Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease
Introduction Recently, “body-first” and “brain-first” subtype in Parkinson's disease (PD) was proposed based on the propagation of α-synuclein. In isolated RBD considered as a premotor stage of body-first PD, α-synuclein was supposed to originate in the enteric nervous system and spreads via au...
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| Veröffentlicht in: | Journal of neurology 2025, Vol.272 (1), p.28 |
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| description | Introduction
Recently, “body-first” and “brain-first” subtype in Parkinson's disease (PD) was proposed based on the propagation of α-synuclein. In isolated RBD considered as a premotor stage of body-first PD, α-synuclein was supposed to originate in the enteric nervous system and spreads via autonomic nervous system. Therefore, we hypothesized that body-first PD is more likely to have a delayed gastric emptying time and reduced cardiac sympathetic denervation. In this study, we aimed to assess gastric motility and its correlation with cardiac sympathetic denervation, dopamine transporter uptake in PD with the body-first PD in comparison with brain-first PD.
Methods
We investigated gastric scintigraphy, dual-phase 18F-FP-CIT PET, and cardiac MIBG scintigraphy in patients with PD. Based on the presence of RBD and delayed H/M ratio in MIBG scintigraphy, we classified patients into the body-first PD and brain-first PD groups. Gastric emptying time (GET) was assessed by dynamic gastric scintigraphy, and half-emptying time (
T
1/2
) was measured.
Results
A total of 18 PD patients (mean age 68.8) were classified into body-first PD group (
n
= 10) and brain-first PD group (
n
= 8). Delayed GET was more prevalent in body-first PD group compared to brain-first PD (
T
1/2
> 110 min, 90.0 vs 37.5%,
p
= 0.043). Striatal dopamine depletion was similar between groups and no significant correlation with
T
1/2
. Washout rate of cardiac MIBG showed a tendency of correlation with
T
1/2
(
r
= 0.454,
p
= 0.077).
Conclusion
This study showed that body-first PD may be associated with a higher prevalence of delayed gastric emptying time compared to the brain-first PD, suggesting higher burden of gastrointestinal dysmotility in brain-first PD. |
| doi_str_mv | 10.1007/s00415-024-12783-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146653817</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3146653817</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1286-1210b47bc132346008823385c5c8b4a35d19508ed593760f36438ada3db82d483</originalsourceid><addsrcrecordid>eNpdkcFOAyEQhonRaK2-gAdD4sXLKuzALj1qo9WkRg96JuxCldplV2DT9OZr-Ho-iWhrTDzNTOabgfl_hI4oOaOElOeBEEZ5RnKW0bwUkBVbaEAZ5BllfLSNBgQYyThwtof2Q5gTQkRq7KI9GBUFT_kALScqRG9rbJourqx7xtE2BiunsY0B1633ZqGibR1e2viCa-W1VTW-u72cYOtw1epVNrM-xJ-ZyivrNnXoq7jqDH5Q_tW60LrP94-AtQ1GBXOAdmZqEczhJg7R0_XV4_gmm95PbscX06yjuSjSXZRUrKxqCjmwIh0gcgDBa16Liingmo44EUbzEZQFmUHBQCitQFci10zAEJ2u93a-fetNiLKxoTaLhXKm7YMEypIUIGiZ0JN_6LztvUu_-6aAJcHS20N0vKH6qjFadt42yq_kr6QJgDUQUss9G_-3hhL5bZxcGyeTcfLHOFnAF6KViG0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3143458423</pqid></control><display><type>article</type><title>Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease</title><source>MEDLINE</source><source>SpringerNature Complete Journals</source><creator>Kim, Min Seung ; Park, Don Gueu ; Shin, In Ja ; An, Young Sil ; Yoon, Jung Han</creator><creatorcontrib>Kim, Min Seung ; Park, Don Gueu ; Shin, In Ja ; An, Young Sil ; Yoon, Jung Han</creatorcontrib><description>Introduction
Recently, “body-first” and “brain-first” subtype in Parkinson's disease (PD) was proposed based on the propagation of α-synuclein. In isolated RBD considered as a premotor stage of body-first PD, α-synuclein was supposed to originate in the enteric nervous system and spreads via autonomic nervous system. Therefore, we hypothesized that body-first PD is more likely to have a delayed gastric emptying time and reduced cardiac sympathetic denervation. In this study, we aimed to assess gastric motility and its correlation with cardiac sympathetic denervation, dopamine transporter uptake in PD with the body-first PD in comparison with brain-first PD.
