Table 6.
Comparison of clinical reports evaluating cardiac innervation in PD using 11C-MHED
| Reference | Number of Patients | Mean PD age (age range) | PD H&Y stage (disease duration yrs) | Methods to evaluate cardiac DYA | PD patient DYA description | Homogenous cardiac perfusion Y/N (radio-tracer) | LV regions analyzed | % of LV global uptake reduction | Region of maximal reduction (% of abnormal sectors - AS) | Significant loss of plasma catechol-amines Y/N | Comments | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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| PD | MSA | PSP | Control | |||||||||||
| 11C-MHED | ||||||||||||||
| Berding et al., 2003 | 5 | 2 | - | - | No mean defined (51-69) | No stage defined (2-16) | OH evaluation with Schellong test | n=3 of 5 PD with OH, n=2 of 5 probable/ possible PD without OH | - | Polar maps created for global MHED influx values. | 23.8-36.4%b,E | - | - | MHED uptake lower in PD and OH (41.4-59.3%b,E of loss) than PD without OH (+2.5-2.1%b,E) compared to MSA. |
| Raffel et al., 2006 | 9 | 10 | 8 | 10 | No mean defined (35-77) | H&Y 1.5-2.5 (disease duration not defined) | No additional cardiac DYA evaluations | n=1 of 9 PD with OH | - | LCX, LAD, and RCA. Polar maps with 480 sectors created. Regional effects are calculated as % of 480 sectors that are abnormal. | 26%b (96%a of 480 sectors have abnormal values) | LCX and RCA (100% AS) | - | MHED retention was abnormal in 4 of 9 PD patients and were the only subjects analyzed and reported. No correlation between MHED uptake and disease duration. |
| Wong et al., 2012 | 27 | - | - | 33 | 62 (50-74) | H&Y 1-2.5 (1-14) | No additional cardiac DYA evaluations | No further description included | - | LCX, LAD, and RCA. Anterior, inferior, lateral and septal walls in respect to proximal and distal areas. Polar maps with 480 sectors created. Regional effects calculated as % of 480 sectors that are abnormal. | 50%b (61.7%a of 480 sectors have abnormal values) | Lateral (distal 68%a AS and proximal 74%a AS); Inferior (distal 63% AS and proximal 69% AS); LCX (70.9%b AS) | - | 23 of 27 PD patients have some global deficit. Of those with abnormal uptake, regional analysis showed abnormal uptake in LCX (7-100%a AS), LAD (5-100%a AS) and RCA (14-100%a AS) perfusion areas. |
Listed percentages describe loss of 18F-FDA uptake compared to controls (unless otherwise noted) and reported originally in the reference (a) or calculated based on data (b numbers or c graph) from the publication. Ecompared to MSA group. 11C-MHED, [11C]-meta-hydroxyephedrine; AS, abornmal sectors; DYA, dysautonmia; H&Y, Hoehn & Yahr; LAD, left anterior descending artery; LCX, left circumflex artery; LV, left ventricle; MSA, multiple systems atrophy; NE, norepinephrine; OH, orthostatic hypotension; PD, Parkinson’s disease; PSP, progressive supranuclear palsy; RCA, right coronary artery.