Research Article

Cardiac sympathetic denervation correlates with clinical and pathologic stages of Parkinson's disease

  1. Hiroshige Fujishiro MD, PhD1,2,
  2. Roberta Frigerio MD3,
  3. Melinda Burnett MD3,
  4. Kevin J. Klos MD4,
  5. Keith A. Josephs MD, MST3,
  6. Anthony DelleDonne PhD1,2,
  7. Joseph E. Parisi MD5,
  8. J. Eric Ahlskog MD, PhD3,
  9. Dennis W. Dickson MD1,2,*

Article first published online: 28 APR 2008

DOI: 10.1002/mds.21989

Issue

Movement Disorders

Movement Disorders

Volume 23, Issue 8, pages 1085–1092, 15 June 2008

Additional Information

How to Cite

Fujishiro, H., Frigerio, R., Burnett, M., Klos, K. J., Josephs, K. A., DelleDonne, A., Parisi, J. E., Ahlskog, J. E. and Dickson, D. W. (2008), Cardiac sympathetic denervation correlates with clinical and pathologic stages of Parkinson's disease. Mov. Disord., 23: 1085–1092. doi: 10.1002/mds.21989

Author Information

  1. 1

    Department of Pathology (Neuropathology), Mayo Clinic, Jacksonville, Florida

  2. 2

    Department of Neuroscience, Mayo Clinic, Jacksonville, Florida

  3. 3

    Department of Neurology, Mayo Clinic, Rochester, Minnesota

  4. 4

    Neurological Associates of Tulsa, Tulsa, Oklahoma

  5. 5

    Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota

*Neuropathology Laboratory, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224

Publication History

  1. Issue published online: 24 JUN 2008
  2. Article first published online: 28 APR 2008
  3. Manuscript Accepted: 22 JAN 2008
  4. Manuscript Revised: 23 OCT 2007
  5. Manuscript Received: 18 JUL 2007

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (185K)

Keywords:

  • presymptomatic;
  • tyrosine hydroxylase;
  • α-synuclein;
  • cardiac;
  • Parkinsons

Abstract

Attention has been drawn to cardiac sympathetic denervation in Parkinson's disease (PD) based on clinical studies using [123I] metaiodobenzylguanidine scintigraphy; however, the histologic correlates and time course of cardiac sympathetic denervation are poorly understood. To address these issues, we used tyrosine hydroxylase (TH) immunohistochemistry to detect cardiac sympathetic nerve fibers in the epicardium of 4 normal controls, 11 cases with incidental Lewy bodies (iLBs), and 14 cases of PD. Cardiac sympathetic innervation was significantly less in PD than in normal controls and cases with iLBs (P < 0.05). There was also a decrease in TH-immunoreactive fibers in iLB cases compared to normal controls (P < 0.01). TH-immunoreactive fibers correlated with the PD stage (r = −0.75, P < 0.001), as well as with Hoehn & Yahr clinical stage (r = −0.61, P < 0.001), and disease duration (r = −0.63, P < 0.001). Immunohistochemistry for α-synuclein showed neurites in epicardium in PD and iLB cases, but not in normal controls. The density of α-synuclein neurites correlated with Braak PD stage (r = 0.38, P < 0.05), Hoehn & Yahr clinical stage (r = 0.44, P < 0.05), and disease duration (r = 0.42, P < 0.05). This study demonstrates that cardiac sympathetic degeneration and α-synuclein pathology is present in presymptomatic phase of PD, and that both increase with disease duration and severity. © 2008 Movement Disorder Society.

View Full Article (HTML) Get PDF (185K)