Skip to main content

Advertisement

SpringerLink
Log in

The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes

  • Review Article
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

Scintigraphy with radiolabeled metaiodobenzylguanidine (MIBG) enables the visualization and quantification of functionally intact adrenergic neurons and cells. In Parkinson disease, MIBG uptake of postganglionic cardiac sympathetic neurons is grossly reduced at an early stage of the disease in almost all patients with a clinical severity score of Hoehn and Yahr II or higher. Based on the meta-analysis of studies with a total of 246 cases of Parkinson disease and 45 cases of multiple system atrophy, the overall sensitivity to positively identify patients with Parkinson disease was 89.7%, and the specificity to discriminate them from patients with multiple system atrophy was 94.6%. Quantification of cardiac MIBG uptake is a valuable tool to identify patients with Parkinson disaase and to discriminate them from other neurodegenerative disorders early in the course of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wieland DM, Brown LE, Tobes MC. Imaging the primate adrenal medulla with 1231 and 1311 meta-iodobenzylguanidine.J Nucl Med 1981; 22:358–364.

    Google Scholar 

  2. Solanki KK, Bomanji J, Moyes J, et al. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG).Nucl Med Commun 1992; 13:513–521.

    Google Scholar 

  3. Wafelman AR, Hoefnagel CA, Maes RA, et al. Radioiodinated metaiodobenzylguanidine: a review of its biodistribution and pharmacokinetics, drug interactions, cytotoxicity and dosimetry.Eur J Nucl Med 1994; 21:545–559.

    Google Scholar 

  4. Glowniak JV, Kilty JE, Amara SG, et al. Evaluation of metaiodobenzylguanidine uptake by the norepinephrine, dopamine and serotonin transporters.J Nucl Med 1993; 34:114–116.

    Google Scholar 

  5. Jaques S, Tobes MC, Sisson JC. Sodium dependency of uptake of norepinephrine andm-iodobenzylquanidine into cultured human pheochromocytoma cells: evidence of uptake-one.Cancer Res 1987; 47:3920–3928.

    Google Scholar 

  6. Wieland DM, Mangner TJ, Inbasekaran MN, et al. Adrenal medulla imaging agents: a structure-distribution relationship study of radiolabeled aralkylguanidines.J Med Chem 1984; 27:149–155.

    Google Scholar 

  7. Gasnier B, Roisin MP, Scherman D, et al. Uptake of metaiodobenzylguanidine by bovine chromaffin granule membranes.Mol Pharmacol 1986; 29:275–280.

    Google Scholar 

  8. Sisson JC, Wieland DM, Sherman P, et al. Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function.J Nucl Med 1987; 28:1620–1624.

    Google Scholar 

  9. Sisson JC, Shapiro B, Meyers L, et al. Metaiodobenzylguanidine to map scintigraphically the adrenergic nervous system in man.J Nucl Med 1987; 28:1625–1636.

    Google Scholar 

  10. Jaques S, Tobes MC. Comparison of the secretory mechanisms of meta-iodobenzylguanidine (MIBG) and norepinephrine (NE) from the cultured bovine adrenomedullary cells [abstract].J Nucl Med 1985; 26:17.

    Google Scholar 

  11. Sisson JC, Lynch JJ, Johnson J, et al. Scintigraphic detection of regional disruption of adrenergic neurons in the heart.Am Heart J 1988; 116:67–76.

    Google Scholar 

  12. Dae MW, O'Connell JW, Botvinick EH, et al. Scintigraphic assessment of regional cardiac adrenergic innervation.Circulation 1989; 79:634–644.

    Google Scholar 

  13. Satoh A, Serita T, Seto M, et al. Loss of123I-MIBG uptake by the heart in Parkinson's disease: assessment of cardiac denervation and diagnostic value.J Nucl Med 1999; 40:371–375.

    Google Scholar 

  14. Yoshita M. Differentiation of idiopathic Parkinson's disease from striatonigral degeneration and progressive supranuclear palsy using iodine 123 metaiodobenzyl-guanidine myocardial scintigraphy.J Neurol Sci 1998; 155:60–67.

    Google Scholar 

  15. Taki J, Nakajima K, Hwang EH, et al. Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific.Eur J Nucl Med 2000; 27:566–573.

    Google Scholar 

  16. Iwasa K, Nakalima K, Yoshikawa H, et al. Decreased myocardial 123I-MIBG uptake in Parkinson's disease.Acta Neurol Scand 1998; 97:303–336.

    Google Scholar 

  17. Mathias CJ, Senard JM, Braune S, et al. L-threo-dihydroxyphenylserine (L-threo-DOPS; droxidopa) in the management of neurogenic orthostatic hypotension: a multi-national, multi-centre dose ranging study in multiple system atrophy (MSA) and pure autonomic failure (PAF).Clin Auton Res 2001; 11:235–242.

    Google Scholar 

  18. Yoshita M, Braune S. Cardiac uptake of [123I]MIBG separates PD from multiple system atrophy.Neurology 2000; 54:1877–1878.