Methods
We investigated gastric scintigraphy, dual-phase 18F-FP-CIT PET, and cardiac MIBG scintigraphy in patients with PD. Based on the presence of RBD and delayed H/M ratio in MIBG scintigraphy, we classified patients into the body-first PD and brain-first PD groups. Gastric emptying time (GET) was assessed by dynamic gastric scintigraphy, and half-emptying time (
T
1/2
) was measured.
Results
A total of 18 PD patients (mean age 68.8) were classified into body-first PD group (
n
= 10) and brain-first PD group (
n
= 8). Delayed GET was more prevalent in body-first PD group compared to brain-first PD (
T
1/2
> 110 min, 90.0 vs 37.5%,
p
= 0.043). Striatal dopamine depletion was similar between groups and no significant correlation with
T
1/2
. Washout rate of cardiac MIBG showed a tendency of correlation with
T
1/2
(
r
= 0.454,
p
= 0.077).
Conclusion
This study showed that body-first PD may be associated with a higher prevalence of delayed gastric emptying time compared to the brain-first PD, suggesting higher burden of gastrointestinal dysmotility in brain-first PD.</description><identifier>ISSN: 0340-5354</identifier><identifier>ISSN: 1432-1459</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-024-12783-6</identifier><identifier>PMID: 39665845</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>3-Iodobenzylguanidine ; Aged ; Autonomic nervous system ; Brain - diagnostic imaging ; Brain - metabolism ; Brain - physiopathology ; Coronary artery disease ; Denervation ; Dopamine ; Dopamine Plasma Membrane Transport Proteins - metabolism ; Dopamine transporter ; Enteric nervous system ; Female ; Gastric emptying ; Gastric Emptying - physiology ; Gastric motility ; Heart - diagnostic imaging ; Heart - innervation ; Heart - physiopathology ; Heart diseases ; Heart rate ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Movement disorders ; Neostriatum ; Nervous system ; Neurodegenerative diseases ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Parkinson Disease - diagnostic imaging ; Parkinson Disease - metabolism ; Parkinson Disease - physiopathology ; Parkinson's disease ; Positron-Emission Tomography ; Radiopharmaceuticals ; Scintigraphy ; Synuclein ; Tropanes</subject><ispartof>Journal of neurology, 2025, Vol.272 (1), p.28</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Jan 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-6180-9848</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-024-12783-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-024-12783-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39665845$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Min Seung</creatorcontrib><creatorcontrib>Park, Don Gueu</creatorcontrib><creatorcontrib>Shin, In Ja</creatorcontrib><creatorcontrib>An, Young Sil</creatorcontrib><creatorcontrib>Yoon, Jung Han</creatorcontrib><title>Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Introduction
Recently, “body-first” and “brain-first” subtype in Parkinson's disease (PD) was proposed based on the propagation of α-synuclein. In isolated RBD considered as a premotor stage of body-first PD, α-synuclein was supposed to originate in the enteric nervous system and spreads via autonomic nervous system. Therefore, we hypothesized that body-first PD is more likely to have a delayed gastric emptying time and reduced cardiac sympathetic denervation. In this study, we aimed to assess gastric motility and its correlation with cardiac sympathetic denervation, dopamine transporter uptake in PD with the body-first PD in comparison with brain-first PD.
Methods
We investigated gastric scintigraphy, dual-phase 18F-FP-CIT PET, and cardiac MIBG scintigraphy in patients with PD. Based on the presence of RBD and delayed H/M ratio in MIBG scintigraphy, we classified patients into the body-first PD and brain-first PD groups. Gastric emptying time (GET) was assessed by dynamic gastric scintigraphy, and half-emptying time (
T
1/2
) was measured.
