Degeneration of cardiac sympathetic nerve can occur in multiple system atrophy
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Decreased cardiac uptake of meta-iodobenzylguanidine (MIBG) on [123I] MIBG myocardial scintigraphy, a sensitive biological marker for Parkinson’s disease (PD), is related to cardiac sympathetic denervation in patients with PD. A slight decrease in cardiac uptake of MIBG has also been reported in some patients with multiple system atrophy (MSA). However, the pathophysiological mechanism accounting for the slight decrease in MIBG uptake in MSA remains to be elucidated. For confirmation, we examined cardiac tissue and sympathetic ganglia from patients with MSA. We immunohistochemically examined each specimen of 15 patients with MSA together with 10 control subjects using antibodies against tyrosine hydroxylase (TH) and neurofilament (NF). The number of TH-immunoreactive nerve fibers in the epicardium was preserved in 8 of 15 patients with MSA as well as in 10 control subjects. The number of TH-immunoreactive, but not of NF-immunoreactive nerve fibers in the epicardium was mildly or moderately decreased in six patients with MSA, of whom four showed a decrease of TH immunoreactivity in the neuronal somata in the sympathetic ganglia. Moreover, TH- and NF-immunoreactive nerve fibers almost entirely disappeared in the heart of one patient with MSA, in whom Lewy body pathology was present in the sympathetic ganglia. These findings suggest that mild degeneration of the cardiac sympathetic nerve can occur in MSA which is closely related to the pathological change of neurons in the sympathetic ganglia, accounting for the slight decrease in cardiac uptake of MIBG. Moreover, concurrent Lewy body pathology in the sympathetic ganglia might accelerate cardiac sympathetic denervation even in MSA.
KeywordsCardiac sympathetic nerve MIBG myocardial scintigraphy Multiple system atrophy Sympathetic ganglia Lewy body pathology
This work was supported in part by grants from the Research Committee on Neurodegenerative Diseases, Ministry of health, Labor and Welfare, Japan and the Japan Foundation for Neuroscience and Mental Health.
- 5.Daniel SE (1999) The neuropathology and neurochemistry of multiple system atrophy. In: Mathias CJ, Bannister SR (eds) Autonomic failure. Oxford University Press, Oxford p 321–328Google Scholar
- 9.Kawasaki H, Shimada H, Tomonaga M (1988) Morphological study on the Lewy bodies in the sympathetic ganglia of the aged person (in Japanese). Jpn J Geriatr 25:282–291Google Scholar
- 11.Nakajima R, Takahashi K, Nakamura H, Otomo E, Kameyama M (1981) A quantitative study on the intermediolateral cells of the thoracic cord in degenerative diseases of the nervous system. Clin Neurol 21:581–586Google Scholar
- 14.Orimo A, Takahashi A, Uchihara A, Mori F, Kakita A, Wakabayashi K, Takahashi H (2006) Degeneration of cardiac sympathetic nerve begins in the early disease process of Parkinson’s disease. Brain Pathol (in press)Google Scholar
- 22.Yoshita M (1998) Differentiation of idiopathic Parkinson’s disease from striatonigral degeneration and progressive supranuclear palsy. Acta Neurol Scand 91:14–18Google Scholar