Abstract
We aimed to characterize the relationship between cardiac sympathetic and parasympathetic
dysfunction employing cardiac 123I-meta-iodobenzylguanidine (MIBG) uptake and other autonomic function parameters in
Parkinson's disease (PD). 79 PD patients were studied. We performed 123I-MIBG myocardial scintigraphy to assess the extent of cardiac sympathetic denervation.
Electrocardiogram readings at rest and postural change in blood pressure were also
examined. Coefficient variation of RR intervals (CVR-R) was used as an index for cardiac
parasympathetic activity. Cardiac 123I-MIBG uptake did not vary significantly among the Hoehn–Yahr (H–Y) stages. There
was a significant correlation between cardiac 123I-MIBG uptake and CVR-R (early, r=0.457, p<0.001; late, r=0.442, p<0.001). While the correlation was present among the patients who had had the disease
less than two years (early, r=0.558, p<0.001; late, r=0.530, p<0.001), the patients with the disease duration longer than two years did not have
such a significant correlation. Age, disease duration, corrected QT interval, or postural
blood pressure change did not correlate with cardiac 123I-MIBG uptake. Orthostatic hypotension was observed in 13 out of 72 subjects, and
reduced CVR-R was a major determinant for the development of orthostatic hypotension.
We conclude that cardiac parasympathetic dysfunction occurs concurrent with sympathetic
denervation as revealed by 123I-MIBG myocardial scintigraphy in PD and contributes to the development of orthostatic
hypotension.
Keywords
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Article info
Publication history
Accepted:
September 3,
2008
Received in revised form:
August 28,
2008
Received:
June 4,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