Results
A total of 18 PD patients (mean age 68.8) were classified into body-first PD group (
n
= 10) and brain-first PD group (
n
= 8). Delayed GET was more prevalent in body-first PD group compared to brain-first PD (
T
1/2
> 110 min, 90.0 vs 37.5%,
p
= 0.043). Striatal dopamine depletion was similar between groups and no significant correlation with
T
1/2
. Washout rate of cardiac MIBG showed a tendency of correlation with
T
1/2
(
r
= 0.454,
p
= 0.077).
Conclusion
This study showed that body-first PD may be associated with a higher prevalence of delayed gastric emptying time compared to the brain-first PD, suggesting higher burden of gastrointestinal dysmotility in brain-first PD.</description><subject>3-Iodobenzylguanidine</subject><subject>Aged</subject><subject>Autonomic nervous system</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - metabolism</subject><subject>Brain - physiopathology</subject><subject>Coronary artery disease</subject><subject>Denervation</subject><subject>Dopamine</subject><subject>Dopamine Plasma Membrane Transport Proteins - metabolism</subject><subject>Dopamine transporter</subject><subject>Enteric nervous system</subject><subject>Female</subject><subject>Gastric emptying</subject><subject>Gastric Emptying - physiology</subject><subject>Gastric motility</subject><subject>Heart - diagnostic imaging</subject><subject>Heart - innervation</subject><subject>Heart - physiopathology</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Neostriatum</subject><subject>Nervous system</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Parkinson Disease - diagnostic imaging</subject><subject>Parkinson Disease - metabolism</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson's disease</subject><subject>Positron-Emission Tomography</subject><subject>Radiopharmaceuticals</subject><subject>Scintigraphy</subject><subject>Synuclein</subject><subject>Tropanes</subject><issn>0340-5354</issn><issn>1432-1459</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFOAyEQhonRaK2-gAdD4sXLKuzALj1qo9WkRg96JuxCldplV2DT9OZr-Ho-iWhrTDzNTOabgfl_hI4oOaOElOeBEEZ5RnKW0bwUkBVbaEAZ5BllfLSNBgQYyThwtof2Q5gTQkRq7KI9GBUFT_kALScqRG9rbJourqx7xtE2BiunsY0B1633ZqGibR1e2viCa-W1VTW-u72cYOtw1epVNrM-xJ-ZyivrNnXoq7jqDH5Q_tW60LrP94-AtQ1GBXOAdmZqEczhJg7R0_XV4_gmm95PbscX06yjuSjSXZRUrKxqCjmwIh0gcgDBa16Liingmo44EUbzEZQFmUHBQCitQFci10zAEJ2u93a-fetNiLKxoTaLhXKm7YMEypIUIGiZ0JN_6LztvUu_-6aAJcHS20N0vKH6qjFadt42yq_kr6QJgDUQUss9G_-3hhL5bZxcGyeTcfLHOFnAF6KViG0</recordid><startdate>2025</startdate><enddate>2025</enddate><creator>Kim, Min Seung</creator><creator>Park, Don Gueu</creator><creator>Shin, In Ja</creator><creator>An, Young Sil</creator><creator>Yoon, Jung Han</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6180-9848</orcidid></search><sort><creationdate>2025</creationdate><title>Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease</title><author>Kim, Min Seung ; Park, Don Gueu ; Shin, In Ja ; An, Young Sil ; Yoon, Jung Han</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1286-1210b47bc132346008823385c5c8b4a35d19508ed593760f36438ada3db82d483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>3-Iodobenzylguanidine</topic><topic>Aged</topic><topic>Autonomic nervous system</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - metabolism</topic><topic>Brain - physiopathology</topic><topic>Coronary artery disease</topic><topic>Denervation</topic><topic>Dopamine</topic><topic>Dopamine Plasma Membrane Transport Proteins - metabolism</topic><topic>Dopamine transporter</topic><topic>Enteric nervous system</topic><topic>Female</topic><topic>Gastric emptying</topic><topic>Gastric Emptying - physiology</topic><topic>Gastric motility</topic><topic>Heart - diagnostic imaging</topic><topic>Heart - innervation</topic><topic>Heart - physiopathology</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Movement disorders</topic><topic>Neostriatum</topic><topic>Nervous system</topic><topic>Neurodegenerative diseases</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Parkinson