Abstract | INTRODUCTION: Lewy body disorders such as Parkinson's disease (PD) and Lewy body dementia (LBD) are associated with cardiac sympathetic denervation, which can be visualized on 123I-MIBG scintigraphy. Our objectives were to study the diagnostic value of this technique in Lewy body disorders and its relationship with PD clinical variables. PATIENTS AND METHODS: We studied 90 patients: 51 with PD, 19 with LBD, 9 with multiple system atrophy (MSA) and 11 controls. Scintigraphy images were qualitatively evaluated and early and delayed heart-to-mediastinum ratios (HMR) were calculated. The main confounding factors ( ischemic heart disease, diabetes, hypertension and drugs) were controlled by multivariate linear regression analysis. We investigated correlations between scintigraphy variables and PD variables. RESULTS: The delayed HMR, which showed better discriminative ability was 2.03 +/- 0.32 in controls, 1.37 +/- 0.30 in PD (p<0.001 vs controls), 1.47+/-0.45 in LBD (p=0.001 vs controls) and 1.69+/-0.28 in MSA (p=0.02 vs controls; p=0.004 vs PD). This ratio was influenced by PD/LBD diagnosis (beta= -0.638; p<0.001) and to a lesser degree, by ischemic heart disease (beta= -0.244; p=0.028). Optimal cut-off value between PD/LBD and controls was 1.71 (83% sensitivity and 82% specificity). Within the PD group, those with a family history of PD/LB showed higher delayed HMR values (1.65+/-0.34 vs 1.30+/-0.24 without history; p<0.001) and proportion with normal scintigraphy (56% vs 5%; p=0.001). CONCLUSIONS: Cardiac 123I-MIBG scintigraphy is useful in the diagnosis of Lewy body disorders, although its value in PD is conditioned by having a family history of PD.
|
Authors | F Escamilla-Sevilla, M J Pérez-Navarro, M Muñoz-Pasadas, T Ortega-Léon, M Gallego-Peinado, D Cabello-García, M Gómez Río, A Ortega-Moreno, C Carnero-Pardo, A C Rebollo-Aguirre, A Mínguez-Castellanos |
Journal | Neurologia (Barcelona, Spain)
(Neurologia)
Vol. 24
Issue 3
Pg. 170-6
(Apr 2009)
ISSN: 0213-4853 [Print] Spain |
Vernacular Title | Valor diagnóstico de la gammagrafía cardíaca con 123I-metaiodobenzilguanidina en las enfermedades con cuerpos de Lewy. |
PMID | 19418293
(Publication Type: English Abstract, Journal Article)
|
Chemical References |
- Radiopharmaceuticals
- 3-Iodobenzylguanidine
|
Topics |
- 3-Iodobenzylguanidine
- Aged
- Aged, 80 and over
- Female
- Heart
(innervation)
- Humans
- Lewy Body Disease
(diagnosis, pathology, physiopathology)
- Male
- Middle Aged
- Myocardial Perfusion Imaging
- Parkinson Disease
(diagnosis, pathology, physiopathology)
- Radiopharmaceuticals
- Sympathectomy
|