MIBG Scintigraphy for Differentiating Parkinson's Disease with Autonomic Dysfunction from Parkinsonism-Predominant Multiple System Atrophy
MIBG Scintigraphy for Differentiating Parkinson's Disease with Autonomic Dysfunction from Parkinsonism-Predominant Multiple System Atrophy
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DOI：
10.1002/mds.22649
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发表时间：
2009-08-15
影响因子：
8.6
通讯作者：
Lee, Gyeong Han
中科院分区：
文献类型：
--
作者：
Chung, Eun Joo;Lee, Won Yon;Lee, Gyeong Han
帕金森病（PD）伴自主神经功能障碍与帕金森病为主的多系统萎缩（MSA-p）很难鉴别。本研究旨在分析MIBG血管造影对伴有自主神经功能障碍和MSA-p的PD患者的有效性。39例患者（PD：27例患者，MSA-p型：12例）和12名年龄匹配的对照者前瞻性入选，并接受MIBG血管造影和自主神经功能测试（AFT）。我们分别计算了早期和延迟的心脏-纵隔（HIM）比值和洗脱率（WR）。AFT包括交感神经皮肤反射和基于心率变异性的副交感神经试验。PD组AFT异常17例（63%），MSA-p组AFT异常10例（83%），PD组与MSA-p组AFT异常比较，早期或迟发HIM比值均无显著性差异（P > 0.05）。只有WR可以区分AFT异常的PD和MSA-p（分别为47.07 ± 57.48和31.39 ± 31.52）（P = 0.026）。根据结果。WR可能比早期和延迟HI M比率更有用，以区分MSA-p与具有异常AFT的PD。此外，MIBG摄取并不反映疾病的持续时间或严重程度。(C)2009运动障碍协会
Parkinson's disease (PD) with autonomic dysfunction is difficult to differentiate from Parkinonism-predominant multiple system atrophy (MSA-p). This study aimed to analyze the validity of MIBG scintigraphy for PD with autonomic dysfunction and MSA-p. Thirty-nine patients (PD: 27 patients, MSA-p type: 12) and 12 age-matched controls were prospectively enrolled and underwent MIBG scintigraphy and autonomic function test (AFT). We separately calculated early and delayed heart-to-mediastinal (HIM) ratio and washout rates (WRs). AFT was composed of sympathetic skin reflex and parasympathetic tests based on heart rate variability. Abnormal AFT was observed in 17 (63%) of PD and 10 (83%) of MSA-p. On comparing PD with abnormal AFT with MSA-p, either the early or delayed HIM ratio in PD was not different from that in MSA-p (P > 0.05). Only the WR could differentiate PD with abnormal AFT from MSA-p (47.07 +/- 57.48 vs. 31.39 +/- 31.52, respectively) (P = 0.026). According to the results. WR may be more useful than the early and delayed HI M ratio to distinguish MSA-p from PD with abnormal AFT. Furthermore, the MlBG uptake did not reflect the disease duration or severity. (C) 2009 Movement Disorder Society