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¹²³I-Metaiodobenzylguanidine Myocardial Scintigraphy in Panic Disorder

¹ Department of Radiology, Tottori University Hospital, Yonago, Japan
² Department of Neuropsychiatry, Tottori University Hospital, Yonago, Japan

Although autonomic function has been investigated in panic disorder, previous studies have not yet revealed a consistent autonomic change in this disease. The purpose of this study was to evaluate the cardiac sympathetic function in panic disorder using ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG). Methods: Myocardial imaging using ¹²³I-MIBG was performed on 9 patients with panic disorder (7 men, 2 women; mean age, 37.4 ± 13.2 y) and 11 control subjects (11 men; mean age, 37.6 ± 9.3 y). Early (30 min) and delayed (4 h) planar images were taken after the injection of 111 MBq ¹²³I-MIBG. The mean counts in the whole heart and the mediastinum were obtained from the early and delayed images to calculate the heart-to-mediastinum count ratios (H/M ratios) and the myocardial washout rate. Results: The ¹²³I-MIBG H/M ratios of the patients with panic disorder were 1.80 ± 0.16 for the early images and 1.86 ± 0.30 for the delayed images, which were significantly lower than those of the control subjects (2.15 ± 0.15 [P = 0.001] and 2.26 ± 0.21 [P = 0.009], respectively). The ¹²³I-MIBG washout rate from the heart in the patients with panic disorder (33.8% ± 6.9%) was significantly higher than that in the control subjects (27.8% ± 3.5%) (P = 0.02). Conclusion: ¹²³I-MIBG myocardial scintigraphy demonstrated impairment of cardiac sympathetic function in panic disorder. The results suggest that ¹²³I-MIBG imaging could become a useful tool for analyzing the pathophysiology of panic disorder.

Key Words: ¹²³I-metaiodobenzylguanidine • cardiac sympathetic function • panic disorder

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