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.

Iodine-123-meta-iodobenzylguanidine myocardial scintigraphy in isolated autonomic failure: Potential red flag for future multiple system atrophy

Baschieri, Francesca;Calandra-Buonaura, Giovanna;Barletta, Giorgio;Contin, Manuela;Parchi, Piero;Cortelli, Pietro
2017

Abstract

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.
Baschieri, Francesca; Calandra-Buonaura, Giovanna; Cecere, Annagrazia; Barletta, Giorgio; Contin, Manuela; Parchi, Piero; Cortelli, Pietro
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/618321
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