title: Cardiac sympathetic denervation preceding motor signs in Parkinson disease.
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-[(18)F]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.
authors.affiliation: Clinical Neurocardiology Section, NINDS, NIH, Bethesda, MD 20892-1620, USA. goldsteind@ninds.nih.gov
authors.forename: David S
authors.initials: DS
authors.lastname: Goldstein
authors.forename: Yehonatan
authors.initials: Y
authors.lastname: Sharabi
authors.forename: Barbara I
authors.initials: BI
authors.lastname: Karp
authors.forename: Oladi
authors.initials: O
authors.lastname: Bentho
authors.forename: Ahmed
authors.initials: A
authors.lastname: Saleem
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
authors.forename: Graeme
authors.initials: G
authors.lastname: Eisenhofer
mesh_terms: D001794:Blood Pressure; D006348:Cardiac Surgical Procedures; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology* / Q000503:physiopathology*; D013562:Sympathectomy