Pathology of the sympathetic nervous system corresponding to the decreased cardiac uptake in 123I-metaiodobenzylguanidine (MIBG) scintigraphy in a patient with Parkinson disease

Jun Mitsui; Yuko Saito; Toshimitsu Momose; Jun Shimizu; Noritoshi Arai; Junji Shibahara; Yoshikazu Ugawa; Ichiro Kanazawa; Shoji Tsuji; Shigeo Murayama

doi:10.1016/j.jns.2005.11.034

Pathology of the sympathetic nervous system corresponding to the decreased cardiac uptake in 123I-metaiodobenzylguanidine (MIBG) scintigraphy in a patient with Parkinson disease

J Neurol Sci. 2006 Apr 15;243(1-2):101-4. doi: 10.1016/j.jns.2005.11.034. Epub 2006 Jan 27.

Authors

Jun Mitsui¹, Yuko Saito, Toshimitsu Momose, Jun Shimizu, Noritoshi Arai, Junji Shibahara, Yoshikazu Ugawa, Ichiro Kanazawa, Shoji Tsuji, Shigeo Murayama

Affiliation

¹ Department of Neurology, Division of Neuroscience, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.

PMID: 16442563
DOI: 10.1016/j.jns.2005.11.034

Abstract

Decreased cardiac uptake in (123)I-metaiodobenzylguanidine (MIBG) scintigraphy has been adopted as one of the most reliable diagnostic tests for Parkinson disease (PD) in Japan. To investigate the morphological basis for this finding, we performed a detailed neuropathological study of the cardiac sympathetic nervous system of a 71-year-old autopsy-proven PD patient, who presented with a marked decrease in cardiac uptake of MIBG, just 1 year prior to death. We carefully examined the intermediolateral column at several levels of the thoracic spinal cord, the sympathetic trunk and ganglia, and the nerve plexus of the anterior wall of the left ventricle and compared the findings with those of five age-matched controls. We found that the cardiac plexus was more heavily involved than the sympathetic ganglia in this patient with PD. Our study may provide further evidence that the markedly decreased cardiac uptake of MIBG observed in PD cases represents preferential involvement of the cardiac sympathetic nerve plexus in this disorder.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

3-Iodobenzylguanidine*
Aged
Autonomic Nervous System Diseases / diagnostic imaging*
Autonomic Nervous System Diseases / metabolism
Autonomic Nervous System Diseases / physiopathology
Ganglia, Sympathetic / metabolism
Ganglia, Sympathetic / pathology
Ganglia, Sympathetic / physiopathology
Heart / diagnostic imaging
Heart / innervation
Humans
Iodine Radioisotopes
Lewy Bodies / metabolism
Lewy Bodies / pathology
Male
Myocardium / metabolism
Norepinephrine / metabolism
Parkinson Disease / complications*
Parkinson Disease / diagnostic imaging*
Parkinson Disease / physiopathology
Radionuclide Imaging / methods*
Spinal Cord / metabolism
Spinal Cord / pathology
Spinal Cord / physiopathology
Sympathetic Fibers, Postganglionic / metabolism
Sympathetic Fibers, Postganglionic / pathology
Sympathetic Fibers, Postganglionic / physiopathology
Sympathetic Nervous System / metabolism
Sympathetic Nervous System / pathology*
Sympathetic Nervous System / physiopathology
Wallerian Degeneration / etiology
Wallerian Degeneration / pathology
Wallerian Degeneration / physiopathology
alpha-Synuclein / metabolism

Substances

Iodine Radioisotopes
alpha-Synuclein
3-Iodobenzylguanidine
Norepinephrine