Cardiac sympathetic denervation and its association with cognitive deficits in Parkinson's disease.
BACKGROUND
There is growing evidence to suggest that cognitive decline in patients with Parkinson's disease (PD) is associated with autonomic involvement, although the clinical and pathological correlations have not been firmly established.


OBJECTIVE
We prospectively investigated the pattern of myocardial sympathetic denervation deficits in PD and its correlation with cognitive decline.


METHODS
Twenty-eight patients with PD who underwent myocardial (123)I-metaiodobenzylguanidine (MIBG) scintigraphy, clinical assessment of stage and severity of PD and detailed neuropsychological investigation were included in the study.


RESULTS
There were significant differences in the MIBG uptake between the PD patients with cognitive deficits and those who did not have cognitive deficits.


CONCLUSIONS
These findings confirm that cognitive decline in patients with PD is associated with autonomic involvement and raises the possibility that the topographical spread of synuclein pathology involving the neocortical areas might be linked to the autonomic system in PD.
Kim
Joong-Seok
JS
Department of Neurology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul 137-701, South Korea. neuronet@catholic.ac.kr
Shim
Yong-Soo
YS
Song
In-Uk
IU
Yoo
Ji-Yeon
JY
Kim
Hee-Tae
HT
Kim
Yeong-In
YI
Lee
Kwang-Soo
KS
D000368:Aged; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009121:Muscle Denervation; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011877:Radionuclide Imaging; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging / Q000503:physiopathology*