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Chapter 41 - Cardiac123I-MIBG scintigraphic findings and REM sleep behavior disorder

from Section 5 - Neuroimaging of sleep disorders

Published online by Cambridge University Press:  05 March 2013

Eric Nofzinger
Affiliation:
University of Pittsburgh
Pierre Maquet
Affiliation:
Université de Liège, Belgium
Michael J. Thorpy
Affiliation:
Sleep-Wake Disorders Center, Montefiore Medical Center, New York
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Summary

This chapter reviews the usefulness of Meta-iodobenzylguanidine (123I-MIBG) in neurology-specific sleep disorders with a particular focus on rapid eye movement (REM) sleep behavior disorder (RBD). Several studies demonstrated the diagnostic reliability of reduced cardiac 123I-MIBG uptake in Parkinson's disease (PD) patients. In general, 123I-MIBG scintigraphy is regarded as an assessment of autonomic function. Autonomic dysfunction is common in α-synucleinopathies, and particularly marked in multiple system atrophy (MSA). Most patients with idiopathic RBD (iRBD) have reduced 123I-MIBG uptake, and an abnormal 123I-MIBG finding supports the diagnosis of RBD. Although an abnormal 123I-MIBG finding cannot predict the development of α-synucleinopathies among iRBD patients, the existence of RBD might be predictive of developing PD with dementia (PDD) in patients with PD. In the near future, 123I-MIBG findings might help predict the development of PDD among PD patients affected with RBD.
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Publisher: Cambridge University Press
Print publication year: 2013

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