Iñigo Gabilondo1,2, Verónica Llorens3,4, Trinidad Rodriguez4, Manuel Fernández3,5,6, Tomas Pérez Concha5, Marian Acera3, Beatriz Tijero3,5, Ane Murueta-Goyena3, Rocío Del Pino3, Jesús Cortés7,8,9, Juan Carlos Gómez-Esteban3,5,6. 1. Neurodegenerative Diseases Group, Biocruces-Bizkaia Health Research Institute, Plaza de Cruces 12, CP 48903, Barakaldo, Bizkaia, Spain. igabilon@gmail.com. 2. Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain. igabilon@gmail.com. 3. Neurodegenerative Diseases Group, Biocruces-Bizkaia Health Research Institute, Plaza de Cruces 12, CP 48903, Barakaldo, Bizkaia, Spain. 4. Nuclear Medicine Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain. 5. Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain. 6. Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain. 7. Computational Neuroimaging Group, Biocruces-Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain. 8. Ikerbasque: The Basque Foundation for Science, Bilbao, Spain. 9. Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain.
Abstract
PURPOSE: To identify myocardial sympathetic denervation patterns suggestive of Lewy body (LB) pathology in patients with genetic and idiopathic parkinsonisms by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. METHODS: We retrospectively analysed myocardial MIBG images acquired with a dual-head gamma camera and low-energy high-resolution collimator (LEHR) in 194 patients with suspected synucleinopathy or atypical parkinsonism, including 34 with genetic Parkinson's disease (PD; 4 PARK1, 8 PARK2 and 22 PARK8), 85 with idiopathic PD (iPD), 6 with idiopathic REM sleep behaviour disorder (iRBD), 17 with dementia with LB (DLB), 40 with multiple system atrophy (MSA) and 12 with progressive supranuclear palsy (PSP), and in 45 healthy controls. We calculated heart-to-mediastinum MIBG uptake ratios (HMR) at 15 min and 4 h (HMR4H) for the LEHR and standardized medium-energy collimators, to obtain classification accuracies and optimal cut-off values for HMR using supervised classification and ROC analyses. RESULTS: While patients with LB disorders had markedly lower HMR4HLEHR than controls (controls 1.86 ± 0.26, iPD 1.38 ± 0.29, iRBD 1.23 ± 0.09, PARK1 1.20 ± 0.09, DLB 1.17 ± 0.11; p < 0.05), for the remaining patient categories differences were smaller (PARK8 1.51 ± 0.32; p < 0.05) or not significant (MSA 1.82 ± 0.37, PSP 1.59 ± 0.23, PARK2 1.51 ± 0.30; p > 0.05). The diagnostic accuracy of HMR4HLEHR was highest in patients with LB disorders (PARK1, iPD, DLB, iRBD; 89% to 97%) and lowest in those with PARK2, PARK8, PSP and MSA (65% to 76%), with an optimal HMR4HLEHR cut-off value of 1.72 for discriminating most patients with LB disorders including iPD and 1.40 for discriminating those with aggressive LB spectrum phenotypes (DLB, PARK1 and iRBD). CONCLUSION: Our study including patients with a wide spectrum of genetic and idiopathic parkinsonisms with different degrees of LB pathology further supports myocardial MIBG scintigraphy as an accurate tool for discriminating patients with LB spectrum disorders.
PURPOSE: To identify myocardial sympathetic denervation patterns suggestive of Lewy body (LB) pathology in patients with genetic and idiopathic parkinsonisms by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. METHODS: We retrospectively analysed myocardial MIBG images acquired with a dual-head gamma camera and low-energy high-resolution collimator (LEHR) in 194 patients with suspected synucleinopathy or atypical parkinsonism, including 34 with genetic Parkinson's disease (PD; 4 PARK1, 8 PARK2 and 22 PARK8), 85 with idiopathic PD (iPD), 6 with idiopathic REM sleep behaviour disorder (iRBD), 17 with dementia with LB (DLB), 40 with multiple system atrophy (MSA) and 12 with progressive supranuclear palsy (PSP), and in 45 healthy controls. We calculated heart-to-mediastinum MIBG uptake ratios (HMR) at 15 min and 4 h (HMR4H) for the LEHR and standardized medium-energy collimators, to obtain classification accuracies and optimal cut-off values for HMR using supervised classification and ROC analyses. RESULTS: While patients with LB disorders had markedly lower HMR4HLEHR than controls (controls 1.86 ± 0.26, iPD 1.38 ± 0.29, iRBD 1.23 ± 0.09, PARK1 1.20 ± 0.09, DLB 1.17 ± 0.11; p < 0.05), for the remaining patient categories differences were smaller (PARK8 1.51 ± 0.32; p < 0.05) or not significant (MSA 1.82 ± 0.37, PSP 1.59 ± 0.23, PARK2 1.51 ± 0.30; p > 0.05). The diagnostic accuracy of HMR4HLEHR was highest in patients with LB disorders (PARK1, iPD, DLB, iRBD; 89% to 97%) and lowest in those with PARK2, PARK8, PSP and MSA (65% to 76%), with an optimal HMR4HLEHR cut-off value of 1.72 for discriminating most patients with LB disorders including iPD and 1.40 for discriminating those with aggressive LB spectrum phenotypes (DLB, PARK1 and iRBD). CONCLUSION: Our study including patients with a wide spectrum of genetic and idiopathic parkinsonisms with different degrees of LB pathology further supports myocardial MIBG scintigraphy as an accurate tool for discriminating patients with LB spectrum disorders.
Authors: Amanda Singleton; Katrina Gwinn-Hardy; Yehonotan Sharabi; Sheng-Ting Li; Courtney Holmes; Raghuveer Dendi; John Hardy; Andrew Singleton; Anthony Crawley; David S Goldstein Journal: Brain Date: 2004-01-21 Impact factor: 13.501
Authors: Beatriz Tijero; Juan Carlos Gómez-Esteban; Elena Lezcano; Carmen Fernández-González; Johanne Somme; Verónica Llorens; Ana Martínez; Javier Ruiz-Martínez; Nerea Foncea; Inés Escalza; Koldo Berganzo; M A Aniel-Quiroga; Verónica Ruiz; Nuria Terán; Horacio Kaufmann; Juan Jose Zarranz Journal: Parkinsonism Relat Disord Date: 2012-09-19 Impact factor: 4.891
Authors: Juan J Zarranz; Javier Alegre; Juan C Gómez-Esteban; Elena Lezcano; Raquel Ros; Israel Ampuero; Lídice Vidal; Janet Hoenicka; Olga Rodriguez; Begoña Atarés; Verónica Llorens; Estrella Gomez Tortosa; Teodoro del Ser; David G Muñoz; Justo G de Yebenes Journal: Ann Neurol Date: 2004-02 Impact factor: 10.422