Mitsui Jun, Saito Yuko, Momose Toshimitsu, Shimizu Jun, Arai Noritoshi, Shibahara Junji, Ugawa Yoshikazu, Kanazawa Ichiro, Tsuji Shoji, Murayama Shigeo
Department of Neurology, Division of Neuroscience, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
J Neurol Sci. 2006 Apr 15;243(1-2):101-4. doi: 10.1016/j.jns.2005.11.034. Epub 2006 Jan 27.
Decreased cardiac uptake in (123)I-metaiodobenzylguanidine (MIBG) scintigraphy has been adopted as one of the most reliable diagnostic tests for Parkinson disease (PD) in Japan. To investigate the morphological basis for this finding, we performed a detailed neuropathological study of the cardiac sympathetic nervous system of a 71-year-old autopsy-proven PD patient, who presented with a marked decrease in cardiac uptake of MIBG, just 1 year prior to death. We carefully examined the intermediolateral column at several levels of the thoracic spinal cord, the sympathetic trunk and ganglia, and the nerve plexus of the anterior wall of the left ventricle and compared the findings with those of five age-matched controls. We found that the cardiac plexus was more heavily involved than the sympathetic ganglia in this patient with PD. Our study may provide further evidence that the markedly decreased cardiac uptake of MIBG observed in PD cases represents preferential involvement of the cardiac sympathetic nerve plexus in this disorder.
在日本，（123）I-间碘苄胍（MIBG）闪烁显像中的心摄取减少已被用作帕金森病（PD）最可靠的诊断测试之一。为了研究这一发现的形态学基础，我们对一名71岁经尸检证实的PD患者的心脏交感神经系统进行了详细的神经病理学研究，该患者在死亡前1年MIBG的心摄取显著降低。我们仔细检查了胸段脊髓多个节段的中间外侧柱、交感干和神经节以及左心室前壁的神经丛，并将结果与五名年龄匹配的对照者进行了比较。我们发现，该PD患者的心脏神经丛比交感神经节受累更严重。我们的研究可能进一步证明，在PD病例中观察到的MIBG心摄取显著降低代表了这种疾病中心脏交感神经丛的优先受累。
