PURPOSE: Due to new advances in molecular and imaging biomarkers, a biological classification of Parkinson's disease (PD) called SyNeurGe (Hoglinger et al. Lancet Neurol 2024
23:191-204) has been proposed for research use recently. [ METHODS: First, we excluded relevant binding of MIBG in the brain as well as DaT in the heart by acquisition of brain scans in patients that received MIBG as well as by acquisition of chest scans in patients that received DaT. Then, we performed a single-day protocol including DaT-SPECT and cardiac MIBG scintigraphy in ten patients with clinically suspected α-synucleinopathies (9 male, 1 female
68.2 ± 7.3 years). Both radiotracers were injected simultaneously and cardiac imaging was performed at 3.5 h after injection followed by brain imaging at 4 h after injection using standard protocols for MIBG-scintigraphy and DaT-SPECT. Additionally, five patients of the dual tracer protocol group received brain FDG-PET after DaT and MIBG imaging. RESULTS: Single tracer imaging confirmed no relevant uptake of [ CONCLUSION: A single day protocol for DaT-SPECT, MIBG, and FDG-PET facilitates biomarker assessments needed for efficient biological characterization of Parkinsonian syndromes according to the SyNeurGe criteria.