Ebina Junya, Mizumura Sunao, Shibukawa Mari, Morioka Harumi, Nagasawa Junpei, Yanagihashi Masaru, Hirayama Takehisa, Ishii Nobutomo, Kobayashi Yukio, Inaba Akira, Orimo Satoshi, Kano Osamu
Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan.
Department of Radiology, Toho University Faculty of Medicine, Tokyo, Japan.
Clin Park Relat Disord. 2024 Nov 20;11:100287. doi: 10.1016/j.prdoa.2024.100287. eCollection 2024.
Cardiac sympathetic denervation is specific to Lewy body disease (LBD). In Parkinson's disease (PD), sympathetic denervation in the major salivary glands (parotid glands [PG] and submandibular glands [SMG]) has been demonstrated by I-metaiodobenzylguanidine (MIBG) scintigraphy. We compared sympathetic denervation in the MSG between PD, dementia with Lewy bodies (DLB), and progressive supranuclear palsy (PSP).
We recruited 81 patients with PD, 12 with DLB, 13 with PSP and 25 with control subjects. We evaluated MIBG uptake in the major salivary glands and heart using a quantitative semi-automatic method. We compared MIBG uptake between PD, DLB, and PSP patients and controls, and we evaluated disease sensitivity and specificity. We compared olfactory function with MIBG uptake between PD and PSP patients.
MIBG uptake in the PG and SMG in the delayed phase was significantly lower in PD and DLB patients than in PSP patients and controls. Conversely, MIBG uptake in the major salivary glands and heart was comparable between PD and DLB. Between LBD and non-LBD, MIBG uptake showed 56-100 % specificity in the PG, while it had 55.6-87.5 % sensitivity in the SMG. Between PD and PSP, MIBG uptake in the PG and SMG had higher disease specificity than olfactory function, while the sensitivity of SMG MIBG uptake was comparable to olfactory function.
PD and DLB patients showed lower MIBG uptake in the major salivary glands than PSP patients, especially in the delayed phase. MIBG uptake in the major salivary glands may differentiate PD from hyposmic PSP.
心脏交感神经去神经支配是路易体病（LBD）所特有的。在帕金森病（PD）中，1-间碘苄胍（MIBG）闪烁扫描已证实主要唾液腺（腮腺[PG]和颌下腺[SMG]）存在交感神经去神经支配。我们比较了PD、路易体痴呆（DLB）和进行性核上性麻痹（PSP）患者唾液腺中的交感神经去神经支配情况。
我们招募了81例PD患者、12例DLB患者、13例PSP患者以及25例对照者。我们采用定量半自动方法评估主要唾液腺和心脏的MIBG摄取情况。我们比较了PD、DLB和PSP患者与对照者之间的MIBG摄取情况，并评估了疾病的敏感性和特异性。我们比较了PD和PSP患者的嗅觉功能与MIBG摄取情况。
PD和DLB患者延迟期PG和SMG的MIBG摄取显著低于PSP患者和对照者。相反，PD和DLB患者主要唾液腺和心脏的MIBG摄取情况相当。在LBD和非LBD之间，PG中MIBG摄取的特异性为56%-100%，而SMG中的敏感性为55.6%-87.5%。在PD和PSP之间，PG和SMG中MIBG摄取的疾病特异性高于嗅觉功能，而SMG中MIBG摄取的敏感性与嗅觉功能相当。
PD和DLB患者主要唾液腺的MIBG摄取低于PSP患者，尤其是在延迟期。主要唾液腺的MIBG摄取可能有助于区分PD和嗅觉减退的PSP。
