123I-MIBG myocardial scintigraphy for differentiating Parkinson’s disease from other neurodegenerative parkinsonism: A systematic review and meta-analysis

Orimo, Satoshi; Suzuki, Masahiko; Inaba, Akira; Mizusawa, Hidehiro

doi:10.1016/j.parkreldis.2012.01.009

Cited by 221 publications

(161 citation statements)

References 29 publications

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“…There are conflicting reports in the literature concerning the moment in wich PD start changes in 123 I cMIBG 25,26 . These studies, unlike ours, solely considered the H/M r and WR, making no mention about the visual analysis of SPECT planar images.…”

Section: Discussionmentioning

confidence: 99%

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

Leite

Nascimento

Pereira

et al. 2014

Arq. Neuro-Psiquiatr.

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Myocardial scintigraphy with meta-iodo-benzyl-guanidine (123I cMIBG) has been studied in Parkinson's disease (PD), especially in Asian countries, but not in Latin America. Most of these studies include individuals with PD associated to a defined dysautonomia. Our goal is to report the cardiac sympathetic neurotransmission in de novo Brazilian patients with sporadic PD, without clinically defined dysautonomia. We evaluated retrospectively a series of 21 consecutive cases with PD without symptoms or signs of dysautonomia assessed by the standard bedside tests. This number was reduced to 14 with the application of exclusion criteria. 123I cMIBG SPECT up-take was low or absent in all of them and the heart/mediastinum ratio was low in 12 of 14. We concluded that 123I cMIBG has been able to identify cardiac sympathetic neurotransmission disorder in Brazilian de novo PD patients without clinically defined dysautonomia.

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Section: Discussionmentioning

confidence: 99%

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

Leite

Nascimento

Pereira

et al. 2014

Arq. Neuro-Psiquiatr.

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“…Two meta-analyses performed by Treglia [42] and Orimo [43] have calculated the diagnostic performances of mIBG in PD, MSA, PSP, CBD, LBD, also considering technical differences. Analyzing 11 studies published with the aim to distinguish PD from other parkinsonism including MSA, PSP and CBD, Orimo et al [43] have observed a sensitivity ranging from 64.5% to 100% by using delayed H/M ratios, while specificities were between 23.1% and 100.0%. In this meta-analysis, the pooled sensitivity and specificity were respectively 89.7% (95% CI: 81.6%, 94.5%) and 82.6% (95% CI: 60.2%, 93.7%).…”

Section: The Role Of Cardiac Mibg Imaging In Pdmentioning

confidence: 99%

Neurological applications for myocardial MIBG scintigraphy

Cacace²,

Antonio³

et al. 2013

Nucl. Med. Rev.

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Signs or symptoms of impaired autonomic regulation of circulation are typically present in patients affected by Parkinson's disease (PD), in agreement with the cardiac sympathetic denervation discovered by Goldstein more than 15 yrs. ago.In particular, the majority of PD patients have a diffuse left ventricular myocardial sympathetic denervation, being a normal neurological condition present only in a small number of affected subjects. Actually MIBG cardiac imaging is a universally accepted method to estimate cardiac sympathetic innervations. This review covers the role of MIBG cardiac imaging in PD as well as in other parkinsonisms, focusing the attention on technical problems and pathophysiological premises for cardiac denervation. In particular new emerging data support the role of MIBG as biomarker of PD, also before motor symptoms became clinically evident. Therefore the timing of cardiac noradrenergic denervation in PD is a key issue and we want to update the analysis of autonomic cardiovascular abnormalities studied with MIBG in PD and related disorders.

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“…Previous reports revealed that cardiac MIBG is significantly reduced in patients with PD, but cardiac MIBG uptake was within the normal range in patients with essential tremor, drug-induced parkinsonism, vascular parkinsonism, and other 'Parkinson plus' syndromes [2,[4][5][6]. Furthermore, MIBG scintigraphy was reported to be an effective tool for distinguishing early PD without significant autonomic symptoms [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Most previous studies using MIBG scintigraphy were based on the heart-to-mediastinum (H/M) ratio derived from early and delayed planar images [4][5][6][7][8]. However, further evaluation of segmental analysis of cardiac sympathetic denervation could be available using single photon emission computed tomography (SPECT) images.…”

Section: Introductionmentioning

confidence: 99%

The Utility of Segmental Analysis in Cardiac I-123 MIBG SPECT in Parkinson’s Disease

Kwon

Yoon

et al. 2015

Nucl Med Mol Imaging

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Purpose Cardiac images using I-123 metaiodobenzylguanidine (MIBG) are widely used to evaluate cardiac sympathetic denervation in Parkinson's disease (PD). The aim of this study was to evaluate the utility of segmental analysis on cardiac MIBG SPECT in PD patients. Materials and Methods In total, 36 patients with PD (n=26) or essential tremor (ET, n=10) who underwent MIBG cardiac SPECT were enrolled. The heart-to-mediastinum (H/M) ratios of MIBG uptake were acquired on planar images. For the segmental analysis of SPECT images, we evaluated the summed defect score (SDS) using a 17-segment model. The diagnostic abilities of H/M ratios and segmental parameters on MIBG SPECT were assessed by ROC curve analysis.Results The H/M ratios were significantly lower in PD than in ET patients (p<0.05). On segmental analysis, SDS was significantly higher in PD patients than in the ET group (7.04± 4.09 vs. 2.90 ± 2.80; p = 0.006). The defect score of the anteroseptal region showed a significant difference between the groups (p=0.002). The ROC analysis suggested only SDS (AUC=0.785, p=0.0003) and defect scores in the anteroseptal (AUC =0.800, p<0.0001) and inferior (AUC =0.667, p= 0.013) regions showed significant diagnostic ability to differentiate PD from ET. Conclusions Segmental parameters from cardiac MIBG SPECT images can provide additional information to differentiate PD from ET patients. Beyond H/M ratios from planar images, we recommend an MIBG SPECT study to evaluate sympathetic denervation in PD.

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123I-MIBG myocardial scintigraphy for differentiating Parkinson’s disease from other neurodegenerative parkinsonism: A systematic review and meta-analysis

Cited by 221 publications

References 29 publications

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

Neurological applications for myocardial MIBG scintigraphy

The Utility of Segmental Analysis in Cardiac I-123 MIBG SPECT in Parkinson’s Disease

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