Research Article

MIBG scintigraphy for differentiating Parkinson's disease with autonomic dysfunction from Parkinsonism-predominant multiple system atrophy†

  1. Eun Joo Chung MD, PhD1,
  2. Won Yong Lee MD, PhD2,*,
  3. Won Tae Yoon MD2,
  4. Byeong Joon Kim MD, PhD2,
  5. Gyeong Han Lee MD, PhD3

Article first published online: 9 JUN 2009

DOI: 10.1002/mds.22649

Issue

Movement Disorders

Movement Disorders

Volume 24, Issue 11, pages 1650–1655, 15 August 2009

Additional Information

How to Cite

Chung, E. J., Lee, W. Y., Yoon, W. T., Kim, B. J. and Lee, G. H. (2009), MIBG scintigraphy for differentiating Parkinson's disease with autonomic dysfunction from Parkinsonism-predominant multiple system atrophy. Movement Disorders, 24: 1650–1655. doi: 10.1002/mds.22649

Author Information

  1. 1

    Department of Neurology, Inje University Pusan Baik Hospital, Pusan, Korea

  2. 2

    Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

  3. 3

    Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

*Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-Dong, Gangnam-Gu, Seoul 135-710, Korea

  1. †

    Potential conflict of interest: None reported.

Publication History

  1. Issue published online: 26 AUG 2009
  2. Article first published online: 9 JUN 2009
  3. Manuscript Accepted: 7 APR 2009
  4. Manuscript Revised: 30 MAR 2009
  5. Manuscript Received: 5 DEC 2008

Funded by

  • Samsung Medical Center Clinical Research Development Program. Grant Number: # CRS105-11-1

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Keywords:

  • Parkinson's disease;
  • autonomic dysfunction;
  • multiple system atrophy;
  • MSA-p;
  • autonomic function test;
  • MIBG scintigraphy

Abstract

Parkinson's disease (PD) with autonomic dysfunction is difficult to differentiate from Parkinsonism-predominant multiple system atrophy (MSA-p). This study aimed to analyze the validity of MIBG scintigraphy for PD with autonomic dysfunction and MSA-p. Thirty-nine patients (PD: 27 patients, MSA-p type: 12) and 12 age-matched controls were prospectively enrolled and underwent MIBG scintigraphy and autonomic function test (AFT). We separately calculated early and delayed heart-to-mediastinal (H/M) ratio and washout rates (WRs). AFT was composed of sympathetic skin reflex and parasympathetic tests based on heart rate variability. Abnormal AFT was observed in 17 (63%) of PD and 10 (83%) of MSA-p. On comparing PD with abnormal AFT with MSA-p, either the early or delayed H/M ratio in PD was not different from that in MSA-p (P > 0.05). Only the WR could differentiate PD with abnormal AFT from MSA-p (47.07 ± 57.48 vs. 31.39 ± 31.52, respectively) (P = 0.026). According to the results, WR may be more useful than the early and delayed H/M ratio to distinguish MSA-p from PD with abnormal AFT. Furthermore, the MIBG uptake did not reflect the disease duration or severity. © 2009 Movement Disorder Society

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