Department of Neurology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Eur J Neurol. 2011 Jul;18(7):1010-3. doi: 10.1111/j.1468-1331.2010.03211.x. Epub 2010 Sep 16.
Metaiodobenzylguanidine (MIBG) cardiac scintigraphy was used to differentiate Parkinson's disease (PD) with Lewy body pathology from other degenerative parkinsonisms. MIBG cardiac scintigraphy demonstrates the extent of degeneration of myocardial post-ganglionic sympathetic nerves in patients with PD. Because of its specificity for Lewy body (LB) pathology, MIBG scan might also be useful biomarker for the neurodegeneration attributed to PD. To estimate the utility of the imaging technique as a biomarker, we conducted sequential imaging analysis and power analysis.
Sixty-three patients who met the UK PD Society Brain Bank criteria were enrolled in this study. (123) I-MIBG myocardial scintigraphy was performed on all subjects, and the heart to mediastinum (H/M) ratio was calculated. A second imaging session was carried out after a mean interval of 268 days.
Sequential imaging revealed a 2.9% decline of the H/M ratio from the baseline to the follow-up image, which reached statistical significance, but the power analysis showed that a relatively large number of patients would be required to demonstrate the neuroprotective effects of any therapy.
Sequential imaging using (123) I-MIBG myocardial scintigraphy revealed progressive degeneration of the cardiac sympathetic nerve in 63 patients with PD. Although careful elimination of other disease conditions that damage the cardiac sympathetic nerve system is necessary, (123) I-MIBG myocardial scintigraphy may be a useful addition to clinical trials that intend to prove neuroprotection among patients with PD.
间碘苄胍（MIBG）心脏闪烁显像术用于区分具有路易体病理的帕金森病（PD）与其他退行性帕金森病。MIBG 心脏闪烁显像术显示 PD 患者心肌节后交感神经变性的程度。由于其对路易体（LB）病理的特异性，MIBG 扫描也可能是 PD 相关神经退行性变的有用生物标志物。为了评估该成像技术作为生物标志物的效用，我们进行了连续成像分析和功效分析。
本研究纳入了 63 名符合英国 PD 协会脑库标准的患者。所有患者均进行了（123）I-MIBG 心肌闪烁显像，并计算了心脏与纵隔（H/M）比值。在平均 268 天后进行了第二次成像检查。
连续成像显示 H/M 比值从基线到随访图像下降了 2.9%，达到统计学意义，但功效分析表明，需要相当数量的患者才能证明任何治疗的神经保护作用。
使用（123）I-MIBG 心肌闪烁显像的连续成像显示 63 例 PD 患者的心脏交感神经进行性变性。尽管需要仔细排除其他损害心脏交感神经系统的疾病，但（123）I-MIBG 心肌闪烁显像可能是旨在证明 PD 患者神经保护的临床试验的有用补充。
