Cerebral and Extracranial Neurodegeneration are Strongly Coupled in Parkinson’s Disease Alternate Title: Cerebral and Extracranial Neurodegeneration

Jörg Spiegel*, 1, Dirk Hellwig2, Wolfgang H Jost3, Georgios Farmakis2, Samuel Samnick2, Klaus Fassbender1, Carl M Kirsch2, Ulrich Dillmann1
1 Departments of Neurology Saarland University, D-66421 Homburg/Saar, Germany
2 Departments of Nuclear Medicine, Saarland University, D-66421 Homburg/Saar, Germany
3 Department of Neurology, Deutsche Klinik fur Diagnostik, D-65191 Wiesbaden, Germany

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© 2007 Bentham Science Publishers Ltd.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Neurology Saarland University, D-66421 Homburg/Saar, Germany; E-mail: joerg.spiegel@uniklinik-saarland.de


In idiopathic Parkinson’s disease (PD), a generalized Lewy body type-degeneration in the brain as well as extracranial organs was identified. It is unclear, whether cerebral and extracranial Lewy body type-degeneration in PD are coupled or not. To address this question, cerebral [123I]FP-CIT SPECT – to quantify cerebral nigrostriatal dopaminergic degeneration – and myocardial [123I]MIBG scintigraphy – to quantify extracranial myocardial sympathetic degeneration – were performed in 95 PD patients and 20 healthy controls. At each Hoehn and Yahr stage separately, myocardial MIBG uptake correlated significantly with striatal FP-CIT uptake. No such correlation was found in the controls. Cerebral and extracranial Lewy body type-degeneration in PD do not develop independently from each other but develop in a strongly coupled manner. Obviously cerebral and extracranial changes are driven by at least similar pathomechanisms. Our findings in controls contradict a physiological correlation between nigrostriatal dopaminergic and myocardial sympathetic function.

Keywords: Parkinson’s disease, FP-CIT SPECT, MIBG scintigraphy.