Abhishek Lenka1,2, Guillaume Lamotte2,3, David S Goldstein2. 1. Department of Neurology Medstar Georgetown University Hospital Washington, DC USA. 2. Autonomic Medicine Section, National Institute of Neurological Disorders and Stroke (NINDS) National Institutes of Health (NIH) Bethesda Maryland USA. 3. Department of Neurology Mayo Clinic Rochester Minnesota USA.
Abstract
BACKGROUND: Parkinson's disease with orthostatic hypotension (PD + OH) can be difficult to distinguish clinically from the parkinsonian form of multiple system atrophy (MSA-P). Previous studies examined cardiac sympathetic neuroimaging to differentiate PD from MSA but without focusing specifically on PD + OH versus MSA-P, which often is the relevant differential diagnostic issue. OBJECTIVE: To investigate the utility of cardiac sympathetic neuroimaging by 18F-dopamine positron emission tomographic (PET) scanning for separating PD + OH from MSA-P. METHODS: Cardiac 18F-dopamine PET data were analyzed from 50 PD + OH and 68 MSA-P patients evaluated at the NIH Clinical Center from 1990 to 2020. Noradrenergic deficiency was defined by interventricular septal 18F-dopamine-derived radioactivity <6000 nCi-kg/cc-mCi in the 5' frame with mid-point 8' after initiation of 3' tracer injection. RESULTS: 18F-Dopamine PET separated the PD + OH from the MSA-P group with a sensitivity of 92% and specificity of 96%. CONCLUSION: Cardiac 18F-dopamine PET scanning efficiently distinguishes PD + OH from MSA-P.
BACKGROUND: Parkinson's disease with orthostatic hypotension (PD + OH) can be difficult to distinguish clinically from the parkinsonian form of multiple system atrophy (MSA-P). Previous studies examined cardiac sympathetic neuroimaging to differentiate PD from MSA but without focusing specifically on PD + OH versus MSA-P, which often is the relevant differential diagnostic issue. OBJECTIVE: To investigate the utility of cardiac sympathetic neuroimaging by 18F-dopamine positron emission tomographic (PET) scanning for separating PD + OH from MSA-P. METHODS: Cardiac 18F-dopamine PET data were analyzed from 50 PD + OH and 68 MSA-P patients evaluated at the NIH Clinical Center from 1990 to 2020. Noradrenergic deficiency was defined by interventricular septal 18F-dopamine-derived radioactivity <6000 nCi-kg/cc-mCi in the 5' frame with mid-point 8' after initiation of 3' tracer injection. RESULTS: 18F-Dopamine PET separated the PD + OH from the MSA-P group with a sensitivity of 92% and specificity of 96%. CONCLUSION: Cardiac 18F-dopamine PET scanning efficiently distinguishes PD + OH from MSA-P.
Authors: Sarah H Shahmoradian; Amanda J Lewis; Christel Genoud; Jürgen Hench; Tim E Moors; Paula P Navarro; Daniel Castaño-Díez; Gabriel Schweighauser; Alexandra Graff-Meyer; Kenneth N Goldie; Rosmarie Sütterlin; Evelien Huisman; Angela Ingrassia; Yvonne de Gier; Annemieke J M Rozemuller; Jing Wang; Anne De Paepe; Johannes Erny; Andreas Staempfli; Joerg Hoernschemeyer; Frederik Großerüschkamp; Daniel Niedieker; Samir F El-Mashtoly; Marialuisa Quadri; Wilfred F J Van IJcken; Vincenzo Bonifati; Klaus Gerwert; Bernd Bohrmann; Stephan Frank; Markus Britschgi; Henning Stahlberg; Wilma D J Van de Berg; Matthias E Lauer Journal: Nat Neurosci Date: 2019-06-24 Impact factor: 24.884
Authors: Giorgio Treglia; Ernesto Cason; Antonella Stefanelli; Fabrizio Cocciolillo; Daniela Di Giuda; Giorgio Fagioli; Alessandro Giordano Journal: Clin Auton Res Date: 2011-07-27 Impact factor: 4.435
Authors: I Litvan; C G Goetz; J Jankovic; G K Wenning; V Booth; J J Bartko; A McKee; K Jellinger; E C Lai; J P Brandel; M Verny; K R Chaudhuri; R K Pearce; Y Agid Journal: Arch Neurol Date: 1997-08
Authors: Risa Isonaka; Christopher H Gibbons; Ningshan Wang; Roy Freeman; David S Goldstein Journal: Clin Auton Res Date: 2019-10-31 Impact factor: 4.435