Abstract
There is substantial interest in identifying biomarkers to detect early Parkinson disease (PD). Cardiac noradrenergic denervation and attenuated baroreflex-cardiovagal function occur in de novo PD, but whether these abnormalities can precede PD has been unknown. Here we report the case of a patient who had profoundly decreased left ventricular myocardial 6-[18F]fluorodopamine-derived radioactivity and low baroreflex-cardiovagal gain, 4 years before the onset of symptoms and signs of PD. The results lead us to hypothesize that cardiac noradrenergic denervation and decreased baroreflex-cardiovagal function may occur early in the pathogenesis of PD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bonuccelli U, Lucetti C, Del Dotto P, Ceravolo R, Gambaccini G, Bernardini S, Rossi G, Piaggesi A (2003) Orthostatic hypotension in de novo Parkinson disease. Arch Neurol 60:1400–1404
Bouhaddi M, Vuillier F, Fortrat JO, Cappelle S, Henriet MT, Rumbach L, Regnard J (2004) Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson’s disease: involvement of L-dopa therapy. Auton Neurosci 116:30–38
Braak H, de Vos RA, Bohl J, Del Tredici K (2006) Gastric alpha-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett 396:67–72
Braak H, Rub U, Gai WP, Del Tredici K (2003) Idiopathic Parkinson’s disease: possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm 110:517–536
Braune S (2001) The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes. Clin Auton Res 11:351–355
Camerlingo M, Aillon C, Bottacchi E, Gambaro P, D’Alessandro G, Franceschi M, Devoti G, Mamoli A (1987) Parasympathetic assessment in Parkinson’s disease. Adv Neurol 45:267–269
Carmichael SW, Wilson RJ, Brimijoin WS, Melton LJ 3rd, Okazaki H, Yaksh TL, Ahlskog JE, Stoddard SL, Tyce GM (1988) Decreased catecholamines in the adrenal medulla of patients with parkinsonism. N Engl J Med 318:254
Druschky A, Hilz MJ, Platsch G, Radespiel-Troger M, Druschky K, Kuwert T, Neundorfer B (2000) Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of I-123-MIBG-SPECT. J Neurol Sci 175:3–12
Edwards LL, Quigley EM, Pfeiffer RF (1992) Gastrointestinal dysfunction in Parkinson’s disease: frequency and pathophysiology. Neurology 42:726–732
Goldstein DS, Holmes C, Sharabi Y, Brentzel S, Eisenhofer G (2003) Plasma levels of catechols and metanephrines in neurogenic orthostatic hypotension. Neurology 60:1327–1332
Goldstein DS, Horwitz D, Keiser HR (1982) Comparison of techniques for measuring baroreflex sensitivity in man. Circulation 66:432–439
Goldstein DS, Tack C (2000) Non-invasive detection of sympathetic neurocirculatory failure. Clin Auton Res 10:285–291
Li ST, Dendi R, Holmes C, Goldstein DS (2002) Progressive loss of cardiac sympathetic innervation in Parkinson’s disease. Ann Neurol 52:220–223
Oka H, Mochio S, Onouchi K, Morita M, Yoshioka M, Inoue K (2006) Cardiovascular dysautonomia in de novo Parkinson’s disease. J Neurol Sci 241:59–65
Oka H, Mochio S, Yoshioka M, Morita M, Onouchi K, Inoue K (2006) Cardiovascular dysautonomia in Parkinson’s disease and multiple system atrophy. Acta Neurol Scand 113:221–227
Orimo S, Amino T, Itoh Y, Takahashi A, Kojo T, Uchihara T, Tsuchiya K, Mori F, Wakabayashi K, Takahashi H (2005) Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease. Acta Neuropathol (Berl) 109:583–588
Pacak K, Eisenhofer G, Carrasquillo JA, Chen CC, Li ST, Goldstein DS (2001) 6-[18F]fluorodopamine positron emission tomographic (PET) scanning for diagnostic localization of pheochromocytoma. Hypertension 38:6–8
Quadri R, Comino I, Scarzella L, Cacioli P, Zanone MM, Pipieri A, Bergamasco B, Chiandussi L (2000) Autonomic nervous function in de novo parkinsonian patients in basal condition and after acute levodopa administration. Funct Neurol 15:81–86
Singaram C, Ashraf W, Gaumnitz EA, Torbey C, Sengupta A, Pfeiffer R, Quigley EM (1995) Dopaminergic defect of enteric nervous system in Parkinson’s disease patients with chronic constipation. Lancet 346:861–864
Stoddard SL, Ahlskog JE, Kelly PJ, Tyce GM, van Heerden JA, Zinsmeister AR, Carmichael SW (1989) Decreased adrenal medullary catecholamines in adrenal transplanted parkinsonian patients compared to nephrectomy patients. Exp Neurol 104:218–222
Stoddard SL, Tyce GM, Ahlskog JE, Zinsmeister AR, Carmichael SW (1989) Decreased catecholamine content in parkinsonian adrenal medullae. Exp Neurol 104:22–27
Takatsu H, Nishida H, Matsuo H, Watanabe S, Nagashima K, Wada H, Noda T, Nishigaki K, Fujiwara H (2000) Cardiac sympathetic denervation from the early stage of Parkinson’s disease: clinical and experimental studies with radiolabeled MIBG. J Nucl Med 41:71–77
Vogel ER, Sandroni P, Low PA (2005) Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. Neurology 65:1533–1537
Acknowledgements
This research was supported by the Intramural Research Program of the NIH, National Institute of Neurological Disorders and Stroke.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Goldstein, D.S., Sharabi, Y., Karp, B.I. et al. Cardiac sympathetic denervation preceding motor signs in Parkinson disease. Clin Auton Res 17, 118–121 (2007). https://doi.org/10.1007/s10286-007-0396-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10286-007-0396-1