    Google Scholar 

  19. Ando Y, Obayashi K, Tanaka Y, et al. Radiolabelled metaiodobenzylguanidine in assessment of autonomic dysfunction.Lancet 1994; 343:984–985.

    Google Scholar 

  20. Hakusui S, Yasuda T, Yanagi T, et al. [123I-MIBG myocardial scintigraphical analysis in patients with and without autonomic disorder].Rinsho Shinkeigaku 1994; 34:402–404 [in Japanese].

    Google Scholar 

  21. Langer A, Freeman MR, Josse RG, et al. Metaiodobenzylguanidine imaging in diabetes mellitus: assessment of cardiac sympathetic denervation and its relation to autonomic dysfunction and silent myocardial ischemia.J Am Coll Cardiol 1995; 25:610–618.

    Google Scholar 

  22. Kreiner G, Wolzt M, Fasching P, et al. Myocardial m-[123I]iodobenzylguanidine scintigraphy for the assessment of adrenergic cardiac innervation in patients with IDDM: comparison with cardiovascular reflex tests and relationship to left ventricular function.Diabetes 1995; 44:543–549.

    Google Scholar 

  23. Schnell O, Kirsch CM, Stemplinger J, et al. Scintigraphic evidence for cardiac sympathetic dysinnervation in long-term IDDM patients with and without ECG-based autonomic neuropathy.Diabetologia 1995; 38:1345–1352.

    Google Scholar 

  24. Senard JM, Valet P, Durrieu G, et al. Adrenergic supersensitivity in parkinsonians with orthostatic hypotension.Eur J Clin Invest 1990; 20:613–619.

    Google Scholar 

  25. Braune S, Reinhardt M, Bathmann J, et al. Impaired cardiac uptake of meta-[123I]iodobenzylguanidine in Parkinson's disease with autonomic failure.Acta Neurol Scand 1998; 97:307–314.

    Google Scholar 

  26. Reinhardt MJ, Jüngling FD, Krause TM, et al. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary123I-MIBG uptake.Eur J Nucl Med 2000; 27:595–600.

    Google Scholar 

  27. Goldstein DS, Holmes C, Li ST, et al. Cardiac sympathetic denervation in Parkinson disease.Ann Intern Med 2000; 133:338–347.

    Google Scholar 

  28. Takatsu H, Nishida H, Matsuo H, et al. Cardiac sympathetic denervation from the early stage of Parkinson's disease: clinical and experimental studies with radiolabeled MIBG.J Nucl Med 2000; 41:71–77.

    Google Scholar 

  29. Wakabayashi K, Takahashi H, Ohama E, et al. Lewy bodies in the visceral autonomic nervous system in Parkinson's disease.Adv Neurol 1993; 60:609–612.

    Google Scholar 

  30. Wakabayashi K. Parkinson's disease: the distribution of Lewy bodies in the peripheral autonomic nervous system.No To Shinkei 1989; 41:965–971 [English abstract].

    Google Scholar 

  31. Goldstein DS, Holmes C, Cannon R, et al. Sympathetic cardioneuropathy in dysautonomias.N Engl J Med 1997; 336:696–702.

    Google Scholar 

  32. Takatsu H, Nagashima K, Murase M, et al. Differentiating Parkinson's disease from multiple system atrophy by measuring cardiac iodine-123 metaiodobenzylguanidine accumulation.JAMA 2000; 284:44–45.

    Google Scholar 

  33. Orimo S, Ozawa E, Nakade S, et al. (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson's disease.J Neurol Neurosurg Psychiatry 1999; 67:189–194.

    Google Scholar 

  34. Braune S, Reinhardt M, Schnitzer R, et al. Cardiac uptake of [123I]MIBG separates Parkinson's disease from multiple system atrophy.Neurology 1999; 53;1020–1025.

    Google Scholar 

  35. Druschky A, Hilz MJ, Platsch G, et al. Differentiation of Parkinson's disease and multiple system atrophy in early disease stages by means of I-123-MIBG-SPECT.J Neurol Sci 2000; 175:3–12.

    Google Scholar 

  36. Brooks DJ. Morphological and functional imaging studies on the diagnosis and progression of Parkinson's disease.J Neurol 2000; (Suppl 2):II/11–II/18.

    Google Scholar 

  37. Antonini A, Leenders KL, Vontobel P, et al. Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson's disease.Brain 1997; 120:2187–2195.

    Google Scholar 

  38. Antonini A, Kazumata K, Feigin A, et al. Differential diagnosis of parkinsonism with [18F]fluorodeoxyglucose and PET.Mov Disord 1998; 13:268–274.

    Google Scholar 

  39. Brefel-Courbon C, Courbon F, Thalamas C, et al. Myocardial meta-[123I] iodobenzylguanidine (MIBG) uptake is different in Parkinson's disease and multiple system atrophy with autonomic failure [abstract].Clin Auton Res 1999; 9:285.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Germany

    Stefan Braune M.D.

Authors
  1. Stefan Braune M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefan Braune M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Braune, S. The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes. Clinical Autonomic Research 11, 351–355 (2001). https://doi.org/10.1007/BF02292766

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02292766

Key words

Search

Navigation