Cardiac sympathetic denervation and its association with cognitive deficits in Parkinson's disease

Abstract Background There is growing evidence to suggest that cognitive decline in patients with Parkinson's disease (PD) is associated with autonomic involvement, although the clinical and pathological correlations have not been firmly established. Objective We prospectively investigated the pattern of myocardial sympathetic denervation deficits in PD and its correlation with cognitive decline. Methods Twenty-eight patients with PD who underwent myocardial123 I-metaiodobenzylguanidine (MIBG) scintigraphy, clinical assessment of stage and severity of PD and detailed neuropsychological investigation were included in the study. Results There were significant differences in the MIBG uptake between the PD patients with cognitive deficits and those who did not have cognitive deficits. Conclusion These findings confirm that cognitive decline in patients with PD is associated with autonomic involvement and raises the possibility that the topographical spread of synuclein pathology involving the neocortical areas might be linked to the autonomic system in PD.