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 (, 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:


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.