MIBG Scintigraphy in Parkinsonian Syndromes

  • Stefan Braune
Part of the Advances in Behavioral Biology book series (ABBI, volume 53)


Active uptake of [123I] metaiodobenzylguanidine (MIBG) reflects localisation and functional integrity of postganglionic adrenergic neurons. There is accumulating evidence, that in patients with Parkinson’s disease MIBG uptake into cardiac sympathetic neurons is selectively and grossly reduced. Currently there are studies available on 239 patients with idiopathic Parkinson’s disease (IPD), 73 patients with MSA and 14 with progressive supranuclear palsy (PSP) in comparison to 78 healthy controls. The overall mean heart/mediastinum ratio of MIBG uptake was 1.29 in IPD, 2.13 in MSA, 1.89 in PSP and 2.24 in controls. The sensitivity to identify IPD patients correctly by their very low cardiac MIBG uptake appears to be higher than 95% and the specificity is 100%, if Hoehn and Yahr stage is II or higher, if no interacting medication is given and if there is no additional polyneuropathy. This significant reduction of uptake is independent of duration of Parkinsonian or autonomic symptoms and the degree of abnormality in cardiovascular function tests. Although it remains to be cleared whether the findings in IPD represent true postganglionic damage or a functional neuronal deficit, in clinical practice cardiac MIBG scintigraphy allows an early discrimination of IPD in relation to MSA and PSP, which appears to be more reliable and less expensive compared to PET and SPECT imaging of the brain.


mUltiple System Atrophy Progressive Supranuclear Palsy Progressive Supranuclear Palsy Autonomic Failure MIBG Uptake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Brefel-Courbon C, Courbon F, Thalamas C et al. Myocardial meta-[123I] iodobenzylguanidine (MIBG) uptake is different in Parkinson’s disease and multiple system atrophy with autonomic failure. Clin Autonom Res 9, 285(1999)Google Scholar
  2. Braune S, Reinhardt M, Bathmann J, et al.. Impaired cardiac uptake of meta-[123I]iodobenzylguanidine in Parkinson’s disease with autonomic failure. Acta Neurol Scand 97, 307–314 (1998)PubMedCrossRefGoogle Scholar
  3. Braune S, Reinhardt M, Schnitzer R, et al.. Cardiac uptake of [123I] MIBG separates Parkinson’s disease from multiple system atrophy. Neurology, 53:1020–1025 (1999)PubMedCrossRefGoogle Scholar
  4. Druschky A, Hilz MJ, Platsch G, et al. Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of 1–123-MIBG-SPECT. J Neurol Sci 175, 3–12 (2000)PubMedCrossRefGoogle Scholar
  5. Goldstein DS, Holmes C, Li ST, et al. Cardiac sympathetic denervation in Parkinson disease. Ann Intern Med 133, 338–47 (2000)PubMedCrossRefGoogle Scholar
  6. Orimo S, Ozawa E, Nakade S, et al. (123)I-metaiodobenzyl-guanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 67, 189–194 (1999)PubMedCrossRefGoogle Scholar
  7. Satoh A, Serita T, Seto M et al. Loss of 123I-MIBG uptake by the heart in Parkinson’s disease: assessment of cardiac denervation and diagnostic value. J Nucl Med 40, 371–375 (1999)PubMedGoogle Scholar
  8. Solanki KK, Bomanji J, Moyes J et al.. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun 13, 513–521 (1992)PubMedCrossRefGoogle Scholar
  9. Takatsu H, Nagashima K, Murase M, et al. Differentiating Parkinson disease from multiple-system atrophy by measuring cardiac iodine-123 metaiodobenzylguanidine accumulation. JAMA 284, 44–45 (2000)PubMedCrossRefGoogle Scholar
  10. Taki J, Nakajima K, Hwang EH, et al. Peripheral sympathetic dysfunction in patients with Parkinson’s disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med 27, 566–573 (2000)PubMedCrossRefGoogle Scholar
  11. Yoshita M. Differentiation of idiopathic Parkinson’s disease from striatonigral degeneration and progressive supranuclear palsy using iodine 123 metaiodobenzyl-guanidine myocardial scintigraphy. J Neurol Sci 155, 60–67 (1998)PubMedCrossRefGoogle Scholar
  12. Yoshita M, Braune S. Cardiac uptake of [123I]MIBG separates PD from multiple system atrophy. Neurology 54, 1877–1878 (2000)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Stefan Braune
    • 1
  1. 1.Department of NeurologyUniversity of FreiburgFreiburgGermany

Personalised recommendations