Satoh A, Serita T, Seto M, Tomita I, Satoh H, Iwanaga K, Takashima H, Tsujihata M
Division of Neurology, Nagasaki Kita Hospital, Japan.
J Nucl Med. 1999 Mar;40(3):371-5.
Myocardial imaging with 123I-metaiodobenzylguanidine (MIBG) was performed on 35 patients with Parkinson's disease and 24 control subjects to evaluate cardiac sympathetic function in patients with Parkinson's disease, verify this phenomenon and examine whether myocardial MIBG uptake and clearance are correlated with the clinical severity of Parkinson's disease.
We studied 35 patients with Parkinson's disease and 24 control subjects with other central nervous system diseases. The latter group consisted of 12 subjects with other neurodegenerative disorders (4 with spinocerebellar degeneration, 2 with amyotrophic lateral sclerosis, 3 with progressive supranuclear palsy and 3 with corticobasal degeneration and 12 patients with cerebral infarction (CI), 6 with vascular parkinsonism and 6 without it. Early and delayed images of the anterior view were obtained 15 min and 4 h after injection of 123I-MIBG, respectively. MIBG uptake was quantified by calculating a heart-to-mediastinum count (H/M) ratio.
The H/M ratio was markedly reduced in the patients with Parkinson's disease (II to V on the Hoehn and Yahr scale) compared with the control subjects. None of the subjects with neurodegenerative diseases showed a marked decrease in myocardial MIBG uptake nor did any subject with CI.
Our findings indicate that, in Parkinson's disease, a reduction in myocardial MIBG uptake is a very common, specific phenomenon that can be used to detect cardiac autonomic dysfunction to diagnose Parkinson's disease, particularly in patients without typical signs and symptoms.
对35例帕金森病患者和24例对照者进行了¹²³I-间碘苄胍（MIBG）心肌显像，以评估帕金森病患者的心脏交感神经功能，验证这一现象，并检查心肌MIBG摄取和清除是否与帕金森病的临床严重程度相关。
我们研究了35例帕金森病患者和24例患有其他中枢神经系统疾病的对照者。后一组包括12例患有其他神经退行性疾病的受试者（4例患有脊髓小脑变性，2例患有肌萎缩侧索硬化，3例患有进行性核上性麻痹，3例患有皮质基底节变性）和12例脑梗死（CI）患者（6例患有血管性帕金森综合征，6例无血管性帕金森综合征）。分别在注射¹²³I-MIBG后15分钟和4小时获得前位的早期和延迟图像。通过计算心脏与纵隔计数（H/M）比值对MIBG摄取进行定量分析。
与对照者相比，帕金森病患者（Hoehn和Yahr分级为II至V级）的H/M比值明显降低。神经退行性疾病患者中无一例心肌MIBG摄取明显降低，CI患者中也无此现象。
我们的研究结果表明，在帕金森病中，心肌MIBG摄取降低是一种非常常见的特异性现象，可用于检测心脏自主神经功能障碍以诊断帕金森病，尤其是在没有典型症状和体征的患者中。
