Differential clinical diagnosis of Parkinsonism: precepts and pitfalls of MIBG scintigraphy

DOI
  • Uchihara Toshiki
    Neurology Clinic with Neuromorphomics Laboratory, Nitobe-Memorial Nakano General Hospital Neurology, Juntendo University Neurology and Neurological Science, Tokyo Medical and Dental University

Bibliographic Information

Other Title
  • 病理からみなおすパーキンソン症候群の鑑別
  • ―MIBG取り込み低下の原則と例外―

Abstract

<p>Lewy-prone neurons are characterized by hyperbranching axons, which innervate to wide areas of brain and body, leading to generalized, poorly somatotopic clinical manifestations such αS mood, motivation, sleep, cognition and autonomic functions. Because αS is enriched in axon terminals, hyperbranching axons provide a heavy αS load to these neurons. Because MIBG is accumulated at axon terminals of cardiac sympathetic nerves, decreased myocardial uptake of MIBG is correlated with degeneration of cardiac sympathetic nerve, induced by αS deposition. Although lower brainstem is rich in αS deposits, upward spread of αS is not consistent. Rather, haphazard development of αS deposits, as multifocal Lewy-body disease may be more plausible. Moreover, decreased myocardial uptake of MIBG may happen even in the absence of Lewy pathology. Although decreased myocardial uptake of MIBG may suggest Lewy pathology, it is time to reconsider this convenient but oversimplified paradigm so that diagnostic accuracy is maximized by referencing to pathology obtained at autopsy.</p>

Journal

Keywords

Details 詳細情報について

  • CRID
    1390299682763647488
  • DOI
    10.32272/ans.61.1_40
  • ISSN
    24347035
    02889250
  • Text Lang
    en
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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