Comparison of severity of obstructive sleep apnea and degree of accumulation of cardiac 123I-MIBG radioactivity as a diagnostic marker for idiopathic REM sleep behavior disorder.

Abstract

OBJECTIVE:

We investigated cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphic assessment as a supportive diagnostic indicator for idiopathic REM sleep behavior disorder (RBD) complicated by moderate to severe obstructive sleep apnea (OSA).

METHODS:

(123)I-MIBG was intravenously injected in 23 idiopathic RBD patients with AHI < 5/h, 9 idiopathic RBD patients with 5 <or= AHI < 15/h, 15 idiopathic RBD patients complicated with moderate to severe OSA with AHI >or= 15/h, and 16 moderate to severe obstructive sleep apnea syndrome (OSAS) patients without RBD by polysomnography.

RESULTS:

Cardiac MIBG uptake based on H/M was significantly decreased in RBD patients with or without OSA compared with patients with moderate to severe OSAS without RBD. ROC analysis revealed that a delayed H/M cut-off value of 1.97 was useful for differentiating idiopathic RBD complicated by moderate to severe OSA from moderate to severe OSAS without RBD.

CONCLUSIONS:

(123)I-MIBG cardiac scintigraphy has the potential to distinguish true RBD from pseudo-RBD associated with OSA. These results are noteworthy because treatment options and follow-up protocols are determined based on evaluation of moderate to severe OSA complicated with RBD, such as overlapping primary sleep disorders.

• Authors: Tomoyuki Miyamoto, Masayuki Miyamoto, Keisuke Suzuki, Akiko Ikematsu, Yasuhiro Usui, Yuichi Inoue, Koichi Hirata
• Journal: Sleep medicine (Sleep Med) Vol. 10 Issue 5 Pg. 577-80 (May 2009) ISSN: 1389-9457 [Print] Netherlands
• PMID: 18752998 (Publication Type: Controlled Clinical Trial, Journal Article)

Chemical References

• Iodine Radioisotopes
• Radiopharmaceuticals
• 3-Iodobenzylguanidine

Topics

• 3-Iodobenzylguanidine
• Aged
• Cross-Sectional Studies
• Female
• Heart (diagnostic imaging)
• Humans
• Iodine Radioisotopes
• Male
• Middle Aged
• Polysomnography
• Predictive Value of Tests
• REM Sleep Behavior Disorder (diagnosis, etiology)
• Radionuclide Imaging
• Radiopharmaceuticals
• Respiratory Function Tests
• Severity of Illness Index
• Sleep Apnea, Obstructive (diagnostic imaging, physiopathology, psychology)