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Journal of Neurology Neurosurgery and Psychiatry 2003;74:423-426
© 2003 BMJ Publishing Group


PAPER

Onset age and severity of motor impairment are associated with reduction of myocardial 123I-MIBG uptake in Parkinson’s disease

K Hamada1, M Hirayama1, H Watanabe1, R Kobayashi1, H Ito1, T Ieda2, Y Koike3, G Sobue1

1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
2 Department of Neurology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
3 Department of Medical Technology, Nagoya University School of Health Sciences, Nagoya, Japan

Correspondence to:
Correspondence to:
Dr G Sobue, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan;
sobueg{at}med.nagoya-u.ac.jp

Objectives: To elucidate the factors associated with severity of cardiac sympathetic nerve involvement in idiopathic Parkinson’s disease (PD).

Methods: 123I-metaiodobenzylguanidine uptake was examined in 88 patients with PD. The ratio of the uptake in the heart (H) to that in the mediastinum (M) (the H/M ratio) was calculated and correlated with age at onset, age at examination, and disease severity and duration. Twenty five healthy people were also examined as a control.

Results: There was a mild but significant negative correlation between H/M ratio and age at onset (early, r = -0.33, p = 0.002; delayed, r = -0.34, p = 0.001) and between Hoehn and Yahr (H-Y) stage (early, r = -0.30, p = 0.006; delayed, r = -0.32, p = 0.003). There was no significant correlation between disease duration and H/M ratio. When patients with PD were classified into four subgroups on the basis of age at onset (> 62 or < 62 years) and disease severity (H-Y > III or H-Y <= II), the median H/M ratio of the older and more severe group was significantly lower than that of the younger and less severe group (p = 0.005).

Conclusion: This study suggests that late onset, high severity PD is associated with myocardial sympathetic dysfunction.


Keywords: 123I-metaiodobenzylguanidine; Parkinson’s disease; age; onset

Abbreviations: H-Y, Hoehn and Yahr; MIBG, 123I-metaiodobenzylguanidine; PD, Parkinson’s disease




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