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Follow-up study of cardiac ¹²³I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

T Miyamoto1, M Miyamoto, M Iwanami

  • 1Department of Neurology, Center of Sleep Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan. sandra.olsson@neuro.gu.se

European Journal of Neurology
|September 15, 2011
PubMed
Abstract

Insights

Cardiac (123) I-metaiodobenzylguanidine ((123) I-MIBG) uptake is reduced in idiopathic REM sleep behavior disorder (iRBD) and Parkinson's disease (PD). Follow-up imaging suggests heterogeneous progression of this cardiac sympathetic denervation in both conditions.

Area of Science:

  • Neurology
  • Cardiology
  • Nuclear Medicine

Background:

  • Cardiac (123) I-metaiodobenzylguanidine ((123) I-MIBG) uptake is reduced in idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD), similar to Parkinson's disease (PD).
  • This reduction suggests impaired cardiac sympathetic denervation in these neurodegenerative conditions.

Purpose of the Study:

  • To evaluate the longitudinal changes in cardiac (123) I-MIBG uptake in patients with iRBD and PD.
  • To assess the progression of cardiac sympathetic denervation over time in these patient groups.

Main Methods:

  • (123) I-MIBG scintigraphy was performed on patients diagnosed with iRBD and PD.
  • Subjects underwent repeat imaging after a mean follow-up period of 2.8 years to assess changes in the heart-to-mediastinum (H/M) ratio.

Main Results:

  • The delayed heart-to-mediastinum (H/M) ratio did not show a statistically significant reduction between the initial and follow-up studies in either iRBD or PD groups (P = 0.050 and P = 0.091, respectively).
  • A mean decline in the delayed H/M ratio was observed: 4.21 ± 9.06% in iRBD and 6.40 ± 19.02% in PD.

Conclusions:

  • Cardiac (123) I-MIBG uptake findings may indicate early progression in iRBD and PD.
  • The progression of cardiac sympathetic denervation appears heterogeneous and is independent of motor symptom development.

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