Cardiac 123I-MIBG scintigraphy can assess the disease severity and phenotype of PD

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

“…This finding was more marked for the delayed compared to the early images ( Figs. 1 and 2), in agreement with several previous studies (4,7,8,(16)(17)(18)(19)(20). 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).…”

“…By contrast, Suzuki et al did not find such a correlation in their population where 123 I-MIBG myocardial uptake was correlated only with the severity of bradykinesia but not with tremor or rigidity (7). In our study, 123 I-MIBG myocardial uptake was significantly lower in TDT patients when compared to ART patients (P=0.0167), findings that are in contrast with those of other studies (7,8,20). These discrepancies may be due to the different disease duration in these two subgroups.…”

“…This finding is in agreement with other studies that reported a decrease in H/M ratio from early and delayed images in normal subjects (17,27,28). Nevertheless, several studies reported a stability or an increase in the H/M ratio over time (1,20,25). A high interindividual and within-subject variability in 123 I-MIBG uptake has been shown and may explain the differences with the previously mentioned studies (1).…”

“…To the best of our knowledge, only a few studies have evaluated the 123 I-MIBG myocardial uptake in different Parkinson's phenotypes (7,8,20). In their study, Spiegel et al found that myocardial 123 I-MIBG uptake was significantly less impaired in TDT patients than in ART patients at the same stage of the disease (8).…”

“…PD with a phenotype characterized by postural instability gait difficulty, which could correspond to the ART phenotype (20). A significant correlation was found when comparing the early and delayed H/M ratio with the severity of hypokinesia and rigidity, a finding showing that the H/M ratio was negatively associated with the severity of these clinical features (8), whereas no correlations have been found with the severity of the resting tremor (8).…”