Differentiation of idiopathic Parkinson's disease from striatonigral degeneration and progressive supranuclear palsy using iodine-123 meta-iodobenzylguanidine myocardial scintigraphy

J Neurol Sci. 1998 Feb 18;155(1):60-7. doi: 10.1016/s0022-510x(97)00278-5.


Iodine-123 meta-iodobenzylguanidine ([123I]MIBG), an analogue of norepinephrine, is a tracer for functioning of sympathetic neurons. To investigate cardiac sympathetic function in PD, SND, and PSP, [123I]MIBG myocardial scintigraphy was performed in 25 patients with PD, 15 patients with SND, 14 patients with PSP, and 20 control subjects. In planar imaging studies, the heart-to-mediastinum average count ratio (H/M) was calculated for both early and delayed images. The mean value of H/M in patients with PD was significantly lower than those with SND, PSP, or no disease. Regardless of disease severity or intensity of anti-Parkinsonian pharmacotherapy, mean values for H/M were always low in patients with PD. The mean value of H/M in SND with orthostatic hypotension (OH) was lower than that in SND without OH. Although the mean value of H/M in PSP with amitriptyline treatment was significantly lower than that in PSP patients without amitriptyline treatment, there was no significant difference between the mean value of H/M in PSP patients without amitriptyline treatment and that in control. Thus, PD may have a abnormality of cardiac sympathetic function which has not been detected by previous cardiovascular autonomic studies. Moreover, particularly in early stages, [123I]MIBG myocardial scintigraphy may provide helpful diagnostic information in these akinetic-rigid syndromes.

MeSH terms

  • 3-Iodobenzylguanidine*
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Iodine Radioisotopes
  • Male
  • Middle Aged
  • Multiple System Atrophy / diagnosis
  • Multiple System Atrophy / diagnostic imaging*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / diagnostic imaging*
  • Radionuclide Imaging
  • Supranuclear Palsy, Progressive / diagnosis
  • Supranuclear Palsy, Progressive / diagnostic imaging*


  • Iodine Radioisotopes
  • 3-Iodobenzylguanidine