Category: Neuroimaging (Non-PD)
Objective: Although there are cases of multiple system atrophy (MSA) with decreased MIBG, there has not been sufficient investigation into the proportion. Thus, we retrospectively examined 35 cases of MSA that we experienced.
Background: 123I-MIBG myocardial scintigraphy considered to be an effective tool for distinguishing PD from parkinson syndromes including MSA. However, previous studies have reported that a decrease in MIBG accumulation may occur in patients with MSA.
Method: The subjects were 35 patients with MSA (age 70.1 ± 7.4 years; mean ± SD), 90 patients with PD (age 71.9 ± 7.8 years; mean ± SD), and 14 patients with essential tremor (ET). A patient (age 72.6±7.5 years; mean±SD) underwent MIBG myocardial scintigraphy, and the H/M ratio and washout rate (WR) of early and late images were compared. Next, the 35 MSA patients were divided into two groups: 23 MSA-P patients and 12 MSA-C patients, and a similar study was conducted.
Results: There was a significant difference in the H/M ratio between early and late images between PD and MSA, and between PD and ET (P<0.001 for each), but there was no significant difference between MSA and ET. Decreased MIBG uptake was observed in 8 of 35 patients (22.8%) with MSA. Decreased MIBG uptake was observed in 76 out of 90 patients (84.4%) with PD. There was no significant difference in the H/M ratio between the two groups in both early and late stages. Among the 35 MSA cases, H/M in early images was below the cutoff value in 8 cases, MSA-P in 7 cases, and MSA-C in 1 case. Although MSA-P was more common, there was no significant difference. Ta. There was no significant difference in disease duration between cases with decreased MSA uptake and those with decreased PD uptake.
Conclusion: In the MSA uptake group, the uptake was reduced to the same level as PD. Furthermore, there was no difference in disease duration, suggesting that a mechanism other than transsynaptic degeneration may be responsible for the decreased uptake. Furthermore, it was suggested that there is a group of MSA patients who exhibit cardiac sympathetic dysfunction to the same extent as PD.
To cite this abstract in AMA style:
R. Yokoyama, T. Yamamoto. A group of patients with multiple system atrophy (MSA) exhibit cardiac sympathetic dysfunction to the same extent as Parkinson’s disease (PD). [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/a-group-of-patients-with-multiple-system-atrophy-msa-exhibit-cardiac-sympathetic-dysfunction-to-the-same-extent-as-parkinsons-disease-pd/. Accessed June 14, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-group-of-patients-with-multiple-system-atrophy-msa-exhibit-cardiac-sympathetic-dysfunction-to-the-same-extent-as-parkinsons-disease-pd/