Shafie Mahan, Mayeli Mahsa, Saeidi Samira, Mirsepassi Zahra, Abbasi Mehrshad, Shafeghat Melika, Aghamollaii Vajiheh
School of Medicine, Tehran University of Medical Sciences.
NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences.
Clin Park Relat Disord. 2022 Jan 7;6:100130. doi: 10.1016/j.prdoa.2022.100130. eCollection 2022.
Considering the difficulties of differentiating Parkinson's disease (PD) from drug-induced Parkinsonism (DIP) in patients receiving antipsychotics, developing robust diagnostic tools is essential. Herein, we used the metaiodobenzylguanidine (MIBG) scan to assess its diagnostic accuracy for this purpose.
44 DIP patients and 32 patients with PD as controls were enrolled. All the participants underwent a cardiac I-MIBG scan. Statistical analysis was conducted to determine the significance of the results, and accuracy analyses were conducted to calculate the related sensitivity and specificity of the MIBG scan.
The mean age of PD and DIP groups were 62.6 ± 5.9 and 51.5 ± 10.8 years, respectively. The mean duration of drug consumption in the DIP group was 52.2 ± 29.4 days (the mean interval between drug initiation and DIP onset was 28.5 ± 20.5). Symptoms relief occurred 40 ± 24.2 days after drug discontinuation. In the PD group, 15.6% showed negative and 84.4% positive results on the MIBG scan. In the DIP group, 86.4% were negative, and the remaining were positive. The difference in MIBG uptake between the two groups was statistically significant (P-value < 0.001). The sensitivity and specificity of the MIBG scan were 84.4% (CI: 84.0-84.8) and 86.36% (CI: 86.0-86.7) for the diagnosis of PD, respectively.
Our results indicated more positive MIBG scans in the PD group than the DIP. Also, the MIBG scan's sensitivity and specificity in differentiating the PD are acceptable. Future works should assess these findings and the role of the MIBG scan in prognosis assessment of DIP and better allocation of the patients to related disciplines.
鉴于在接受抗精神病药物治疗的患者中区分帕金森病（PD）和药物性帕金森综合征（DIP）存在困难，开发可靠的诊断工具至关重要。在此，我们使用间碘苄胍（MIBG）扫描来评估其在这方面的诊断准确性。
纳入44例DIP患者和32例PD患者作为对照。所有参与者均接受了心脏I-MIBG扫描。进行统计分析以确定结果的显著性，并进行准确性分析以计算MIBG扫描的相关敏感性和特异性。
PD组和DIP组的平均年龄分别为62.6±5.9岁和51.5±10.8岁。DIP组的平均用药时间为52.2±29.4天（用药开始至DIP发病的平均间隔为28.5±20.5天）。停药后40±24.2天症状缓解。在PD组中，15.6%的患者MIBG扫描结果为阴性，84.4%为阳性。在DIP组中，86.4%为阴性，其余为阳性。两组之间MIBG摄取的差异具有统计学意义（P值<0.001）。MIBG扫描诊断PD的敏感性和特异性分别为84.4%（CI：84.0 - 84.8）和86.36%（CI：86.0 - 86.7）。
我们的结果表明，PD组的MIBG扫描阳性结果多于DIP组。此外，MIBG扫描在区分PD方面的敏感性和特异性是可以接受的。未来的工作应评估这些发现以及MIBG扫描在DIP预后评估中的作用，以及更好地将患者分配到相关学科。
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