MIBG Myocardial Scintigraphy can Predict the Occurrence of Wearing-off Phenomenon in Early-stage Parkinson’s Disease

Miyazaki, Yoshitsugu

doi:10.4172/2329-6895.1000154

Cited by 1 publication

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References 7 publications

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“…In addition, the results of this study also showed that a young onset age of PD was associated with a higher risk for the occurrence of wearing-off. The results of our study are consistent with those of a previous Japanese preliminary study with 23 PD patients, which showed a significant difference in the occurrence of wearing-off between the 2 groups that were divided according to H/M ratio (11). On the basis of the findings from our study and the previous one, impaired 123 I-MIBG uptake in PD patients could be an independent factor that can predict the complication of the wearing-off phenomenon.…”

Section: Discussionsupporting

confidence: 92%

Cardiac Sympathetic Denervation Can Predict the Wearing-off Phenomenon in Patients with Parkinson Disease

et al. 2018

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Recent studies have suggested that preserved cardiac sympathetic denervation may be associated with a small motor burden in Parkinson disease (PD) and serve as a good marker, which is not associated with other nonmotor symptoms. We sought to investigate whether cardiac sympathetic denervation increases the risk of the early wearing-off phenomenon in PD. This hospital-based prospective study enrolled 266 de novo patients with PD who underwentI-metaiodobenzylguanidine (I-MIBG) scintigraphy on initial evaluation. The patients visited the outpatient clinic every 2-6 mo and were followed for a minimum of 18 mo from the time they began taking dopaminergic medication. Each patient was assessed for the wearing-off phenomenon on the basis of the clinical assessments and symptom diaries. Clinical events were analyzed from the date of evaluation by I-MIBG scintigraphy until the date of the first occurrence of the wearing-off phenomenon, or until the last follow-up date without wearing-off. During a mean follow-up period of 30.4 ± 14.8 mo, 71 patients developed wearing-off. The wearing-off phenomenon occurred more in patients with decreased I-MIBG uptake. A Cox regression analysis revealed that both lowI-MIBG uptake and early onset age significantly predicted the development of wearing-off. Our study suggests that a reduction in myocardialI-MIBG uptake in PD patients may be associated with a subsequent increased risk for the wearing-off phenomenon. Findings strongly support that PD patients with normal cardiac sympathetic innervation might have less involvement of the midbrain dopaminergic circuitry and a concomitant reduced risk for motor complications, such as wearing-off.

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Section: Discussionsupporting

confidence: 92%