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Cardiac sympathetic “morbidity” might reflect the neurobiology of early Parkinson’s disease

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Abstract

Background

An appropriate extracranial biomarker that delineates endophenotypes of Parkinson’s disease (PD) at an early stage and reflects the neurodegenerative process is lacking. An evaluation of myocardial sympathetic nerve terminals could be a good candidate. This study aimed to explore subtypes of PD patients that showed cardiac catecholaminergic vesicular defect and their characteristics.

Methods

This study included 122 early drug-naïve PD patients who were followed for approximately 4–5 years. All patients were examined with 18F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane positron-emission tomography and 123I-meta-iodobenzylguanidine myocardial scintigraphy. Cardiac scans were reexamined two or three times. Patients were subgrouped into the sympathetic denervated group at the initial scan, those without evidence of denervated myocardium in the first and subsequent scans, and the converters whose myocardium was initially normal but became impaired in the subsequent scans. Cognition in 99 patients was initially assessed with neuropsychological tests. Any associations between cardiac denervation subtypes and presynaptic dopamine transporter densities were investigated. Cognitive status relevant to cardiac sympathetic denervation status was evaluated.

Results

This study found that cross-sectional comparisons of presynaptic monoamine transporter availability with a predefined order of cardiac denervation groups revealed parallel degeneration. A quadratic correlation between cardiac catecholamine capacity and cognition was observed. This association was interpreted to reflect the early neurobiology of PD.

Conclusion

An observed cardiac catecholaminergic gradient was to mirror the central neurobiology of early PD.

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Data availability

Anonymized data generated during this study are available from the corresponding author on request from individuals affiliated with research or healthcare institutions.

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Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1D1A1B06028086 to J.-S. Kim) and by the Ministry of Education (NRF-2021R1I1A1A01050492 to S.-W. Yoo). This research was also supported by the Korea National Institute of Health Research Project (2021-ER1008-02 awarded to S.-W. Yoo and J.-S. Kim). The funding agencies had no role in the study design, or collection, analysis, and interpretation of data, the writing of the manuscript, or in the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. Department of Neurology, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Sang-Won Yoo, Yoon-Sang Oh, Dong-Woo Ryu, Yuna Kim, Ji-Yeon Yoo & Joong-Seok Kim

  2. Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Seunggyun Ha

  3. Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Chul Hyoung Lyoo

Authors
  1. Sang-Won Yoo
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  2. Yoon-Sang Oh
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  3. Dong-Woo Ryu
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  4. Seunggyun Ha
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  5. Chul Hyoung Lyoo
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  6. Yuna Kim
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  7. Ji-Yeon Yoo
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  8. Joong-Seok Kim
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Contributions

SWY and JSK: conceptualized the study; SWY and JSK: designed methodology; SWY, SH, CHL, and JSK: provided software; SWY, YSO, DWR, and JSK: validated the study; SWY and JSK: involved in formal analysis; SWY, YSO, DWR, SH, CHL, YK, JYY, and JSK: investigated the study; SWY and JSK: provided resources; SWY, YSO, DWR, SH, CHL, YK, JYY, and JSK: curated the data; SWY: wrote the original draft; YSO, DWR, SH, CHL, YK, JYY, and JSK: wrote, reviewed, and edited the manuscript; JSK: supervised the study; SWY and JSK: administered the project; SWY and JSK: acquired funding; and all authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Joong-Seok Kim.

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Conflicts of interest

The authors declare no competing interests.

Institutional review board statement

This study was approved by the Institutional Review Board of Seoul St. Mary’s Hospital (approval nos. KC17ONSI0423 and KC22RASI0284). All experiments were conducted in accordance with relevant guidelines and regulations.

Informed consent

All subjects provided written informed consent to participate.

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Supplementary file1 (PDF 885 KB)

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Yoo, SW., Oh, YS., Ryu, DW. et al. Cardiac sympathetic “morbidity” might reflect the neurobiology of early Parkinson’s disease. J Neurol 271, 944–954 (2024). https://doi.org/10.1007/s00415-023-12049-7

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  • DOI: https://doi.org/10.1007/s00415-023-12049-7

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