The marked decrease in cardiac MIBG-uptake correlates with the severity of sleep disturbance in patients with Parkinson’s disease

We investigated the relationship between sleep disturbances and 123I-meta-iodobenzylguanidine (MIBG)-uptake during myocardial scintigraphy in patients with Parkinson’s disease (PD). We studied consecutive PD patients who underwent MIBG scintigraphy at our institution. Collected data included Hoehn and Yahr (HY) stage, the heart/mediastinum (H/M) ratio of MIBG scintigraphy, Epworth Sleepiness Scale score, PD Sleep Scale (PDSS)-2 score (total PDSS-2 score and its three subscales: motor problems at night, PD symptoms at night, and disturbed sleep), levodopa daily dose, total levodopa-equivalent daily dose (LEDD), and LEDD of dopamine agonists. We determined the specific binding ratio (SBR) in patients who underwent DaTSPECT to examine the relationship between each sleep disturbance scale and SPECT changes and the other evaluated items. We examined 31 patients with PD. There was a significant negative correlation between the H/M ratio and the score for disturbed sleep. The more the decreased the cardiac MIBG uptake, the higher the score for disturbed sleep (p = 0.040). There was no correlation between the H/M ratio and other sleep scales. The HY stage correlated with the score for PD symptoms at night (p = 0.0244), but not with other sleep scales. Twenty-one patients were evaluated by DaTSPECT; there was no correlation between SBR and any other scores used to evaluate sleep disturbances. The score for disturbed sleep on the PDSS-2 is mainly related insomnia symptoms. Thus, MIBG myocardial scintigraphy detects the severity of sleep disturbance in PD patients.