Impaired cardiac uptake of meta-[123I]iodobenzylguanidine in Parkinson's disease with autonomic failure

Acta Neurol Scand. 1998 May;97(5):307-14. doi: 10.1111/j.1600-0404.1998.tb05958.x.


Objective: To selectively investigate postganglionic sympathetic cardiac neurons in patients with Parkinson's disease and autonomic failure.

Material and methods: Metaiodobenzylguanidine (MIBG) is a pharmacologically inactive analogue of noradrenaline, which is similarly metabolized in noradrenergic neurons. Therefore the uptake of radiolabelled MIBG represents not only the localization of postganglionic sympathetic neurons but also their functional integrity. Ten patients with Parkinson's disease and autonomic failure underwent standardized autonomic testing, assessment of catecholamine plasma levels and scintigraphy with [123I]MIBG.

Results: The cardiac uptake of MIBG, as demonstrated by the heart/mediastinum ratio, was significantly lower in patients in comparison with controls. Scintigraphy with MIBG allowed the selective in-vivo investigation of postganglionic sympathetic cardiac efferents in patients with autonomic failure, a procedure which was previously confined to post-mortem examination.

Conclusion: These findings point to a relevant postganglionic pattern of involvement of the autonomic nervous system (ANS) in Parkinson's disease and autonomic failure.

MeSH terms

  • 3-Iodobenzylguanidine / pharmacokinetics*
  • Aged
  • Aged, 80 and over
  • Autonomic Nervous System Diseases / complications
  • Autonomic Nervous System Diseases / diagnostic imaging
  • Autonomic Nervous System Diseases / metabolism*
  • Case-Control Studies
  • Female
  • Heart / diagnostic imaging
  • Heart / innervation
  • Humans
  • Iodine Radioisotopes / pharmacokinetics
  • Male
  • Myocardium / metabolism*
  • Norepinephrine / blood
  • Parkinson Disease / complications
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / metabolism*
  • Sympathetic Nervous System / diagnostic imaging
  • Sympathetic Nervous System / physiopathology*
  • Sympatholytics / pharmacokinetics*
  • Tomography, Emission-Computed, Single-Photon


  • Iodine Radioisotopes
  • Sympatholytics
  • 3-Iodobenzylguanidine
  • Norepinephrine