 |
 |
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