Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Neurol Neurosurg Psychiatry. 2015 Sep;86(9):945-51. doi: 10.1136/jnnp-2015-310327. Epub 2015 May 2.
The aim of this study was to investigate chronological changes of (123)I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy and its relation to clinical features in patients with Parkinson's disease (PD), and to characterise patients with PD with normal or mildly low MIBG uptakes at their early stages.
The participants were 70 patients with PD who underwent (123)I-MIBG myocardial scintigraphy twice or more. A cluster analysis was performed using parameters calculated from heart to mediastinum (H/M) ratio and washout ratio (WR).
At baseline, the mean early H/M ratio (H/M(E)), delayed H/M ratio (H/M(D)) and WR were 1.83, 1.69 and 41.7%, respectively. After a mean interval of 3.0 years, follow-up studies showed significantly declined H/M(E) (1.69, p<0.001), declined H/M(D) (1.47, p<0.001) and enhanced WR (43.8%, p=0.007). Our longitudinal observations revealed that there existed heterogeneous changes in MIBG uptakes among patients. The cluster analysis classified the patients into two subgroups: 42 patients with markedly low MIBG uptakes at baseline (group A) and 28 patients with normal or mildly low MIBG uptakes at baseline (group B). Group B showed a significantly higher ratio of females, younger age at onset, lower Hoehn and Yahr stage and less demented, compared with group A.
Follow-up studies of MIBG divided the patients with PD into two major subgroups. A subgroup of patients with PD with normal or mildly low MIBG uptakes at the early stages of illness was characterised by female-dominant, young onset, slow progression in motor dysfunctions and preserved cognitive function.
本研究旨在探讨（123）I-间碘苄胍（MIBG）心肌闪烁显像在帕金森病（PD）患者中的时间变化及其与临床特征的关系，并对早期 MIBG 摄取正常或轻度降低的 PD 患者进行特征描述。
本研究纳入了 70 名接受过两次或更多次（123）I-MIBG 心肌闪烁显像的 PD 患者。使用心/纵隔（H/M）比值和洗脱率（WR）计算参数进行聚类分析。
基线时，早期 H/M 比值（H/M(E)）、延迟 H/M 比值（H/M(D)）和 WR 的平均值分别为 1.83、1.69 和 41.7%。平均间隔 3.0 年后，随访研究显示 H/M(E)显著下降（1.69，p<0.001）、H/M(D)下降（1.47，p<0.001）和 WR 增加（43.8%，p=0.007）。我们的纵向观察表明，患者之间的 MIBG 摄取存在异质性变化。聚类分析将患者分为两组：基线时 MIBG 摄取明显降低的 42 名患者（A 组）和基线时 MIBG 摄取正常或轻度降低的 28 名患者（B 组）。与 A 组相比，B 组女性比例更高、发病年龄更小、Hoehn 和 Yahr 分期更低、痴呆程度更低。
MIBG 随访研究将 PD 患者分为两个主要亚组。一个亚组的 PD 患者在疾病早期 MIBG 摄取正常或轻度降低，其特征为女性为主、发病年龄较小、运动功能障碍进展缓慢、认知功能保留。
1033。
