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

Mol Med Report. 2012 Sep 27. doi: 10.3892/mmr.2012.1104. [Epub ahead of print]

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.

Source

Department of Biopathology and Diagnostic Imaging, University Tor Vergata, Rome, Italy.

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.