/L) and PSP (6.64 +/- 0.82 microg/L) patients, and controls (8.59 +/- 0.44 microg/L). Growth hormone peaked later in PSP patients than in PD patients and controls. At a cut-off level of 4 microg/L, arginine test distinguished MSA-P from PD with a sensitivity of 92% and a specificity of 96%, and MSA-P from PSP with a sensitivity of 78% and a specificity of 96%. The GH response to arginine differentiates MSA-P from PD and PSP with a good diagnostic accuracy. The neuroendocrine response to arginine of PSP patients differed from that of MSA-P patients, but was not identical to that of normal controls and PD patients. Our results suggest that the impairment of the central mechanisms modulating GH release differs between PSP and MSA-P.</div>
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