The potential role of the cardiac MIBG scan in differentiating the drug-induced Parkinsonism from Parkinson’s disease

Shafie, Mahan; Mayeli, Mahsa; Saeidi, Sara; Mirsepassi, Zahra; Abbasi, Mehrshad; Shafeghat, Melika; Aghamollaii, Vajiheh

doi:10.1016/j.prdoa.2022.100130

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…Moreover, Shafie et al reported that [123I]-MIBG scans could be used to determine the prognosis of people with parkinsonism secondary to drugs. The subjects with drug-induced parkinsonism that did not improve motor symptoms after offending drug discontinuation had a low heart-to-mediastinum ratio [95].…”

Section: [123i]-mibg Cardiac Imagingmentioning

confidence: 96%

Neuroimaging Techniques in Differentiating Parkinson’s Disease from Drug-Induced Parkinsonism: A Comprehensive Review

Pitton Rissardo,

Caprara

2023

Clinics and Practice

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Neuroimaging can provide significant benefits in evaluating patients with movement disorders associated with drugs. This literature review describes neuroimaging techniques performed to distinguish Parkinson’s disease from drug-induced parkinsonism. The dopaminergic radiotracers already reported to assess patients with drug-induced parkinsonism are [123I]-FP-CIT, [123I]-β-CIT, [99mTc]-TRODAT-1, [18F]-DOPA, [18F]-AV-133, and [18F]-FP-CIT. The most studied one and the one with the highest number of publications is [123I]-FP-CIT. Fludeoxyglucose (18F) revealed a specific pattern that could predict individuals susceptible to developing drug-induced parkinsonism. Another scintigraphy method is [123I]-MIBG cardiac imaging, in which a relationship between abnormal cardiac imaging and normal dopamine transporter imaging was associated with a progression to degenerative disease in individuals with drug-induced parkinsonism. Structural brain magnetic resonance imaging can be used to assess the striatal region. A transcranial ultrasound is a non-invasive method with significant benefits regarding costs and availability. Optic coherence tomography only showed abnormalities in the late phase of Parkinson’s disease, so no benefit in distinguishing early-phase Parkinson’s disease and drug-induced parkinsonism was found. Most methods demonstrated a high specificity in differentiating degenerative from non-degenerative conditions, but the sensitivity widely varied in the studies. An algorithm was designed based on clinical manifestations, neuroimaging, and drug dose adjustment to assist in the management of patients with drug-induced parkinsonism.

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Section: [123i]-mibg Cardiac Imagingmentioning

confidence: 96%

Neuroimaging Techniques in Differentiating Parkinson’s Disease from Drug-Induced Parkinsonism: A Comprehensive Review

Pitton Rissardo,

Caprara

2023

Clinics and Practice

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“… 2 This pathophysiology clinically manifests through common motor symptoms, including resting tremor, bradykinesia, gait difficulties, muscle rigidity, and postural instability, which interferes with activities of daily living. 3 , 4 Although PD is mainly known by motor symptoms, many nonmotor symptoms (NMS) are proposed to be associated with PD. Importantly, motor symptoms are usually associated with the advanced disease, while NMS could be utilized as early biomarkers of the disease even before the diagnosis of PD.…”

Section: Introductionmentioning

confidence: 99%

“…As one of the most common progressive neurodegenerative disorders worldwide, mainly among the elderly population, Parkinson's disease (PD) is characterized by piecemeal loss and death of the substantia nigra pars compacta neurons and aggregation of the α‐synuclein (α‐syn) protein in the central nervous system 2 . This pathophysiology clinically manifests through common motor symptoms, including resting tremor, bradykinesia, gait difficulties, muscle rigidity, and postural instability, which interferes with activities of daily living 3,4 . Although PD is mainly known by motor symptoms, many nonmotor symptoms (NMS) are proposed to be associated with PD.…”

