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

• Published in: Molecular medicine reports Vol. 6; no. 6; pp. 1337 - 1342
• Main Authors: CHIARAVALLOTI, A, STEFANI, A, TAVOLOZZA, M, PIERANTOZZI, M, DI BIAGIO, D, OLIVOLA, E, DI PIETRO, B, STAMPANONI, M, DANIELI, R, SIMONETTI, G, STANZIONE, P, SCHILLACI, O
• Format: Journal Article
• Language: English
• Published: Greece D.A. Spandidos 01.12.2012; Spandidos Publications UK Ltd
• Subjects: 123I-MIBG; 3-Iodobenzylguanidine - chemistry; Age; Age Factors; Aged; akinetic rigid type; Denervation; DNA nucleotidylexotransferase; Female; Heart - physiopathology; Heart diseases; Humans; Hypokinesia - pathology; Iodine Radioisotopes - chemistry; Magnetic Resonance Imaging; Male; Mediastinum; Middle Aged; Motor task performance; Movement disorders; Myocardium - metabolism; Neurodegenerative diseases; Parkinson Disease - diagnostic imaging; Parkinson Disease - physiopathology; Parkinson Disease - surgery; Parkinson's disease; Patients; Quantitative analysis; Radionuclide Imaging; Radiopharmaceuticals - chemistry; Severity of Illness Index; Studies; Sympathectomy; sympathetic system; Tremor; Tremor - pathology; tremor-type; Values
• ISSN: 1791-2997; 1791-3004
• DOI: 10.3892/mmr.2012.1104

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.