Hi everyone,
We received the abstract below from Pam Bower who runs the
Shy-Drager Syndrome(SDS) list.
Aliza and I would be interested in knowing if any of you
had this test and  about its availability and cost.
Warm regards.
Gil,CG for Aliza,dx PD 2/95,dx SDS/MSA 10/98
---------------------------------------
>Date: Mon, 08 Nov 1999 16:29:11 -0400
>From: Pam Bower <[log in to unmask]>
>Reply-To: [log in to unmask]
>Organization: Maritime Life Assurance
>X-Mailer: Mozilla 3.0 (Win95; I)
>To: Gil Lieberman <[log in to unmask]>
>Subject: Re: SDS/MSA Support Group Leaders
>
>Hi Gil,
>
>Here's the abstract of the article you mentioned. Very interesting.
>I'll see if I can dig up any more information about it.
>
>Regards,
>Pam
>
>
>Neurology 1999 Sep 22;53(5):1020-5
>
>Cardiac uptake of [123I]MIBG separates Parkinson's disease from multiple
>system atrophy.
>
>Braune S, Reinhardt M, Schnitzer R, Riedel A, Lucking CH
>
>Neurologische, Universitatsklinik Freiburg, Germany.
>
>
>OBJECTIVE: To improve the differential diagnosis between patients with
>multiple system atrophy (MSA) and idiopathic PD (IPD) with autonomic
>failure.
>
>BACKGROUND: Some patients diagnosed with IPD are discovered to have
>alternative diseases such as MSA, despite the application of stringent
>diagnostic criteria. This differentiation is particularly difficult if
>patients with IPD also show symptoms of autonomic failure. In IPD,
>autonomic failure is caused by damage of the postganglionic part of the
>autonomic nervous system, whereas in MSA, degeneration of preganglionic
>and central autonomic neurons is revealed histopathologically.
>
>METHODS:  Scintigraphy with [123I]metaiodobenzylguanidine (MIBG) enables
>the quantification of postganglionic sympathetic cardiac innervation.
>Fifteen patients with IPD and 5 patients with MSA underwent standard
>autonomic function tests and scintigraphy with MIBG.
>
>RESULTS: In all patients, cardiovascular testing showed evidence of
>autonomic failure of varying severity. In all patients with IPD, the
>heart-mediastinum (H/M) ratio of MIBG uptake was pathologically imaired,
>independent of duration and severity of autonomic and
>parkinsonian symptoms. All patients with MSA had a regular H/M ratio.
>Each patient could be assigned to the correct diagnostic group based on
>the results of the MIBG scintigraphy, even if the duration of the
>disease was only 2 years or less.
>
>CONCLUSIONS: This population assessment of the heart-mediastinum ratio
>of [123I]metaiodobenzylguanidine uptake showed a high sensitivity for
>the detection of autonomic involvement in patients with idiopathic IPD
>and also a high specificity for the discrimination between idiopathic PD
>and MSA.
>
>
>PMID: 10496261, UI: 99424580
>
>
>Gil Lieberman wrote:
>>
>> Hi Pam,
>> Thanks for the info.
>> The following from J.R. Bruman's CSR may be of interest to you.
>> Do you have any info on the test referred to?
>>
>> Braune S et al; Neur 1999;53:1020-1025:
>> PD may affect the autonomic nervous system as well as the motor
>> centers, in a different way than multiple system atrophy (MSA).
>> Scintigraphy with the marker MIBG of the heart offers a sensitive
>> test of such failure in PD, as well as distinction from MSA.
>>
>> You can find the full version of J. R. Bruman's excellent Current
>> Science Review (CSR) at http://james.parkinsons.org.uk/csr.htm.
>>
>> Best regards.
>> Gil
>> -----------
>> At 11:48 PM 11/7/99 -0400, you wrote:
>> >Hi Gil,
>> >
>> >Check out Jeff's SDS/MSA Resource page.  He does a good job of condensing
>> >the medical posts from the list to a searchable archive.
>> >
>> > http://www.hooked.net/~ccjm/shy-drager/links.html
>> >
>> >To get back on the SDS list send an email with the following message:
>> >
>> >subscribe shy-drager
>> >
>> >to:  [log in to unmask]
>> >
>> >Regards,
>> >Pam

>> >"There can be no happiness if the things we believe in are different
>> >from the things we do." - Author Unknown


>"We cannot do great things on this earth.  We can only do small things
>with great love." - Mother Teresa