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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
10:28

Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

Published on: July 24, 2019

Relationship between (123)I-MIBG scintigrams and REM sleep behavior disorder in Parkinson's disease

Takashi Nomura1, Yuichi Inoue, Birgit Högl

  • 1Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan. ntnomura@med.tottori-u.ac.jp

Parkinsonism & Related Disorders
|September 18, 2010
PubMed
Abstract

Insights

Patients with Parkinson's disease (PD) and REM sleep behavior disorder (RBD) show reduced cardiac MIBG uptake, indicating accelerated autonomic dysfunction. This suggests a broader alpha-synuclein pathology in PD patients with RBD.

Area of Science:

  • Neurology
  • Cardiology
  • Sleep Medicine

Background:

  • Reduced cardiac uptake of 123I-labeled meta-iodobenzylguanidine (MIBG) is observed in idiopathic REM sleep behavior disorder (RBD) and Parkinson's disease (PD).
  • Autonomic dysfunction is a common feature in PD, and its progression may be influenced by comorbid RBD.

Purpose of the Study:

  • To investigate the association between MIBG scintigraphic findings and RBD severity in non-dementia PD patients.
  • To determine if RBD accelerates autonomic dysfunction in Parkinson's disease.

Main Methods:

  • Clinical interviews and polysomnograms (PSG) were used to assess RBD symptoms in 49 PD patients.
  • MIBG scintigraphy was performed to evaluate cardiac sympathetic nerve function.
  • Patients were categorized into three groups: PD with clinical RBD, PD with subclinical RBD, and PD with normal REM sleep.

Main Results:

  • PD patients with clinical RBD exhibited significantly lower MIBG uptake (heart-to-mediastinum ratio) compared to those with subclinical RBD or normal REM sleep.
  • Multiple linear regression analysis confirmed that RBD symptoms were the sole significant predictor of reduced MIBG uptake in PD patients without dementia, after adjusting for covariates.
  • These findings highlight a correlation between RBD and impaired cardiac sympathetic innervation in PD.

Conclusions:

  • Clinical RBD in PD patients is associated with reduced cardiac sympathetic ganglia function, as indicated by lower MIBG uptake.
  • This suggests that RBD may be linked to a more widespread alpha-synuclein pathology in Parkinson's disease.
  • Early identification of RBD in PD patients could aid in predicting autonomic dysfunction progression.

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