A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

“…In keeping with our results, a cardiac sympathetic denervation has already been hypothesized in patients with severe orthostatic hypotension by means of MIBG myocardial scintigraphy 17 and on the basis of a reduced LF component in the power spectrum of RR variability both on short 16 and 24-hour periods. 34 Finally, immunohistochemical staining of postmortem specimens of cardiac tissue showed a decreased number of sympathetic axons innervating the left anterior ventricular wall of the heart of 4 patients suffering from Parkinson's disease.…”

“…16 Reduced uptake of meta-([123]I)iodobenzylguanedine (MIBG), suggestive of partial cardiac sympathetic denervation, has been observed in patients with Parkinson's disease by means of MIBG myocardial scintigraphy. 17 In a study based on cardiac norepinephrine spillover and positron emission tomography scan using radiolabeled interventricular fluorodopamine, a selective cardiac sympathetic denervation has also been described. 18 To the best of our knowledge, only 1 study has simultaneously described the alterations of cardiac and vascular autonomic control in patients with Parkinson's disease and orthostatic hypotension.…”

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

“…The use of 123 I-MIBG has been suggested as a useful marker in the diagnosis of PD (19) and as a sensitive tool in the early detection of silent autonomic dysfunction (18). Being an analogue of noradrenaline (8), 123 I-MIBG uptake reflects presynaptic sympathetic integrity, while a reduced myocardial uptake of this tracer is consistent with cardiac sympathetic dysfunction or denervation (21). Nevertheless, Matsui et al demonstrated that there were no significant correlations between orthostatic hypotension or constipation and cardiac 123 I-MIBG uptake, indicating that not all components of the autonomic nervous system are uniformly affected in PD (19).…”

Differential Recovery in Cardiac and Vasomotor Sympathetic Functional Markers in a Patient with Acute Autonomic Sensory and Motor Neuropathy

“…In this case, the autonomic failure was caused by injury to the postganglionic neurons. The results of a noradrenaline infusion test and 123 I-MIBG myocardial scintigraphy established the existence of postganglionic sympathetic nerve injuries (7,8,11). A noradrenaline infusion test indicated the presence of denervation hypersensitivity and vasomotor sympathetic dysfunction (11), while the 123 I-MIBG myocardial scintigraphy abnormalities indicated the presence of cardiac sympathetic dysfunction (7,8).…”

“…Although the degree, timing and prognosis of sensory and motor deficits were variable in these reported cases, severe autonomic failure affecting both the sympathetic and parasympathetic functions in the initial phase of the disease was the common feature in these patients. 123 I-meta-iodobenzylguanidine ( 123 I-MIBG) myocardial scintigraphy has been used to examine the function of cardiac sympathetic nerves, particularly the postganglionic fibers (7,8). The beneficial aspects and therapeutic efficacy of 123 I-MIBG myocardial scintigraphy in assessing sympathetic dysfunction have not been described in patients with this type of neuropathy.…”