Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease
Identifieur interne : 000190 ( France/Analysis ); précédent : 000189; suivant : 000191Cardiac 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 ] ; 2003-08.
English descriptors
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. © 2003 Movement Disorder Society
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DOI: 10.1002/mds.10461
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2003-08">2003-08</date><biblScope unit="volume">18</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="890">890</biblScope><biblScope unit="page" to="897">897</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">F0F8E3F36BB538F3323C070CEE5B4E26857F27FD</idno><idno type="DOI">10.1002/mds.10461</idno><idno type="ArticleID">MDS10461</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>autonomic failure</term><term>cardiac MIBG scintigraphy</term><term>multiple system atrophy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">[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. © 2003 Movement Disorder Society</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 Ourbon, Christine" sort="Brefel Ourbon, Christine" uniqKey="Brefel Ourbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><name sortKey="Montastruc, Jean Ouis" sort="Montastruc, Jean Ouis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><name sortKey="Montastruc, Jean Ouis" sort="Montastruc, Jean Ouis" 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 Ichel" sort="Senard, Jean Ichel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name><name sortKey="Senard, Jean Ichel" sort="Senard, Jean Ichel" 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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