Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson's disease: Molecular imaging with 123I-MIBG

Chiaravalloti,A.; Stefani,A.; Tavolozza,M.; Pierantozzi,M.; Di Biagio,D.; Olivola,E.; Di Pietro,B.; Stampanoni,M.; Danieli,R.; Simonetti,G.; Stanzione,P.; Schillaci,O.

doi:10.3892/mmr.2012.1104

Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson's disease: Molecular imaging with 123I-MIBG

Authors:
- A. Chiaravalloti
- A. Stefani
- M. Tavolozza
- M. Pierantozzi
- D. Di Biagio
- E. Olivola
- B. Di Pietro
- M. Stampanoni
- R. Danieli
- G. Simonetti
- P. Stanzione
- O. Schillaci
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Affiliations: Department of Biopathology and Diagnostic Imaging, University Tor Vergata, Rome, Italy, Department of Neurological Sciences, University Tor Vergata, Rome, Italy, IRCCS Fondazione S. Lucia, Rome, Italy
Published online on: September 27, 2012 https://doi.org/10.3892/mmr.2012.1104
Pages: 1337-1342

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Abstract

The aim of this study was to evaluate the correlation between the clinical motor phenotypes of Parkinson's disease (PD) and 123I-MIBG myocardial uptake. In total, 53 patients with PD [31 males and 22 females, mean age 62±10 years; 19 Hoehn & Yahr (H&Y) stage 1, 9 stage 1.5, 15 stage 2 and 10 at stage 3] were examined and subdivided into different clinical forms on the basis of dominance of resting tremor (n=19, TDT) and bradykinesia plus rigidity (n=34, ART). This status was correlated with the semi-quantitative analysis of 123I-MIBG myocardial uptake. An age-matched control group of 18 patients was recruited (8 males and 10 females, mean age 62.4±16.3 years). 123I-MIBG myocardial uptake significantly correlated with disease duration in early (r2=0.1894; P=0.0028) and delayed images (r2=0.1795; P=0.0037) in PD patients, while no correlation was found when considering age at examination, UPDRS III motor examination section score and H&Y score. PD patients showed a reduced 123I‑MIBG myocardial uptake compared to the control group in early (P=0.0026) and delayed images (P=0.0040), and 123I-MIBG myocardial uptake was significantly lower in delayed images in TDT patients compared with ART patients (P=0.0167). A decrease was detected in the heart-to-mediastinum (H/M) ratio in delayed images compared to that of the early images in TDT patients (P=0.0040) and in the whole PD population (P=0.0012), while no differences were found in ART patients (P=0.1043). The results of the present study revealed that the cardiac sympathetic system is more severely impaired in TDT than in ART patients and 123I-MIBG molecular imaging has the potential help in improving therapeutic planning in these patients.

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