Striatal dopamine activity and myocardial 123I-metaiodobenzylguanidine uptake in early Parkinson's disease

Yoon-Sang Oh; Joong-Seok Kim; Sang-Won Yoo; Eo-Jin Hwang; Chul Hyoung Lyoo; Kwang-Soo Lee

doi:10.1016/j.parkreldis.2019.02.012

Striatal dopamine activity and myocardial ¹²³I-metaiodobenzylguanidine uptake in early Parkinson's disease

Parkinsonism Relat Disord. 2019 Jun:63:156-161. doi: 10.1016/j.parkreldis.2019.02.012. Epub 2019 Feb 14.

Authors

Yoon-Sang Oh¹, Joong-Seok Kim², Sang-Won Yoo¹, Eo-Jin Hwang³, Chul Hyoung Lyoo⁴, Kwang-Soo Lee¹

Affiliations

¹ Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
² Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: neuronet@catholic.ac.kr.
³ Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
⁴ Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

PMID: 30796009
DOI: 10.1016/j.parkreldis.2019.02.012

Abstract

Introduction: Dopamine transporter imaging and myocardial ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) scintigraphy have been widely used to diagnose and discriminate degenerative parkinsonism. Many studies have reported that both imaging findings are associated with a variety of motor and non-motor phenomena in Parkinson's disease (PD). However, the association between striatal dopamine activity and myocardial ¹²³I-MIBG uptake has not been well investigated. The objective of this study is to identify the dopamine transporter activity of the corpus striatum and thalamus according to myocardial ¹²³I-MIBG uptake in PD.

Methods: Ninety-six newly diagnosed, non-medicated PD patients were enrolled. All patients underwent ¹²³I-MIBG myocardial scintigraphy, positron emission tomography (PET) using ¹⁸FN-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane and T1-weighted magnetic resonance imaging (MRI). Patients were stratified into normal and decreased ¹²³I-MIBG groups according to their delayed heart-to-mediastinum ratio (cutoff value = 1.78). After normalizing the PET images with spatially normalized MRI, the regional standardized uptake value ratios (SUVRs) were analyzed with a volume-of-interest template between the two groups.

Results: Thirty-one patients showed normal myocardial ¹²³I-MIBG uptake, and 65 patients showed reduced uptake. The SUVR of the globus pallidus in the group with reduced ¹²³I-MIBG uptake was significantly lower than the SUVR in the normal ¹²³I-MIBG uptake group. The heart-to-mediastinum ratio was correlated well with the SUVR of the globus pallidus, independent of age, disease duration, and the severity of motor symptoms.

Conclusion: Early PD patients with normal ¹²³I-MIBG uptake showed a relatively preserved dopamine reserve in the globus pallidus than patients with reduced ¹²³I-MIBG uptake.

Keywords: (123)I-metaiodobenzylguanidine scintigraphy; Dopamine transporter scan; Parkinson's disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

3-Iodobenzylguanidine*
Aged
Dopamine Plasma Membrane Transport Proteins / metabolism*
Female
Globus Pallidus / diagnostic imaging*
Globus Pallidus / metabolism
Humans
Male
Middle Aged
Myocardial Perfusion Imaging*
Nortropanes*
Parkinson Disease / diagnostic imaging*
Parkinson Disease / metabolism
Positron-Emission Tomography*
Radiopharmaceuticals*

Substances

Dopamine Plasma Membrane Transport Proteins
N-(3-(18F)fluoropropyl)-2beta-carbomethoxy-3beta-(4-fluorophenyl)nortropane
Nortropanes
Radiopharmaceuticals
3-Iodobenzylguanidine