Murakami Nagahisa, Sako Wataru, Haji Shotaro, Furukawa Takahiro, Otomi Yoichi, Otsuka Hideki, Izumi Yuishin, Harada Masafumi, Kaji Ryuji
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Front Neurol. 2019 Apr 12;10:376. doi: 10.3389/fneur.2019.00376. eCollection 2019.
Falls are associated with poor prognosis in patients with Parkinson's disease (PD). Although several factors related to falls were reported in patients with PD, objective predictors of falls are not identified. We aimed to determine whether I-meta-iodobenzylguanidine (MIBG) cardiac scintigraphy could be a useful biomarker to predict falls. Forty-five patients with PD were enrolled in this study. These subjects were followed up more than 5 years after MIBG scintigraphy and were divided into two groups: one with decreased uptake of MIBG and the other without decreased uptake of MIBG. The cut-off value for the delayed heart-to-mediastinum ratio was 1.8. Kaplan-Meier analysis and a log-rank test were performed to test the predictive power of MIBG cardiac scintigraphy for falls. Univariate analysis was selected because we did not have appropriate data for adjustment, such as motor and cognitive assessment. The group with decreased uptake of MIBG had a significantly higher incidence of falls than that without decreased uptake of MIBG ( = 0.022, log-rank test). Although the limitations of this study were lack of several key factors including motor and cognitive assessment, MIBG cardiac scintigraphy may be used to predict falls in patients with PD.
跌倒与帕金森病（PD）患者的不良预后相关。尽管已有报道指出PD患者存在一些与跌倒相关的因素，但尚未确定跌倒的客观预测指标。我们旨在确定间碘苄胍（MIBG）心肌显像是否可作为预测跌倒的有用生物标志物。本研究纳入了45例PD患者。这些受试者在MIBG显像后随访了5年以上，并分为两组：一组MIBG摄取减少，另一组MIBG摄取未减少。延迟心纵隔比的临界值为1.8。采用Kaplan-Meier分析和对数秩检验来检验MIBG心肌显像对跌倒的预测能力。由于我们没有合适的调整数据，如运动和认知评估数据，因此选择了单因素分析。MIBG摄取减少组的跌倒发生率显著高于MIBG摄取未减少组（对数秩检验，P = 0.022）。尽管本研究存在包括缺乏运动和认知评估等几个关键因素的局限性，但MIBG心肌显像可能可用于预测PD患者的跌倒。
