Rinsho Shinkeigaku (Clinical Neurology)

The 49th Annual Meeting of the Japanese Society of Neurology

Clinical and pathological study on early diagnosis of Parkinson's disease and dementia with Lewy bodies

Satoshi Orimo, M.D.

Department of Neurology, Kanto Central Hospital

Cardiac uptake of meta-iodobenzylguanidine (MIBG) is specifically reduced in Lewy body disease (LBD). To see pathological basis of the reduced cardiac uptake of MIBG in LBD, we immunohistichemically examined cardiac tissues from patients with LBD, related movement disorders and Alzheimer's disease (AD). In LBD, cardiac sympathetic denervation occurs, which accounts for the reduced cardiac uptake of MIBG. Patients with LBD have Lewy bodies (LBs) in the nervous system, whereas patients with the other neurodegenerative parkinsonism, parkin-associated Parkinson's disease (PD) and AD and have no LBs. Therefore, cardiac sympathetic denervation is closely related to the presence of LBs in a wide range of neurodegenerative processes. We further investigate how α-synuclein aggregates are involved in degeneration of the cardiac sympathetic nerve in PD. Accumulation of α-synuclein aggregates in the distal axons of the cardiac sympathetic nervous system precedes that of neuronal somata or neurites in the paravertebral sympathetic ganglia and that it heralds centripetal degeneration of the cardiac sympathetic nerve in PD. This chronological and dynamic relationship between α-synuclein aggregates and degeneration of the cardiac sympathetic nervous system may represent the pathological mechanism underlying a common degenerative process in PD.
Full Text of this Article in Japanese PDF (239K)

(CLINICA NEUROL, 48: 831|834, 2008)
key words: Parkinson's disease, dementia with Lewy bodies, meta-iodobenzylguanidine (MIBG), cardiac sympathetic denervation, α-synuclein

(Received: 15-May-08)