Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan.
Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan; Urayasu Rehabilitation Education Center, Chiba University Hospital, 7-2-32 Takasu, Urayasu City, Chiba, 279-0023, Japan; TUMS Urayasu Hospital, 7-2-32 Takasu, Urayasu City, Chiba, 279-0023, Japan.
Parkinsonism Relat Disord. 2021 May;86:61-66. doi: 10.1016/j.parkreldis.2021.03.016. Epub 2021 Mar 28.
Patients with Parkinson's disease (PD) often present with gastric symptoms. Electrogastrography (EGG) can noninvasively assess gastric electric activity and may be useful for early PD diagnosis. The present study aimed to compare the efficacy of EGG in early PD diagnosis with those of I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and odor stick identification test -Japanese version (OSIT-J).
Thirty-seven untreated PD patients (mean age ± SD, 66 ± 8years; disease duration < 3 years) and 20 healthy control subjects (68 ± 6.9 years) were recruited. EGG and OSIT-J were performed in both groups, and MIBG scintigraphy in the PD group. EGG parameters were assessed in the preprandial and early and late postprandial segments using power spectrum analysis.
Irregular EGG waves were observed in PD patients. The preprandial instability coefficient of dominant frequency (ICDF), an index of EGG irregularity, in PD patients (9.5% [6.3%]) was higher than that in controls (3.9% [3.9%], p = 0.00005). The OSIT-J score was also lower in PD patients (4.6 [3.3]) than in controls (7.7 [3.3], p = 0.006). In receiver operating characteristics analyses, the areas under the curves of preprandial ICDF and OSIT-J were 0.83 and 0.72, respectively. The sensitivities of preprandial ICDF and MIBG (delayed-phase) scintigraphy were 73% and 70%, respectively.
Early and untreated PD patients showed irregular EGG waves and high ICDF. EGG showed better accuracy than the olfactory test for early PD diagnosis and similar sensitivity to MIBG scintigraphy.
帕金森病（PD）患者常伴有胃部症状。胃电图（EGG）可无创性评估胃电活动，可能有助于早期 PD 的诊断。本研究旨在比较胃电图在早期 PD 诊断中的作用与 I-间碘苄胍（MIBG）心肌闪烁显像和日本版气味棒识别试验（OSIT-J）的作用。
招募了 37 例未经治疗的 PD 患者（平均年龄±标准差，66±8 岁；病程<3 年）和 20 例健康对照者（68±6.9 岁）。对两组均进行胃电图和 OSIT-J 检查，PD 组进行 MIBG 闪烁显像。使用功率谱分析评估胃电图在餐前、早餐后和晚餐后的参数。
PD 患者出现不规则胃电图波。PD 患者餐前主导频率不稳定性系数（ICDF）（9.5%[6.3%]）高于对照组（3.9%[3.9%]，p=0.00005），这是胃电图不规则的一个指标。PD 患者 OSIT-J 评分（4.6[3.3]）也低于对照组（7.7[3.3]，p=0.006）。在受试者工作特征曲线分析中，餐前 ICDF 和 OSIT-J 的曲线下面积分别为 0.83 和 0.72。餐前 ICDF 和 MIBG（延迟相）闪烁显像的灵敏度分别为 73%和 70%。
未经治疗的早期 PD 患者出现不规则胃电图波和高 ICDF。胃电图在早期 PD 诊断中的准确性优于嗅觉测试，与 MIBG 闪烁显像的灵敏度相当。
