SCOPA-AUT scale in different parkinsonisms and its correlation with (123) I-MIBG cardiac scintigraphy.

Our objective was to assess the usefulness of the Scales for Outcomes in Parkinson's disease - Autonomic (SCOPA-AUT) in the differential diagnosis of Parkinsonisms and clarify its relation with 123-I-MIBG cardiac scintigraphy. A total of 112 patients with Parkinson's disease (PD), 12 with multiple system atrophy parkinsonian variant (MSA-P) and 20 with progressive supranuclear palsy (PSP) participated in the study. The following variables were collected: age, sex, age at onset, length of illness, type and dose of anti-Parkinson medication, and score on the Unified Parkinson's Disease Rating Scale. The Unified Multiple System Atrophy Rating Scale was administered to patients with MSA and the Progressive Supranuclear Palsy Rating Scale to those with PSP. Finally, the SCOPA-AUT was administered to all the patients. Cardiac 123I-MIBG SPECT scans were performed on a subset of patients (25 with PD and 5 with MSA-P). Statistically significant differences were observed (p < 0.01) in the SCOPA-AUT scores between patients with PD (14.75+/-8.09) and those with MSA (21.07+/-5.56), the latter having higher scores on the bowel function (20.07+/-13.40 vs 34.92+/-14.91) and urinary domains (30.21+/-21.55 vs 49.26+/-21.40) (p < 0.01). No correlation was found between the SCOPA-AUT score and anti-Parkinson's medication and heart:mediastinum (H/M) MIBG uptake ratio in the cardiac SPECT (at 4 h). Severity of dysautonomia as measured by the SCOPA-AUT was not correlated with clinical severity, time since onset or the H/M ratio. In the patients with PD, the only variable associated with the H/M ratio was age at onset of the disease.

Berganzo K ，Tijero B ，Somme JH ，Llorens V ，Sánchez-Manso JC ，Low D ，Iodice V ，Vichayanrat E ，Mathias CJ ，Lezcano E ，Zarranz JJ ，Gómez-Esteban JC ... -  《-》

[Iodine 123-labeled meta-iodobenzylguanidine myocardial scintigraphy in the cases of idiopathic Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy].

Yoshita M ，Hayashi M ，Hirai S 《-》

PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage.

Kurata T ，Kametaka S ，Ohta Y ，Morimoto N ，Deguchi S ，Deguchi K ，Ikeda Y ，Takao Y ，Ohta T ，Manabe Y ，Sato S ，Abe K ... -  《-》

MIBG scintigraphy for differentiating Parkinson's disease with autonomic dysfunction from Parkinsonism-predominant multiple system atrophy.

Parkinson's disease (PD) with autonomic dysfunction is difficult to differentiate from Parkinsonism-predominant multiple system atrophy (MSA-p). This study aimed to analyze the validity of MIBG scintigraphy for PD with autonomic dysfunction and MSA-p. Thirty-nine patients (PD: 27 patients, MSA-p type: 12) and 12 age-matched controls were prospectively enrolled and underwent MIBG scintigraphy and autonomic function test (AFT). We separately calculated early and delayed heart-to-mediastinal (H/M) ratio and washout rates (WRs). AFT was composed of sympathetic skin reflex and parasympathetic tests based on heart rate variability. Abnormal AFT was observed in 17 (63%) of PD and 10 (83%) of MSA-p. On comparing PD with abnormal AFT with MSA-p, either the early or delayed H/M ratio in PD was not different from that in MSA-p (P > 0.05). Only the WR could differentiate PD with abnormal AFT from MSA-p (47.07 +/- 57.48 vs. 31.39 +/- 31.52, respectively) (P = 0.026). According to the results, WR may be more useful than the early and delayed H/M ratio to distinguish MSA-p from PD with abnormal AFT. Furthermore, the MIBG uptake did not reflect the disease duration or severity.

Chung EJ ，Lee WY ，Yoon WT ，Kim BJ ，Lee GH ... -  《-》

Comparison of autonomic dysfunction in patients with Parkinson's Disease, progressive supranuclear palsy, and multiple system atrophy.

Malkiewicz JJ ，Siuda J 《Neurologia i Neurochirurgia Polska》