Session Information
Date: Thursday, June 8, 2017
Session Title: Parkinson's Disease: Neuroimaging And Neurophysiology
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To evaluate the utility of the combined use of cardiac metaiodobenzylguanidine (MIBG) scintigraphy, olfactory testing, and substantia nigra (SN) hyperechogenicity on transcranial sonography (TCS) in differentiating Parkinson’s disease (PD) from atypical parkinsonian syndromes (APSs), such as multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) during the early stage.
Background: A clinical diagnosis of parkinsonian disorders especially in the early stage is difficult and it is difficult to differentiate PD and APS.
Methods: We defined early-stage patients as drug-naïve patients with a disease duration of 3 years or less. Cardiac MIBG scintigraphy, card-type odor identification testing (Open Essence (OE), Wako, Japan), and TCS were carried out in those patients, which were 42 patients with PD and 24 patients with APSs.
Results: The area under the receiver operating characteristic curve was 0.74 (95% CI, 0.58-0.89), 0.66 (95% CI, 0.53-0.79), and 0.70(95% CI, 0.57-0.83) for TCS, cardiac MIBG scintigraphy, and olfactory testing, respectively, in differentiating PD from APSs. The diagnostic sensitivity and specificity were 50% and 93.8%, respectively, for TCS, 57.1% and 87.5%, respectively, for cardiac MIBG scintigraphy, 54.8% and 79.2%, respectively, for OE. At least one positive result from 3 tests improved sensitivity (76.2%) but decreased specificity (66.7%). In contrast, at least 2 positive results from 3 tests had good discrimination (50% sensitivity and 95.8% specificity). Positive results for all 3 tests yielded 100% specificity but low sensitivity (25%). In PD group, there was a positive correlation between cardiac MIBG scintigraphy and OE.
Conclusions: Our study results suggest that at least 2 positive results from among TCS, cardiac MIBG scintigraphy, and olfactory testing are useful in distinguishing PD from APSs during the early stage.
To cite this abstract in AMA style:
h. fujita, K. Suzuki, A. Numao, Y. Watanabe, T. Uchiyama, T. Miyamoto, M. Miyamoto, T. Kadowaki, K. Hirata. Cardiac 123I-MIBG Scintigraphy, olfactory testing and transcranial sonography for differentiating between Parkinson’s disease and atypical parkinsonian syndromes during the early stage [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/cardiac-123i-mibg-scintigraphy-olfactory-testing-and-transcranial-sonography-for-differentiating-between-parkinsons-disease-and-atypical-parkinsonian-syndromes-during-the-early-stage/. Accessed May 12, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cardiac-123i-mibg-scintigraphy-olfactory-testing-and-transcranial-sonography-for-differentiating-between-parkinsons-disease-and-atypical-parkinsonian-syndromes-during-the-early-stage/