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• Vol.44 No.11
• CLINICA NEUROL, 44: 827−829, 2004
• Vol.44 No.11 contents

The 45th Annual Meeting of the Japanese Society of Neurology

A useful marker for differential diagnosis of Parkinson's disease -MIBG myocardial scintigraphy-

Satoshi Orimo, M.D.¹⁾, Takeshi Amino, M.D.¹⁾, Eisuke Ozawa, M.D.¹⁾, Tohru Kojo, M.D.²⁾, Toshiki Uchihara, M.D.²⁾, Atsushi Takahashi, M.D.³⁾, Kuniaki Tsuchiya, M.D.⁴⁾, Koichi Wakabayashi, M.D.⁵⁾ and Hitoshi Takahashi, M.D.⁶⁾

¹⁾Department of Neurology, Kanto Central Hospital
²⁾Department of Neuropathology, Tokyo Metropolitan Institute for Neuroscience
³⁾Department of Organ and Function Pathology Division, Yokufukai Geriatric Hospital
⁴⁾Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital
⁵⁾Department of Neuropathology, Hirosaki University School of Medicine
⁶⁾Department of Pathology, Brain Research Institute, Niigata University

We performed [¹²³I] -meta-iodobenzylguanidine (MIBG) myocardial scintigraphy in 180 patients with PD, 24 patients with DLB and 73 patients with the other related diseases. The heart-to-mediastinum (H/M) ratio in PD and DLB was significantly low compared to that in MSA, PSP, CBD and AD. The H/M ratio tended to decrease with the disease progression in PD. These findings suggest that MIBG myocardial scintigraphy could be a marker for differential diagnosis of PD and DLB.
We immunohistochemically examined heart tissues from patients with pathologically confirmed PD, DLB and the other related diseases using monoclonal antibody against tyrosine hydroxylase (TH). The number of TH-immunoreactive nerve fibers in the epicardium was moderate or abundant in most patients with MSA, PSP, CBD and AD as well as in the control subjects. Contrarily, the number of TH-immunoreactive nerve fibers in the epicardium had almost completely disappeared in nearly all the patients with PD and DLB. These findings suggest that postganglionic cardiac sympathetic nerve denervation occurs in PD and DLB but not in MSA, PSP, CBD and AD, which accounts for the decreased cardiac uptake of MIBG in PD and DLB, but not in the other diseases.

(CLINICA NEUROL, 44: 827−829, 2004)
key words: Parkinson's disease, dementia with Lewy bodies, MIBG myocardial scintigraphy, cardiac sympathetic nerve, denervation

(Received: 13-May-04)