Document Detail


Cardiac ¹²³I-MIBG scintigraphy as an outcome-predicting tool for subthalamic nucleus stimulation in Parkinson's disease.
MedLine Citation:
PMID:  20927559     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: ¹²³I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for differentiating idiopathic Parkinson's disease (PD) from other parkinsonian syndromes, but its prognostic value in PD has not been established. The objective of this study was to clarify the correlation between cardiac MIBG uptake parameters and the outcome in PD patients subjected to the subthalamic nucleus stimulation.
METHOD: We enrolled 31 consecutive PD patients and calculated the heart-to-mediastinum ratio (H/M) and washout rate (WR) based on the activity measured at 15 min (early phase) and 3 h (delayed phase) after the intravenous injection of MIBG (111 MBq). Cardinal motor symptoms and activity of daily living (ADL) were assessed on the Unified Parkinson's Disease Rating Scale (UPDRS) and Schwab and England (S-E) ADL scale, before and 3 months after surgery.
FINDINGS: Neither early nor delayed H/M correlated with any of the preoperative subscores on the UPDRS or S-E, nor with postoperative outcome. On the other hand, increased WR was a positive predictor for postoperative improvement rate on S-E in medication-off state (p = 0.00003). Also, WR showed a more faint but significant correlation with preoperative levodopa responsiveness on S-E (p = 0.008).
CONCLUSION: Our findings suggest that ¹²³I-MIBG scintigraphy in combination with levodopa-responsiveness evaluation may represent a useful tool for prediction of outcomes in patients subjected to STN stimulation.
Authors:
Kazumichi Yamada; Shin-ya Shiraishi; Tadashi Hamasaki; Jun-ichi Kuratsu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-07
Journal Detail:
Title:  Acta neurochirurgica     Volume:  152     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  2063-8     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Kumamoto University, Japan. yamadakazu@fc.kuh.kumamoto-u.ac.jp
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