Imaging the Autonomic Nervous System in Parkinson's Disease

Current Neurology and Neuroscience Reports
Karoline Knudsen, Per Borghammer

Abstract

Patients with Parkinson's disease (PD) often display gastrointestinal and genitourinary autonomic symptoms years or even decades prior to diagnosis. These symptoms are thought to be caused in part by pathological α-synuclein inclusions in the peripheral autonomic and enteric nervous systems. It has been proposed that the initial α-synuclein aggregation may in some PD patients originate in peripheral nerve terminals and then spread centripetally to the spinal cord and brainstem. In vivo imaging methods can directly quantify the degeneration of the autonomic nervous system as well as the functional consequences such as perturbed motility. Here, we review the methodological principles of these imaging techniques and the major findings in patients with PD and atypical parkinsonism. Loss of sympathetic and parasympathetic nerve terminals in PD can be visualized using radiotracer imaging, including 123I-MIBG scintigraphy, and 18F-dopamine and 11C-donepezil PET. Recently, ultrasonographical studies disclosed reduced diameter of the vagal nerves in PD patients. Radiological and radioisotope techniques have demonstrated dysmotility and prolonged transit time throughout all subdivisions of the gastrointestinal tract in PD. The prevalence...Continue Reading

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Citations

Apr 6, 2019·Journal of Neural Transmission·Rezzak YilmazDaniela Berg
Jul 17, 2019·Molecular Imaging and Biology : MIB : the Official Publication of the Academy of Molecular Imaging·Susanna NuvoliBarbara Palumbo
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Apr 4, 2021·Journal of Clinical Medicine·Ditte S KornumKlaus Krogh
Apr 17, 2021·Annals of Medicine·Elisa MenozziAnthony H V Schapira

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