Correlation between cardiac ¹²³I‐MIBG and odor identification in patients with Parkinson's disease and multiple system atrophy

Abstract

Abstract:We investigated an association between olfaction and cardiac 123 I-metaiodobenzylguanidine (MIBG) uptake in patients with Parkinson's disease (PD) and multiple system atrophy (MSA). There was a significant positive correlation between cardiac MIBG uptake and the CrossCultural Smell Identification (CCSI) score in patients with PD (r ‫؍‬ 0.56; P ‫؍‬ 0.003) independent of the disease duration or clinical rating of motor status. However, patients with MSA did not show a significant correlation between cardiac MIBG uptake and the CCSI score. Our findings suggest that the functional losses of the olfactory and cardiac sympathetic systems are closely coupled in PD.

Biomarkers to detect central dopamine deficiency and distinguish Parkinson disease from multiple system atrophy

“…In distinguishing PD from MSA, the UPSIT was surprisingly robust for a relatively simple, non-invasive test, because about half of PD patients and none of the MSA patients were anosmic, and about half of MSA patients and none of the PD patients had normal olfaction. Individual UPSIT scores correlated positively with the magnitude of cardiac 6-[ 18 F]fluorodopamine-derived radioactivity, confirming a report using another sympathoneural imaging agent, 123 Imetaiodobenzylguanidine [23]. Thus, in alpha-synucleinopathies the loss of sense of smell seems to be related to the loss of cardiac sympathetic nerves.…”

“…Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Loss of sense of smell in PD has been associated with neuroimaging evidence of both central DA deficiency [22] and cardiac noradrenergic denervation [23]. Decreased olfaction also can occur in MSA [24,25], and it has been unclear how efficiently olfactory testing separates PD from MSA.…”

User interface design guidelines for smartphone applications for people with Parkinson’s disease

“…Sensory symptoms (olfactory dysfunction, pain, paresthesia, akathisia, oral pain and genital pain) are frequent in PwP, but are often not recognised as parkinsonian symptoms [21,46,25,10].…”

Association of anosmia with autonomic failure in Parkinson disease

“…1 In contrast with weak or absent relationships of severity of parkinsonism with olfactory dysfunction or autonomic failure, recent reports have noted an association between loss of sense of smell and loss of noradrenergic innervation in the heart. 1, 15 Cardiac sympathetic neuroimaging is not available at most centers in the United States, and this modality assesses only one component of the autonomic nervous system, in one organ. Studies have not yet addressed whether anosmia is related to more generally available and accepted indices of autonomic failure, such as deficient baroreflex-cardiovagal function, abnormal beat-to-beat blood pressure responses to the Valsalva maneuver, orthostatic increments in plasma levels of norepinephrine (NE) and its neuronal metabolite dihydroxyphenylglycol (DHPG), decreased sweat production in the quantitative sudomotor axon reflex test (QSART), or OH.…”