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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer-Verlag

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DOI

10.1002/chin.199727267

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1432-1459

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The comparison of clonidine arginine and both com

Authors: Kezhong Zhang Yanyin Zeng Chunjie Song Yu Fu Qi Wan
Publish Date: 2010/04/20
Volume: 257, Issue: 9, Pages: 1486-1491
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Abstract

This study was aimed at comparing the diagnostic accuracy of the growth hormone GH response to clonidine arginine and both combined in order to establish a more reliable test to differentiate parkinsonism type multiple system atrophy MSAp from Parkinsons disease PD Twentyfour patients with MSAp and 26 cases with PD entered the study They were submitted to treatments of clonidine arginine and a combination of the two in a random manner on three different nonconsecutive days The GH peak in serum at different times was evaluated and used as a primary variable for analysis of the stimulation test By ROC analysis we compared the sensitivity and specificity of tests of clonidine arginine and both combined After clonidine administration the maximal average was significantly lower in patients with MSAp than in those with PD 362 ± 081 vs 691 ± 113 P  005 with a sensitivity and specificity of 8261 and 7692 After arginine administration the maximal average GH concentration in serum at 30 min was also significantly lower in patients with MSAp than in those with PD 407 ± 080 vs 789 ± 129 P  005 with a sensitivity and specificity of 7826 and 7308 The sensitivity and specificity in differentiating MSAp from PD was higher in the clonidine GH stimulation test than in the arginine GH stimulation test However when the clonidine and arginine were applied combined the contrast of the maximal average GH concentration in serum in two groups was markedly increased 502 ± 112 vs 1075 ± 111 P  005 with a sensitivity and specificity of 7391 and 9231 and the specificity was notably increased in the combined GH stimulation test Compared to the arginine GH stimulation test the clonidine GH stimulation displayed a higher sensitivity and specificity combined GH stimulation test of clonidine plus arginine could significantly enhance the specificity in differential diagnosis of MSAp from PD

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