Escamilla-Sevilla F, Pérez-Navarro M J, Muñoz-Pasadas M, Ortega-Léon T, Gallego-Peinado M, Cabello-García D, Gómez Río M, Ortega-Moreno A, Carnero-Pardo C, Rebollo-Aguirre A C, Mínguez-Castellanos A
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada.
Neurologia. 2009 Apr;24(3):170-6.
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.
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.
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).
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.
路易体疾病，如帕金森病（PD）和路易体痴呆（LBD），与心脏交感神经去神经支配有关，这在123I - MIBG闪烁扫描中可以显现出来。我们的目的是研究该技术在路易体疾病中的诊断价值及其与PD临床变量的关系。
我们研究了90名患者：51名PD患者、19名LBD患者、9名多系统萎缩（MSA）患者和11名对照者。对闪烁扫描图像进行定性评估，并计算早期和延迟的心脏与纵隔比值（HMR）。通过多变量线性回归分析控制主要混杂因素（缺血性心脏病、糖尿病、高血压和药物）。我们研究了闪烁扫描变量与PD变量之间的相关性。
显示出更好鉴别能力的延迟HMR在对照组中为2.03±0.32，在PD组中为1.37±0.30（与对照组相比，p<(0.001)），在LBD组中为1.47±0.45（与对照组相比，p = (0.001)），在MSA组中为1.69±0.28（与对照组相比，p = (0.02)；与PD组相比，p = (0.004)）。该比值受PD/LBD诊断影响（β = -0.638；p<(0.001)），且在较小程度上受缺血性心脏病影响（β = -0.244；p = (0.028)）。PD/LBD与对照组之间的最佳截断值为1.
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