Cardiac sympathetic denervation preceding motor signs in Parkinson disease.
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.
Clinical Neurocardiology Section, NINDS, NIH, 10 Center Drive MSC-1620, Building 10, Room 6N252, Bethesda, MD 20892-1620, USA. goldsteind@ninds.nih.gov
David S
DS
Goldstein
Yehonatan
Y
Sharabi
Barbara I
BI
Karp
Oladi
O
Bentho
Ahmed
A
Saleem
Karel
K
Pacak
Graeme
G
Eisenhofer