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Research paper
Chronological changes of 123I-MIBG myocardial scintigraphy and clinical features of Parkinson's disease
  1. Koyo Tsujikawa1,
  2. Yasuhiro Hasegawa1,
  3. Satoshi Yokoi2,
  4. Keizo Yasui1,
  5. Ichiro Nanbu3,
  6. Tsutomu Yanagi4,
  7. Akira Takahashi1
  1. 1Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
  2. 2Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  3. 3Department of Radiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
  4. 4Obu Dementia Care Research and Training Center, Aichi, Japan
  1. Correspondence to Dr Yasuhiro Hasegawa, Department of Neurology, Nagoya Daini Red Cross Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya 446-8650 Japan; yhase{at}


Objectives The aim of this study was to investigate chronological changes of 123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy and its relation to clinical features in patients with Parkinson's disease (PD), and to characterise patients with PD with normal or mildly low MIBG uptakes at their early stages.

Methods The participants were 70 patients with PD who underwent 123I-MIBG myocardial scintigraphy twice or more. A cluster analysis was performed using parameters calculated from heart to mediastinum (H/M) ratio and washout ratio (WR).

Results At baseline, the mean early H/M ratio (H/M(E)), delayed H/M ratio (H/M(D)) and WR were 1.83, 1.69 and 41.7%, respectively. After a mean interval of 3.0 years, follow-up studies showed significantly declined H/M(E) (1.69, p<0.001), declined H/M(D) (1.47, p<0.001) and enhanced WR (43.8%, p=0.007). Our longitudinal observations revealed that there existed heterogeneous changes in MIBG uptakes among patients. The cluster analysis classified the patients into two subgroups: 42 patients with markedly low MIBG uptakes at baseline (group A) and 28 patients with normal or mildly low MIBG uptakes at baseline (group B). Group B showed a significantly higher ratio of females, younger age at onset, lower Hoehn and Yahr stage and less demented, compared with group A.

Conclusions Follow-up studies of MIBG divided the patients with PD into two major subgroups. A subgroup of patients with PD with normal or mildly low MIBG uptakes at the early stages of illness was characterised by female-dominant, young onset, slow progression in motor dysfunctions and preserved cognitive function.

Trial registration number 1033.


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