Regular Paper

Acta Neuropathologica

, Volume 109, Issue 6, pp 583-588

Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease

  • Satoshi OrimoAffiliated withDepartment of Neurology, Kanto Central Hospital Email author 
  • , Takeshi AminoAffiliated withDepartment of Neurology, Kanto Central Hospital
  • , Yoshinori ItohAffiliated withDepartment of Internal Medicine, Yokufukai Geriatric Hospital
  • , Atsushi TakahashiAffiliated withOrgan and Function Pathology Division, Yokufukai Geriatric Hospital
  • , Tohru KojoAffiliated withDepartment of Neuropathology, Tokyo Metropolitan Institute for Neuroscience
  • , Toshiki UchiharaAffiliated withDepartment of Neuropathology, Tokyo Metropolitan Institute for Neuroscience
  • , Kuniaki TsuchiyaAffiliated withDepartment of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital
  • , Fumiaki MoriAffiliated withDepartment of Neuropathology, Institute of Brain Science, Hirosaki University School of Medicine
  • , Koichi WakabayashiAffiliated withDepartment of Neuropathology, Institute of Brain Science, Hirosaki University School of Medicine
    • , Hitoshi TakahashiAffiliated withDepartment of Pathology, Brain Research Institute, University of Niigata

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Abstract

Decreased cardiac uptake of meta-iodobenzylguanidine (MIBG) on [123I]MIBG myocardial scintigraphy has been reported in Parkinson’s disease (PD) and dementia with Lewy bodies (DLB). We hypothesized that cardiac sympathetic denervation might account for the pathomechanism. To elucidate the extent, frequency and pattern of cardiac sympathetic nerve involvement in Lewy body disease and related neurodegenerative disorders, we immunohistochemically examined heart tissues from patients with PD (n=11), DLB (n=7), DLB with Alzheimer’s disease (DLB/AD; n=4), multiple system atrophy (MSA; n=8), progressive supranuclear palsy (PSP; n=5), pure AD (n=10) and control subjects (n=5) together with sympathetic ganglia from patients with PD (n=5) and control subjects (n=4), using an antibody against tyrosine hydroxylase (TH). TH-immunoreactive nerve fibers in the hearts had almost entirely disappeared in nearly all the patients with PD, DLB and DLB/AD, whereas they were well preserved in all the patients with PSP and pure AD as well as in all except for one patient with MSA. In PD, neurons in the sympathetic ganglia were preserved in all except for one patient. Decreased cardiac uptake of MIBG in Lewy body disease reflects actual cardiac sympathetic denervation, which precedes the neuronal loss in the sympathetic ganglia.

Keywords

meta-iodobenzylguanidine Cardiac sympathetic denervation Sympathetic ganglia Parkinson’s disease Dementia with Lewy bodies