Association of visual hallucinations with reduction of MIBG cardiac uptake in Parkinson's disease
Received 3 April 2007; received in revised form 10 July 2007; accepted 11 July 2007.
Abstract
Background
Postganglionic cardiac sympathetic denervation is evident in patients with Parkinson’s disease (PD) and iodine-123 metaiodobenzylguanidine (123I-MIBG) cardiac scintigraphy has proven to be a useful tool for diagnosis of PD.
Objective
To elucidate the factors associated with severity of cardiac sympathetic nerve dysfunction in PD patients.
Methods
We investigated 95 PD patients hospitalized in the Department of Neurology at Tottori University Hospital. 123I-MIBG cardiac scintigraphy was performed on each patient and the early and delayed heart to mediastinum (H/M) ratios and washout rate (WR) of 123I-MIBG cardiac scintigraphy were calculated. Independent predictive variables for parameters of 123I-MIBG cardiac scintigraphy were analyzed by multivariate regression analysis.
Results
Multivariate regression analysis revealed that the presence of visual hallucinations (VH) and the patient’s age at the time of evaluation independently predicted the early or delayed H/M ratio. Analysis of covariance, adjusted for the age of the patients as covariates, revealed that the early and delayed H/M ratios of PD patients with VH but no dementia, as well as PD patients with dementia were significantly lower than the ratios in PD patients with no VH or dementia.
Conclusion
Cardiac sympathetic dysfunction may be associated with the presence of VH in PD patients.
aDepartment of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
bDivision of Legal Medicine, Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
Corresponding author. Department of Neurology, Institute of Neurological Sciences Faculty of Medicine, Tottori University 36-1 Nishi-cho, Yonago, 683-8504, Japan. Tel.: +81 859 38 6757; fax: +81 859 38 6759.
ABSTRACT