Department of Biopathology and Diagnostic Imaging, University Tor Vergata, Rome, Italy.
Mol Med Rep. 2012 Dec;6(6):1337-42. doi: 10.3892/mmr.2012.1104. Epub 2012 Sep 27.
The aim of this study was to evaluate the correlation between the clinical motor phenotypes of Parkinson's disease (PD) and ¹²³I-MIBG myocardial uptake. In total, 53 patients with PD [31 males and 22 females, mean age 62±10 years; 19 Hoehn & Yahr (H&Y) stage 1, 9 stage 1.5, 15 stage 2 and 10 at stage 3] were examined and subdivided into different clinical forms on the basis of dominance of resting tremor (n=19, TDT) and bradykinesia plus rigidity (n=34, ART). This status was correlated with the semi-quantitative analysis of ¹²³I-MIBG myocardial uptake. An age-matched control group of 18 patients was recruited (8 males and 10 females, mean age 62.4±16.3 years). ¹²³I-MIBG myocardial uptake significantly correlated with disease duration in early (r²=0.1894; P=0.0028) and delayed images (r²=0.1795; P=0.0037) in PD patients, while no correlation was found when considering age at examination, UPDRS III motor examination section score and H&Y score. PD patients showed a reduced ¹²³I-MIBG myocardial uptake compared to the control group in early (P=0.0026) and delayed images (P=0.0040), and ¹²³I-MIBG myocardial uptake was significantly lower in delayed images in TDT patients compared with ART patients (P=0.0167). A decrease was detected in the heart-to-mediastinum (H/M) ratio in delayed images compared to that of the early images in TDT patients (P=0.0040) and in the whole PD population (P=0.0012), while no differences were found in ART patients (P=0.1043). The results of the present study revealed that the cardiac sympathetic system is more severely impaired in TDT than in ART patients and ¹²³I-MIBG molecular imaging has the potential help in improving therapeutic planning in these patients.
本研究旨在评估帕金森病（PD）的临床运动表型与 ¹²³I-MIBG 心肌摄取之间的相关性。共纳入 53 例 PD 患者[31 名男性和 22 名女性，平均年龄 62±10 岁；19 例 Hoehn & Yahr（H&Y）分期 1 期，9 例分期 1.5 期，15 例分期 2 期，10 例分期 3 期]，并根据静止性震颤（TDT）和运动迟缓伴强直（ART）的优势对其进行临床分型，同时对 ¹²³I-MIBG 心肌摄取进行半定量分析。纳入 18 例年龄匹配的对照组患者（8 名男性和 10 名女性，平均年龄 62.4±16.3 岁）。PD 患者早期和延迟图像的 ¹²³I-MIBG 心肌摄取与疾病病程显著相关（r²=0.1894；P=0.0028 和 r²=0.1795；P=0.0037），而在考虑检查时的年龄、UPDRS III 运动检查部分评分和 H&Y 评分时则无相关性。与对照组相比，PD 患者的早期（P=0.0026）和延迟图像（P=0.0040）的 ¹²³I-MIBG 心肌摄取明显减少，TDT 患者的延迟图像摄取显著低于 ART 患者（P=0.0167）。与早期图像相比，TDT 患者的延迟图像的心脏与纵隔（H/M）比值降低（P=0.0040），在整个 PD 患者群体中也降低（P=0.0012），而 ART 患者则无差异（P=0.1043）。本研究结果表明，TDT 患者的心脏自主神经系统损伤较 ART 患者更严重，¹²³I-MIBG 分子成像有助于改善这些患者的治疗计划。
