Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, 4-11-1, Izumihoncho, Komae, Tokyo, 201-8601, Japan.
J Neural Transm (Vienna). 2011 Sep;118(9):1323-7. doi: 10.1007/s00702-011-0598-5. Epub 2011 Feb 18.
It remains unclear whether cardiac iodine-123-labeled metaiodobenzylguanidine ((123)I-MIBG) uptake is clinically related to autonomic dysfunction on conventional autonomic function testing in de novo Parkinson's disease (PD). We therefore studied the relation between cardiac (123)I-MIBG uptake and cardiovascular autonomic dysfunction in patients with de novo PD. The subjects were 26 patients with de novo PD. The ratio of the average pixel count in the heart to that in the mediastinum was calculated to derive the cardiac (123)I-MIBG uptake. Cardiovascular autonomic function was evaluated on the basis of cardiovascular autonomic response on the Valsalva maneuver (VM), and systolic blood pressure response (SBP) on head-up tilt-table testing (HUT). Patients with de novo PD had significantly reduced cardiac (123)I-MIBG uptake as compared with controls (1.58 ± 0.43 vs. 2.25 ± 0.34, p = 0.0001) and cardiovascular autonomic response on the VM. No significant difference in the fall in SBP on HUT was found between patients with de novo PD and the controls. Cardiac (123)I-MIBG uptake in de novo PD was not significantly related to vasomotor sympathetic function, baroreceptor reflex gain, cardiac parasympathetic function, or the changes in SBP on HUT. Cardiac (123)I-MIBG uptake was, however, significantly related to the blood pressure overshoot in phase IV of the VM (r = 0.648, p = 0.0003). Cardiac (123)I-MIBG uptake began to decrease in association with the reduction in the overshoot of phase IV on the VM. Cardiac (123)I-MIBG uptake clinically reflects cardiac sympathetic dysfunction in de novo PD.
心脏碘-123 标记间碘苄胍 ((123)I-MIBG) 摄取是否与新发帕金森病 (PD) 患者常规自主功能测试中的自主神经功能障碍有关尚不清楚。因此，我们研究了新发 PD 患者心脏 (123)I-MIBG 摄取与心血管自主神经功能障碍的关系。研究对象为 26 例新发 PD 患者。计算心脏平均像素计数与纵隔平均像素计数的比值，以得出心脏 (123)I-MIBG 摄取率。心血管自主功能根据瓦尔萨尔瓦动作 (VM) 时的心血管自主反应以及头高位倾斜试验 (HUT) 时的收缩压反应 (SBP) 进行评估。与对照组相比，新发 PD 患者的心脏 (123)I-MIBG 摄取显著减少（1.58±0.43 比 2.25±0.34，p=0.0001），VM 时的心血管自主反应也显著减少。新发 PD 患者与对照组相比，HUT 时 SBP 下降无显著差异。心脏 (123)I-MIBG 摄取与血管运动交感神经功能、压力感受器反射增益、心脏副交感神经功能或 HUT 时 SBP 变化无显著相关性。然而，心脏 (123)I-MIBG 摄取与 VM 第四相血压过冲显著相关（r=0.648，p=0.0003）。心脏 (123)I-MIBG 摄取开始下降与 VM 第四相过冲减少相关。心脏 (123)I-MIBG 摄取在临床上反映了新发 PD 患者的心脏交感神经功能障碍。
