Frontiers in Neurology (May 2017)

Iodine-123-meta-iodobenzylguanidine Myocardial Scintigraphy in Isolated Autonomic Failure: Potential Red Flag for Future Multiple System Atrophy

  • Francesca Baschieri,
  • Giovanna Calandra-Buonaura,
  • Giovanna Calandra-Buonaura,
  • Annagrazia Cecere,
  • Annagrazia Cecere,
  • Giorgio Barletta,
  • Giorgio Barletta,
  • Manuela Contin,
  • Manuela Contin,
  • Piero Parchi,
  • Piero Parchi,
  • Pietro Cortelli,
  • Pietro Cortelli

DOI
https://doi.org/10.3389/fneur.2017.00225
Journal volume & issue
Vol. 8

Abstract

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Pure autonomic failure is challenging as it can be the presenting feature of a central nervous system syncleinopathy such as Parkinson’s disease (PD) or multiple system atrophy (MSA). Because the prognosis of MSA and PD is so different, predictive features for a possible conversion can be extremely valuable. In this paper, we report three cases (two with autopsy-proven diagnosis) that had isolated AF for many years before converting to MSA or PD. Of all the tests that were performed during the premotor stage, Iodine-123-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy was predictive of the conversion to MSA. We suggest that MIBG myocardial scintigraphy, when performed in patients with isolated AF, may be a valuable predictor of conversion to MSA. On the contrary, the role of such test in parkinsonian patients irrespective of the presence of AF is still to be clarified.

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