Neurological applications for myocardial MIBG scintigraphy

Abstract

Signs or symptoms of impaired autonomic regulation of circulation
are typically present in patients affected by Parkinson’s
disease (PD), in agreement with the cardiac sympathetic
denervation discovered by Goldstein more than 15 yrs. ago.
In particular, the majority of PD patients have a diffuse left ventricular
myocardial sympathetic denervation, being a normal
neurological condition present only in a small number of affected
subjects. Actually MIBG cardiac imaging is a universally
accepted method to estimate cardiac sympathetic innervations.
This review covers the role of MIBG cardiac imaging in PD as well
as in other parkinsonisms, focusing the attention on technical
problems and pathophysiological premises for cardiac denervation.
In particular new emerging data support the role of MIBG as
biomarker of PD, also before motor symptoms became clinically
evident. Therefore the timing of cardiac noradrenergic denervation
in PD is a key issue and we want to update the analysis of
autonomic cardiovascular abnormalities studied with MIBG in
PD and related disorders.