Dr. Junya Ebina and Professor Osamu Kano from the Department of Neurology, Toho University Faculty of Medicine, along with Professor Sunao Mizumura from the Department of Radiology, have reported that patients with Parkinson’s disease (PD) exhibiting sympathetic denervation in the major salivary glands and the heart tend to have more advanced non-motor symptoms as they age, suggesting that age plays an important role in disease progression. This research outcome could potentially contribute to a better understanding of the pathophysiological progression of PD. This study was made available online on February 12, 2024 and was published in Article 122932, Volume 458 of the Journal of the Neurological Sciences, on 15 March 2024.
Key Points:
Presentation Overview:
PD is a progressive neurodegenerative disorder characterized by abnormal aggregates of α-synuclein known as Lewy bodies. Lewy bodies are not only found in the central nervous system but also in peripheral organs. In PD, cardiac sympathetic denervation detected by 123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is associated with the presence of Lewy bodies. Conversely, although Lewy bodies are frequently found in the digestive tract, including in the major salivary glands, the process of pathophysiological progression in peripheral organs is unclear. A research group previously reported sympathetic denervation in the submandibular and parotid glands of patients with PD. Therefore, in this study, they hypothesized and verified whether patients with PD and sympathetic nerve dysfunction in the heart and major salivary glands have more advanced clinical symptoms.
Patients with PD with sympathetic denervation in both major salivary glands and heart areas (dual-SD group) were found to be older, have more severe olfactory dysfunction, and a higher likelihood of having REM sleep behavior disorder and severe autonomic nerve dysfunction compared to the single-SD group or non-SD group. However, the duration of illness and cognitive function were similar among the groups. Logistic regression analysis with age, sex, and duration of illness as variables showed that age was an important factor affecting clinical evaluation items in the progression of the disease.
In conclusion, patients with PD and decreased MIBG uptake in both the major salivary glands and heart areas exhibited a progression of symptoms centered around non-motor symptoms, suggesting that autonomic nerve dysfunction may progress independently of nigrostriatal dopaminergic degeneration. Furthermore, the potential contribution of age to the pathophysiological progression of PD was suggested. This study may aid in understanding the pathophysiological progression of PD and may be used for future staging of individual patients.
Journal
Journal of the Neurological Sciences
Title
Clinical characteristics of patients with Parkinson’s disease with reduced 123I-metaiodobenzylguanidine uptake in the major salivary glands and heart
Authors
Junya Ebina, Sunao Mizumura, Harumi Morioka, Mari Shibukawa, Junpei Nagasawa, Masaru Yanagihashi, Takehisa Hirayama, Nobutomo Ishii, Yukio Kobayashi, Akira Inaba, Satoshi Orimo and Osamu Kano*
DOI No.
https://doi.org/10.1016/j.jns.2024.122932
Journal of the Neurological Sciences
Observational study
People
Clinical characteristics of patients with Parkinson's disease with reduced 123I-metaiodobenzylguanidine uptake in the major salivary glands and heart
15-Mar-2024
The authors declare no conflicts of interest associated with this article.