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Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson's disease: molecular imaging with ¹²³I-MIBG.

Abstract
The aim of this study was to evaluate the correlation between the clinical motor phenotypes of Parkinson's disease (PD) and ¹²³I-MIBG myocardial uptake. In total, 53 patients with PD [31 males and 22 females, mean age 62±10 years; 19 Hoehn & Yahr (H&Y) stage 1, 9 stage 1.5, 15 stage 2 and 10 at stage 3] were examined and subdivided into different clinical forms on the basis of dominance of resting tremor (n=19, TDT) and bradykinesia plus rigidity (n=34, ART). This status was correlated with the semi-quantitative analysis of ¹²³I-MIBG myocardial uptake. An age-matched control group of 18 patients was recruited (8 males and 10 females, mean age 62.4±16.3 years). ¹²³I-MIBG myocardial uptake significantly correlated with disease duration in early (r²=0.1894; P=0.0028) and delayed images (r²=0.1795; P=0.0037) in PD patients, while no correlation was found when considering age at examination, UPDRS III motor examination section score and H&Y score. PD patients showed a reduced ¹²³I-MIBG myocardial uptake compared to the control group in early (P=0.0026) and delayed images (P=0.0040), and ¹²³I-MIBG myocardial uptake was significantly lower in delayed images in TDT patients compared with ART patients (P=0.0167). A decrease was detected in the heart-to-mediastinum (H/M) ratio in delayed images compared to that of the early images in TDT patients (P=0.0040) and in the whole PD population (P=0.0012), while no differences were found in ART patients (P=0.1043). The results of the present study revealed that the cardiac sympathetic system is more severely impaired in TDT than in ART patients and ¹²³I-MIBG molecular imaging has the potential help in improving therapeutic planning in these patients.
AuthorsA Chiaravalloti, A Stefani, M Tavolozza, M Pierantozzi, D Di Biagio, E Olivola, B Di Pietro, M Stampanoni, R Danieli, G Simonetti, P Stanzione, O Schillaci
JournalMolecular medicine reports (Mol Med Rep) Vol. 6 Issue 6 Pg. 1337-42 (12 2012) ISSN: 1791-3004 [Electronic] Greece
PMID23023866 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine
Topics
  • 3-Iodobenzylguanidine (chemistry)
  • Age Factors
  • Aged
  • Female
  • Heart (physiopathology)
  • Humans
  • Hypokinesia (pathology)
  • Iodine Radioisotopes (chemistry)
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardium (metabolism)
  • Parkinson Disease (diagnostic imaging, physiopathology, surgery)
  • Radionuclide Imaging
  • Radiopharmaceuticals (chemistry)
  • Severity of Illness Index
  • Sympathectomy
  • Tremor (pathology)

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