Acta Neuropathologica

, Volume 113, Issue 1, pp 81–86 | Cite as

Degeneration of cardiac sympathetic nerve can occur in multiple system atrophy

  • Satoshi Orimo
  • Toshiro Kanazawa
  • Ayako Nakamura
  • Toshiki Uchihara
  • Fumiaki Mori
  • Akiyoshi Kakita
  • Koichi Wakabayashi
  • Hitoshi Takahashi
Original Paper


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.


Cardiac 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.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Satoshi Orimo
    • 1
    • 2
  • Toshiro Kanazawa
    • 1
    • 2
  • Ayako Nakamura
    • 2
  • Toshiki Uchihara
    • 2
  • Fumiaki Mori
    • 3
  • Akiyoshi Kakita
    • 4
  • Koichi Wakabayashi
    • 3
  • Hitoshi Takahashi
    • 4
  1. 1.Department of NeurologyKanto Central HospitalTokyoJapan
  2. 2.Department of NeuropathologyTokyo Metropolitan Institute for NeuroscienceTokyoJapan
  3. 3.Department of NeuropathologyInstitute of Brain Science, Hirosaki University School of MedicineHirosakiJapan
  4. 4.Department of PathologyBrain Research Institute, University of NiigataNiigataJapan

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