Disease - diagnostic imaging</topic><topic>Parkinson Disease - metabolism</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson's disease</topic><topic>Positron-Emission Tomography</topic><topic>Radiopharmaceuticals</topic><topic>Scintigraphy</topic><topic>Synuclein</topic><topic>Tropanes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Min Seung</creatorcontrib><creatorcontrib>Park, Don Gueu</creatorcontrib><creatorcontrib>Shin, In Ja</creatorcontrib><creatorcontrib>An, Young Sil</creatorcontrib><creatorcontrib>Yoon, Jung Han</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Min Seung</au><au>Park, Don Gueu</au><au>Shin, In Ja</au><au>An, Young Sil</au><au>Yoon, Jung Han</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2025</date><risdate>2025</risdate><volume>272</volume><issue>1</issue><spage>28</spage><pages>28-</pages><issn>0340-5354</issn><issn>1432-1459</issn><eissn>1432-1459</eissn><abstract>Introduction
Recently, “body-first” and “brain-first” subtype in Parkinson's disease (PD) was proposed based on the propagation of α-synuclein. In isolated RBD considered as a premotor stage of body-first PD, α-synuclein was supposed to originate in the enteric nervous system and spreads via autonomic nervous system. Therefore, we hypothesized that body-first PD is more likely to have a delayed gastric emptying time and reduced cardiac sympathetic denervation. In this study, we aimed to assess gastric motility and its correlation with cardiac sympathetic denervation, dopamine transporter uptake in PD with the body-first PD in comparison with brain-first PD.
Methods
We investigated gastric scintigraphy, dual-phase 18F-FP-CIT PET, and cardiac MIBG scintigraphy in patients with PD. Based on the presence of RBD and delayed H/M ratio in MIBG scintigraphy, we classified patients into the body-first PD and brain-first PD groups. Gastric emptying time (GET) was assessed by dynamic gastric scintigraphy, and half-emptying time (
T
1/2
) was measured.
Results
A total of 18 PD patients (mean age 68.8) were classified into body-first PD group (
n
= 10) and brain-first PD group (
n
= 8). Delayed GET was more prevalent in body-first PD group compared to brain-first PD (
T
1/2
> 110 min, 90.0 vs 37.5%,
p
= 0.043). Striatal dopamine depletion was similar between groups and no significant correlation with
T
1/2
. Washout rate of cardiac MIBG showed a tendency of correlation with
T
1/2
(
r
= 0.454,
p
= 0.077).
Conclusion
This study showed that body-first PD may be associated with a higher prevalence of delayed gastric emptying time compared to the brain-first PD, suggesting higher burden of gastrointestinal dysmotility in brain-first PD.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39665845</pmid><doi>10.1007/s00415-024-12783-6</doi><orcidid>https://orcid.org/0000-0001-6180-9848</orcidid></addata></record> |
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| source | MEDLINE; SpringerNature Complete Journals |
| subjects | 3-Iodobenzylguanidine Aged Autonomic nervous system Brain - diagnostic imaging Brain - metabolism Brain - physiopathology Coronary artery disease Denervation Dopamine Dopamine Plasma Membrane Transport Proteins - metabolism Dopamine transporter Enteric nervous system Female Gastric emptying Gastric Emptying - physiology Gastric motility Heart - diagnostic imaging Heart - innervation Heart - physiopathology Heart diseases Heart rate Humans Male Medicine Medicine & Public Health Middle Aged Movement disorders Neostriatum Nervous system Neurodegenerative diseases Neurology Neuroradiology Neurosciences Original Communication Parkinson Disease - diagnostic imaging Parkinson Disease - metabolism Parkinson Disease - physiopathology Parkinson's disease Positron-Emission Tomography Radiopharmaceuticals Scintigraphy Synuclein Tropanes |
| title | Gastric emptying time and its correlation with cardiac MIBG in body-first and brain-first subtype Parkinson’s disease |
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