Section: Introductionmentioning

confidence: 99%

Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis

Mayeli,

Shafie,

Shiravi

et al. 2024

Health Science Reports

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Background and aimsThe nonmotor symptoms (NMS) of Parkinson's disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and NMS of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension.MethodsA total of 93 PD patients with depression and 67 PD patients without depression were included in the study, and NMS were compared between the two groups. Furthermore, the possible associations between depression severity measured by Beck Depression Inventory (BDI) and NMS were investigated using linear regression or binary logistic regression models controlled for possible confounders. Eventually, we performed a subgroup analysis in each mild, moderate, and severe depression group.ResultsOrthostatic hypotension, constipation, and hyposexuality showed a significant difference between PD patients with and without depression (p < 0.001, p = 0.029, and p < 0.001, respectively). The BDI score was significantly associated with hyposexuality, Montreal cognitive assessment (MoCA), and Pittsburgh Sleep Quality (p = 0.016, p = 0.010, and p = 0.011, respectively); however, after adjustments for possible confounders, the associations of the BDI score with the MoCA score and hyposexuality remained significant (p = 0.015 and p = 0.019, respectively). Considering subgroup analysis, a similar pattern of significant results was observed particularly in the severe group.ConclusionsThis study suggests a possible association between depression in PD patients and some NMS observed in the course of PD. These findings could be beneficial for early diagnosis of the disease, which eventually could make a considerable difference in the management of PD patients. Additional interventional longitudinal studies are warranted to explore how controlling depression could impact the NMS of patients with PD.

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“…As one of the most common progressive neurodegenerative disorders worldwide, chie y among the elderly population, Parkinson's disease (PD) is characterized by piecemeal loss and death of the substantia nigra pars compacta neurons and aggregation of the alpha-synuclein protein (α-syn) in the central nervous system (2,3). This pathophysiology clinically manifests through common motor symptoms, including resting tremor, bradykinesia, gait di culties, muscle rigidity, and postural instability, which interferes with activities of daily living (4). However, although PD is mainly known by motor symptoms, many non-motor symptoms (NMS), ranging from sensory abnormalities, cognitive impairment, sleep disturbances (insomnia, REM sleep behavior disorder (RBD), Excessive daytime sleepiness, painful dystonia), autonomic dysfunction (orthostatic hypotension, obstipation), psychosis are proposed to be correlated with PD (4).…”

Section: Introductionmentioning

confidence: 99%

“…This pathophysiology clinically manifests through common motor symptoms, including resting tremor, bradykinesia, gait di culties, muscle rigidity, and postural instability, which interferes with activities of daily living (4). However, although PD is mainly known by motor symptoms, many non-motor symptoms (NMS), ranging from sensory abnormalities, cognitive impairment, sleep disturbances (insomnia, REM sleep behavior disorder (RBD), Excessive daytime sleepiness, painful dystonia), autonomic dysfunction (orthostatic hypotension, obstipation), psychosis are proposed to be correlated with PD (4).…”

Section: Introductionmentioning

confidence: 99%

Depression links with the non-motor symptoms of Parkinson’s disease

Mayeli

Shafie

Shiravi

et al. 2022

Preprint

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Background: The non-motor symptoms (NMS) of Parkinson’s disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and non-motor symptoms of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension. Methods: After obtaining written informed consent, the diagnosis was confirmed using the criteria developed by the United Kingdom PD Society Brain Bank for the clinical diagnosis of PD. The stage and the severity of the disease were determined using the UPDRS and Hoehn & Yahr criteria. Demographics as well as the family history, habitual history, and past medical history data were obtained. Depression was determined through a psychiatric consultation based on DSMV criteria and Beck Depression Inventory (BDI). Sleep quality was assessed using the Pittsburgh Sleep Quality (PSQ), and Epworth and REM Sleep Behavior Disorder Sleep Questionnaire (RBDSQ) was applied to investigate daytime sleepiness and REM sleep disorders, respectively. Cognitive disorders were also investigated using Montreal cognitive assessment (MoCA).Results: 93 patients were enrolled. The BDI score was significantly correlated with hyposexuality, MoCA scores, and PSQ scores. Depression was significantly more severe in those with hyposexuality (p-value = 0.018). After adjustments, a significant association existed between the BDI score and the MoCA score and hyposexuality.Conclusions: Besides the known correlations of depression with cognitive decline in PD, depression is also significantly associated with hyposexuality in these patients. The etiological underpinnings of these associations are to be explored in the future.

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The potential role of the cardiac MIBG scan in differentiating the drug-induced Parkinsonism from Parkinson’s disease

Cited by 5 publications

References 23 publications

Neuroimaging Techniques in Differentiating Parkinson’s Disease from Drug-Induced Parkinsonism: A Comprehensive Review

Neuroimaging Techniques in Differentiating Parkinson’s Disease from Drug-Induced Parkinsonism: A Comprehensive Review

Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis

Depression links with the non-motor symptoms of Parkinson’s disease

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