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Clinical Manifestations.

Jie Sun1, Qijun Li2, Yanfeng Li3

  • 1Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, Tianjin, China.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
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Summary
This summary is machine-generated.

Iodine-131-meta-iodobenzylguanidine (131I-MIBG) cardiac scintigraphy reveals sympathetic denervation in neurodegenerative diseases. Patients with Parkinson

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Area of Science:

  • Nuclear medicine and neurodegenerative disease research.
  • Cardiovascular autonomic nervous system function assessment.

Background:

  • Iodine-131-meta-iodobenzylguanidine (131I-MIBG) cardiac scintigraphy assesses cardiac sympathetic nervous system function.
  • Reduced myocardial 131I-MIBG uptake is observed in some neurodegenerative conditions.

Purpose of the Study:

  • To compare sympathetic denervation in the myocardium across various neurodegenerative diseases.
  • Investigate differences in cardiac autonomic function in Parkinson's Disease (PD), Parkinson's Disease Dementia (PDD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA), Pure Autonomic Failure (PAF), Progressive Supranuclear Palsy (PSP), and Parkinsonian Syndrome (PDS).

Main Methods:

  • Recruited 222 patients with PD, 37 with PDD, 10 with DLB, 116 with MSA, 14 with PAF, 9 with PSP, and 63 with PDS.
  • Calculated the heart-to-mediastinum ratio (H/M ratio) at 15 minutes and 4 hours post-injection of 131I-MIBG cardiac scintigraphy.
  • Compared H/M ratios among the different neurodegenerative disease groups.

Main Results:

  • Patients with PD, PDD, and DLB showed significantly lower H/M ratios compared to PAF, MSA, PSP, and PDS (p < 0.05).
  • PDD and DLB groups exhibited significantly reduced H/M ratios compared to the PD group (p < 0.05).
  • No significant differences in H/M ratios were found between the PDD and DLB groups.

Conclusions:

  • 131I-MIBG cardiac scintigraphy is valuable for understanding autonomic nervous system involvement in neurodegenerative diseases.
  • PDD and DLB patients demonstrate lower cardiac MIBG uptake than PD patients, suggesting distinct pathological changes.
  • Findings offer novel insights into potential differences in pathology among PD, PDD, and DLB.